The most utilized ultrasound enhancing agent is approved for use in pediatric patients
Data on file, Lantheus.
Diagnostic
Challenges
The Challenges of Nondiagnostic Echoes
Even with advancements in echocardiography, imaging can be suboptimal,1 which may lead to2:
- Inadequate treatment plans
- Unnecessary additional testing
- Increased hospital stays
- Avoidable hospital readmissions
Apical hypertrophic cardiomyopathy
Unenhanced
DEFINITY®7
How to Obtain Diagnostic Echoes
Implementing the American Society of Echocardiography (ASE) guidelines for ultrasound enhancing agents can help improve efficiency and patient care.3
A Summary from the ASE UEA Guidelines3:
- When 2 or more LV segments cannot be visualized
- In all patients for whom quantitative assessment of LVEF is important
- For all technically difficult ICU and ED patients for quick and accurate diagnosis and to reduce additional diagnostic testing
- In ED patients presenting with myocardial ischemia and nondiagnostic EKG
- When LV thrombus cannot be ruled in or out
- When structural abnormalities cannot be adequately assessed, such as noncompaction, apical hypertrophy, aneurysms
- For diagnosis and exclusion of pseudoaneurysms
Create written policies for using ultrasound enhancing
agents4
Establish quality assessment and improvement programs4
Maintain personnel
training and credentialing4
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Know your suboptimal echo rate. Ask about the IMPROVE program.
References:
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Lindner JR. A practical approach to contrast echocardiography. American College of Cardiology. Published July 10, 2017. Accessed May 27, 2021. https://www.acc.org/latest-in-cardiology/articles/2017/07/10/09/17/a-practical-approach-to-contrast-echocardiography
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Kurt M, Shaikh KA, Peterson L, et al. Impact of contrast echocardiography on evaluation of ventricular function and clinical management in a large prospective cohort. J Am Coll Cardiol. 2009;53(9):802-810.
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Porter TR, Mulvagh SL, Abdelmoneim SS, et al. Clinical applications of ultrasonic enhancing agents in echocardiography: 2018 american society of echocardiography guidelines update. J Am Soc Echocardiogr. 2018:31(3):241-274.
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Porter TR, Abdelmoneim S, Belcik JT, et al. Guidelines for the cardiac sonographer in the performance of contrast echocardiography: a focused update from the American Society of Echocardiography. J Am Soc Echocardiogr. 2014;27(8):797-810.