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Frage | Antworten |
_______ can be used as a contrast agent during a TEE/TTE | Agitated saline |
How is agitated saline used and what is it used to look for? | Injected through an IV and travels to right side of the heart; bubbles will be seen traveling to the left atrium; saline is usually absorbed in the lungs so will not be seen normally in the left side Used to look for IAS shunts; usually looking for PFO |
Why were new contrast agents developed (gas bubble with fat) | to improve LV endocardial border resolution |
When can new contrast agents be used? | During normal echo exams or during stress echo |
True/False: contrast agent is small enough to pass by the lungs (not absorbed) and present in the LV | True - smaller than a RBC |
Some common contrast agents | Imigent (not a front runner) Optison (actual traces of human blood) Definity (All man made) |
Indications for contrast use | Better LV endocardial resolution for poor echo images Improved assessment of LV function Assessment for thrombus, atypical deformities (I.e. Apical hypertrophic CM) |
Contraindications for contrast | Pregnancy (not researched) Septal defects causing shunts (ASD, VSD, PFO) |
Technique and equipment for optimum image | Harmonic setting, low mechanical index (0.3-0.5), focus mid screen, 12-15 CM depth (minimal visualization of LA), low frequency (higher penetration) |
With contrast perfusion imaging, how is the and what contrast is injected? | With a vasodilator Adenosine or persantine; common contrast used is Definity MCE |
How does contrast perfusion imaging show up? | Seen as light gray bubbles within the myocardium (can use color to see better) but black indicates no perfusion |
When is contrast perfusion helpful? | When catch lab determines reflow but unable to determine epicardium and not myocardium. Contrast perfusion can determine the difference |
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