Question

While performing an apical view during a microbubble contrast echo on a patient with suspected wall motion abnormalities in the basal anterolateral left ventricular segment, you notice significant swirling of the contrast in the area of the apex. How can you adjust the controls to reduce this swirling?

Answer 1

To reduce swirling during a microbubble contrast echo, one should adjust the mechanical index, focus position, and gain settings.

Step-by-step explanation:

When performing a microbubble contrast echo and encountering significant swirling of the contrast in the apical area, there are several control adjustments that can be made to reduce this effect. Firstly, you might want to reduce the mechanical index (MI) to minimize the rupture of microbubbles, as a high MI can cause excessive microbubble destruction leading to swirling patterns. Additionally, adjusting the focus position might be beneficial, as bringing it closer to the area of interest can enhance the chances of detecting wall motion without swirls. Finally, the gain settings should be optimized to ensure that the contrast is neither too weak nor too strong, which can either cause underestimation of wall motion or contribute to swirling artifacts, respectively.