Contrast echocardiography is a relatively new and dynamically developing branch of diagnostic imaging. New generations of contrast agents consist of microbubbles of air or other gas in a stabilizing capsule. The big difference between acoustic impedance of the plasma and the microbubble gas is the reason behind its high echogenic properties. Intravascular application of such agent induces enhanced display of blood in all heart chambers, arteries, microvessels and veins. Applying harmonic imaging and intermittent acquisition significantly improved the detection of contrast microbubbles. The physical characteristics of newer contrast agents and the recently developed imaging modalities allows improved LV endocardial delineation, enhanced color and spectral Doppler measurements, noninvasive transthoracic assessment of coronary flow reserve and myocardial perfusion imaging. Currently lots of clinical research are in progress to apply contrast echocardiography in the detection of stable coronary artery disease, acute coronary syndromes, during cardiovascular surgery, percutaneus coronary intervention and for local drug delivery. The ability to perform a safe and fast assessment of myocardial perfusion in real time imaging may cause contrast echocardiography to be one of the most frequently used tools for assessing myocardial perfusion in the future.

Keywords: Contrast echocardiography, contrast agents, myocardial perfusion