Diagnosis of myocardial stunning: a new use for myocardial contrast and dobutamine echocardiography.

Myocardial stunning is a recently described phenomenon in which myocardium subjected to short-lasted episodes of ischemia remains hypokinetic or even akinetic (stunned) after adequate flow is reestablished. Therefore, diagnostic technique that can assess regional perfusion could be of value in establishing this diagnosis. This postischemic abnormality in contractility can last minutes, hours, or days, but eventually recovers. Faster recovery of function occurs under inotropic stimulation, and this knowledge has been applied clinically to diagnose this entity, ie, with the use of dobutamine echocardiography. This article is a review of current literature on the use of dobutamine echocardiography and of myocardial contrast echocardiography, two techniques found to be useful in the diagnosis of myocardial stunning.