Contrast echocardiography is a diagnostic technique that uses ultrasound to create images of the heart, with the addition of an injectable contrast agent to enhance the visibility of certain structures or blood flow within the heart. The contrast agent is typically a microbubble solution that is injected into a vein, usually in the arm. Once in the bloodstream, the microbubbles flow to the heart and can be seen on the ultrasound image. Contrast echocardiography is used to help evaluate the function of the heart and blood vessels, as well as to detect certain conditions such as blood clots, leaks in heart valves, and abnormal blood flow. It is especially useful in evaluating the left ventricular function and can detect the presence of myocardial ischemia. One of the most common uses of contrast echocardiography is to evaluate the left ventricular function. This includes measuring the size and shape of the left ventricle, as well as assessing the movement of the heart walls and the blood flow within the chamber. Contrast echocardiography can also be used to detect leaks in heart valves, which can occur as a result of valve disease or other conditions. In these cases, the contrast agent can help to highlight any leakage around the valve, allowing the doctor to evaluate the severity of the leak and determine the best course of treatment. Another use of contrast echocardiography is to detect abnormal blood flow within the heart. This can occur with certain conditions such as a patent foramen ovale (PFO) or atrial septal defect (ASD) which are congenital heart defects that can cause blood to flow between the two upper chambers of the heart, rather than flowing through the lungs. Contrast echocardiography is considered safe, and most patients do not experience any significant side effects. However, some patients may experience a slight burning sensation at the injection site, or a brief feeling of warmth or flushing. Rarely, some individuals may experience an allergic reaction to the contrast agent. Overall, contrast echocardiography is a useful diagnostic tool that can provide important information about the function and structure of the heart, as well as detect certain conditions that may not be visible on standard echocardiography. Dr. A. Arrazaghi. MD,FRCPC