Page 313 - Cardiac Nursing

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C HAPTER 1 3 / Echocardiography 289
■ Figure 13-21 Left: Apical four-chamber view in a patient with poor endocardial definition and thus subop-
timal image quality. Right: The same patient with improved image quality with the administration of a transpul-
monary contrast agent (Definity). Notice the endocardial definition is now of diagnostic quality. (Echo courtesy
of University of Washington Medical Center, Seattle, Washington.)

■ Figure 13-22 Apical four-cham-
ber view of patient undergoing a
dobutamine stress echo. Top: At rest,
there is normal wall motion and the
left ventricular cavity is noticeably
smaller in systole. Bottom: During
peak stress, the left ventricular cavity
is smaller in systole but there is a no-
ticeable wall motion abnormality in
s
the apical septum and apex (arrows),
which would be consistent with ob-
structive epicardial disease in the left
anterior descending coronary artery.
(Echo courtesy of Harborview Med-
ical Center, Seattle, Washington.)