Dobutamine stress echocardiography is a variation of exercise echocardiography to unmask coronary artery blockages. During this test, the heart is stressed by infusing dobutamine. Dobutamine is commonly used to treat patients with low blood pressure, to improve circulation and as a diagnostic testing agent. Dobutamine increases the heart rate and blood pressure and the degree to which the heart contracts. It therefore mimics the effects of exercise for patients who are unable to exercise to a sufficient degree.
The examination starts with the resting transthoracic echocardiogram. After that, dobutamine is infused at a low dose. Following, the dose is increased every three minutes to increase the heart rate and cardiac contractions. At each of these three-minute stages, the heart is scanned using transthoracic echocardiography. An electrocardiogram has to be continuously recorded and blood pressure automatically checked every three minutes.
Disconcerting and stress-related sensations of the patient is to expect during infusion of dobutamine and does not represent any harmful effect. As soon as the infusion is completed, it is discontinued and usually within five to ten minutes the heart rate and blood pressure will return to the levels before starting the exam. Only qualified staff with specific training should perform this test. As for all types of cardiovascular stress testing, all of the necessary equipment and medicines to treat complications must be available in the stress testing room.

(MCE) Myocardial contrast echocardiography is a contrast enhanced ultrasound method that utilizes intravenous injected microbubbles as red blood cell tracers. MCE can assess myocardial perfusion both at rest and stress to evaluate viable myocardium after acute infarction.
MCE perfusion imaging improves the blood echoes during the microbubble passage and the imaging system suppresses the clutter represented by non-contrast-bearing tissue.

See also Injection Rate, Stress Echocardiogram, and Myomap.

Stress echocardiograms are used for detection of coronary artery disease, or to determine the cardiac performance. Stress echocardiograms are less performed to evaluate pulmonary artery pressures, pulmonary hypertension or the significance of valvular heart disease.
Stress increases the degree to which the heart contracts. After a myocardial infarction there will be a region of the heart muscle that contracts abnormal at rest. This area may worsen with stress. A coronary artery blockage most often do not impairs the function of the heart at rest. With stress, a region of the heart does not receive enough blood to work effectively and wall motion abnormalities occur. The echocardiographer compares rest and exercise and can determine the presence and severity of a coronary artery blockage.

Stress echocardiograms involve:
A bicycle stress echocardiogram involves transthoracic echocardiography performed at the rest baseline and after or during different stages of physical exercise.
A dobutamine stress echocardiography uses the drug dobutamine instead physical exercise.
Transthoracic echocardiograms are routinely performed during stress and rest.
Cardiovascular stress represents a minimal risk to the patient.

See also Transesophageal Echocardiography, Echocardiography, M-Mode, Curved Transducer, Doppler Ultrasound, History of Ultrasound and History of Ultrasound Contrast Agents.

Cardiac ultrasound, also known as echocardiography or echocardiogram, is used to provide several different levels and types of heart testing. Cardiac ultrasound utilizes the same ultrasound principles as used for obstetric and gynecologic evaluations of pregnant women, gallbladder ultrasound and other abdominal structures.
The ultrasound is directed out of a hand held probe which can be moved to image the heart from different positions. Additionally, so that heart events can be timed, ECG leads are placed on the chest. The reflected wave is converted into an actual image of the heart and displayed in a real-time mode or M-mode ultrasound format. M-mode recordings permit measurement of cardiac dimensions and detailed analysis of complex motion patterns depending on transducer angulations. Also the time relationships with other physiological variables such as ECG, heart sounds, and pulse tracings, can be recorded simultaneously. A stress echocardiogram provides information about the cardiac performance.
Two-dimensional tomographic images of selected cardiac sections give more information than M-mode about the shape of the heart and also show the spatial relationships of its structures during the cardiac cycle (diastole to systole).

See also M-Mode Echocardiography, and Myocardial Contrast Echocardiography.

From Lantheus Medical Imaging.
Activated DEFINITY® Injectable Suspension is indicated for use in patients with suboptimal echocardiograms to opacify the left ventricular chamber and to improve the delineation of the left ventricular endocardial border. The perflutren lipid microspheres exhibit lower acoustic impedance than blood and enhance the intrinsic backscatter of blood.
Echocardiography with Definity produced more detailed images of the heart in difficult-to-image patients versus echocardiography alone, and images obtained with the contrast agent provided a more accurate assessment of segmental wall motion compared with unenhanced images.

See also Coherent Contrast Imaging.

In August 2001 DuPont Pharmaceuticals Company received FDA approval.