Figure 1

Myocardial contrast echocardiography images in the apical four-chamber view 3 beats after the high-mechanical index flash impulse (left panel) and 10 beats after the flash (right panel). The arrow shows the contrast extrusion from the left ventricular cavity into the myocardium in the lateral wall, before reaching the pericardial space, suggesting an impending rupture. LV = left ventricle; RV = right ventricle.