The Controversy Regarding Contrast Echocardiography and How It Affects Patients With the Cardiometabolic Syndrome

T T is a 59-year-old man with ischemic cardiomyopathy who was admitted with sudden onset of left arm and leg weakness as well as facial numbness. His symptoms were transient, resolving within a few hours. The patient had a history of cardiometabolic syndrome (hypertension, impaired fasting glucose, and abdominal adiposity with a body mass index of 31) and coronary artery disease requiring coronary artery bypass surgery. Head computed tomography and brain magnetic resonance imaging did not show evidence of acute stroke. Transthoracic echocardiography was performed for assessment of a cardiac source of embolism. Initial to intra-ventricular but images demonstrated apical mural The and later with a left ventricle free of thrombi stability. The microbubbles produced are approximately the size of red blood cells (6–8 µm in diameter) and can pass through the pulmonary capillary bed to the left heart. Ultrasonographic waves interact with these microbubbles, causing them to vibrate and generate sound waves at multiple frequencies that are detected by the ultrasound machine, and they are represented as an echogenic area on the generated echocardiographic image.