Importance of machine settings for using contrast for LV opacification. (a) In this example, endocardial border definition is probably adequate with standard tissue harmonic imaging – [see additional file 2.] (b) The use of contrast for LVO with standard diagnostic harmonic imaging machine settings provides worse border definition in the lateral wall, and apical bubble destruction, illustrating the importance of appropriate machine settings – [see additional file 3]. Image (c) shows machine settings for myocardial perfusion imaging – this provides assessment of myocardial perfusion and wall motion, but the frame rate for WMA is 20–25 Hz and thus subtle WMA's could be missed – [see additional file 4]. Therefore for optimal assessment of WMA image (d) displays specific intermediate MI imaging at high frame rate designed specifically to enhance the endocardial/cavity border. Even in this example there is some apical swirling despite the focal zone set in the mid LV – [see also additional file 5].