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Utility Contrast Echocardiography in the Emergency Department

Cardiovascular Division, Oregon Health and Science University, Portland, Oregon

^_* Reprint requests and correspondence: Dr. Kevin Wei, 3181 SW Sam Jackson Park Road, UHN 62, Portland, Oregon 97239 (Email: weik{at}ohsu.edu).

The diagnosis and risk stratification of patients presenting with suspected cardiac chest pain to the emergency department (ED) is difficult, inefficient, and costly. Echocardiography can be used to directly detect myocardial ischemia through the identification of a new wall thickening (WT) abnormality. Contrast echocardiography provides further incremental benefit both for assessment of WT, as well as from the evaluation of myocardial perfusion. This review will discuss how echocardiography can be used to diagnose, risk stratify, and potentially reduce costs in patients with suspected acute coronary syndromes in the ED.

Key Words: myocardial • echocardiography • emergency department

Abbreviations and Acronyms   ACS = acute coronary syndrome   AMI = acute myocardial infarction   CP = chest pain   ECG = electrocardiogram   ED = emergency department   MBF = myocardial blood flow   MCE = myocardial contrast echocardiography   MP = microvascular perfusion   mTIMI = modified Thrombolysis In Myocardial Infarction   NSTEMI = non–ST-segment elevation myocardial infarction   SPECT = single-photon emission computed tomography   UA = unstable angina   WT = wall thickening

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