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Year : 2023  |  Volume : 24  |  Issue : 4  |  Page : 212-216

Abnormal resting myocardial contrast echocardiographic uptake: Clue of an ongoing acute coronary artery event

1 Department of Internal Medicine, University of Missouri Kansas City, Kansas City, MO, USA
2 Department of Internal Medicine, University of Missouri Kansas City; University Health Truman Medical Center, Kansas City, MO, USA

Correspondence Address:
Dr. Angel López-Candales
Division of Cardiovascular Diseases, University Health Truman Medical Center, Hospital Hill, University of Missouri-Kansas City, 2301 Holmes Street, Kansas City, MO 64108
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/heartviews.heartviews_32_23

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Acute coronary syndromes (ACSs) present most frequently with chest pain, but angina equivalents such as dyspnea, diaphoresis, and fatigue are not uncommon. Atypical presentations are especially seen in women, the elderly, and diabetics. Cardiac evaluation using a transthoracic echocardiogram is almost always done before or immediately after someone undergoes left heart catheterization for ACS. It provides information valuable information regarding wall motion, left ventricular systolic function, diastolic function, right ventricular involvement, pulmonary pressures, incidental valvular disease, pericardial fluid, or any other unsuspected abnormality. We describe a novel case where an atypical presentation of ACS was suspected based on the lack of intravenous contrast administered, to enhance endocardial border resolution. The use of contrast during echocardiography has been used during stress protocols to assess microcirculation during perfusion assessment studies. However, we described a reduced uptake during the acquisition of resting myocardial echocardiogram images and it was very useful to direct therapy.

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