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Contrast echocardiography in acute chest pain.

McCabe C, Dwivedi G, Senior R

Department of Cardiology, Northwick Park Hospital, Harrow, United Kingdom.

A 45-year-old man presented with atypical central chest pain and ST-T changes on electrocardiogram. Repeated arterial blood gas examinations were unremarkable and portable echocardiography demonstrated mildly dilated right atrium and ventricle. Initial treatment for acute coronary syndrome was initiated, as there was evidence of myocardial necrosis on blood examination. However, use of contrast agent enabled visualization of saddle embolus in the pulmonary artery on 2-dimensional echocardiography, which was later confirmed on computed tomographic pulmonary angiography. The patient subsequently made an uneventful recovery. Use of contrast agents in accident and emergency as a bedside tool can be very useful in patients with atypical presentation.

Published 2 October 2007 in J Am Soc Echocardiogr, 20(10): 1220.e1-3.
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