Usefulness of contrast echocardiography in arrhythmogenic right ventricular dysplasia

Arrhythmogenic right ventricular (RV) dysplasia or cardiomyopathy is a familiar heart muscle disease, characterized by progressive fibrofatty replacement of RV myocardium. Echocardiography can be used to evaluate the wide spectrum of abnormalities that range from a normal RV to severe RV dilation, with localized aneurysms. In the context of a positive family history, even minimal RV abnormalities represent a disease expression. This suggests the need for a careful echocardiographic investigation focusing in subtle structural changes. However, echocardiography may be limited by poor endocardial visualization in several patients. Contrast echocardiography may improve endocardial border delineation in these cases and, thus, the ability to assess arrhythmogenic RV dysplasia or cardiomyopathy at the initial stages of the disease.