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©2013 UpToDate ® Print Email Apical 4-chamber view of an echocardiogram showing contrast-enhanced images in left ventricular dysfunction Successive frames obtained from an apical 4-chamber view of a two dimensional contrast enchanced echocardiogram demonstrates a swirling left ventricular intracavitary contrast flow (pattern B) in a patient with LV dyssynergy and reduced global function. Reproduced from Thanigaraj, S, Chugh, R, Schectman, KB, et al. Am J Cardiol 2000; 85:65, with permission from Excerpta Medica, Inc. file://www.elsevier.com/locate/jacc file://www.sciencedirect.com