Hemodynamic instability after receiving intravenous Perflutren for contrast echocardiography in an elderly female

Myocardial contrast echocardiography (MCE) has been used with increasing frequency and is considered a safe way to improve left ventricular border opacification. Studies have consistently documented that MCE can improve the ability to assess both global and regional left ventricular function by echocardiography. We report the case of an 83-year-old female who developed immediate and sustained hemodynamic instability after the injection of Perflutren for a contrast echocardiogram. We reviewed the literature and found no such previous reactions with Perflutren. Based on the temporal sequence of hypotension following Perflutren injection along with other clinical data, we concluded that our patient's hemodynamic instability was most likely secondary to an anaphylactic reaction.