IMR Press / RCM / Volume 23 / Issue 3 / DOI: 10.31083/j.rcm2303086
Open Access Review
Rest contrast echocardiography unmasks hidden wall motion abnormalities in patients with chest pain. A case series and review of pertinent literature
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1 Cardiology Department, University Hospital of Parma, 43126 Parma, Italy
*Correspondence: (Sergio Suma)
Academic Editor: Ezra Abraham Amsterdam
Rev. Cardiovasc. Med. 2022, 23(3), 86;
Submitted: 20 November 2021 | Revised: 13 January 2022 | Accepted: 13 January 2022 | Published: 4 March 2022
(This article belongs to the Special Issue Prognostic value of echocardiography and stress-echocardiography)
Copyright: © 2022 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.

We present a case series of three patients that underwent myocardial contrast echocardiography (MCE) in the setting of recent chest pain, as paradigmatic examples of the usefulness of contrast-echocardiography with very-low mechanical index imaging in the context of rest wall motion assessment. Moreover, we analysed the pertinent literature about the use of rest MCE in the context of chest pain of unknown origin, showing its diagnostic and prognostic impact. We think that MCE could play a key role in detecting chest pain subtended by previously unknown coronary artery disease (CAD). For example, in pts without significant electrocardiogram (ECG) modifications or in whom high sensitivity troponins show only borderline increase (still below the upper limit) or have no clearly significant delta. In such cases the more sensitive evaluation of wall motion (WM) powered by MCE could add diagnostic information, above all in pts with severe CAD but apparently normal WM at standard echocardiography.

myocardial contrast echocardiography
ischemic heart disease
chest pain
Fig. 1.
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