Introduction to Cardiac Investigation
Author: Prof Rohan Jayasinghe
Indications for resting cardiac echo (ECHOCARDIOGRAPHY):
Chest pain – to look for any regional wall motion abnormalities in the left ventricle / rule out severe aortic stenosis.
Pleuritic chest pain – to rule out any pericardial thickening / pericardial effusion.
Shortness of breath – to look at the left ventricular function; systolic or diastolic dysfunction.
Ankle oedema – to look at the left ventricular and right ventricular function.
Hypertension – To look for left ventricular hypertrophy / diastolic dysfunction / evolving left ventricular failure.
Atrial fibrillation – to look for mitral valve disease / size of the left atrium / left atrial thrombus.
Lethargy / fatigue – to look for heart failure / valve pathology.
Hypotension – to look for left ventricular dysfunction.
Chronic asthma – to look for right ventricular dysfunction (corpulmonale) / tricuspid regurgitation / pulmonary hypertnesion.
Palpitations – to look for anatomical cardiac abnormality / tachycardia induced cardiomyopathy / Mitral prolapse.
Syncope / dizziness / light headedness – LV dysfunction / aortic stenosis / HOCM.
Stroke / TIA – LV thrombus / aortic stenosis / Patent foramen ovale.
Unexplained fever – valvular vegetations of infective endocarditis.
Unexplained weight loss – valvular vegetations of infective endocarditis.
Emphysema – to look for right ventricular dysfunction (corpulmonale) / tricuspid regurgitation / pulmonary hypertnesion.
History of thyroid disease – to looks for LV dysfunction / left atrial enlargement with paroxysmal AF / pericardial effusion.
Anti-depressant / anti-psychotics use – To look for cardiomyopathy.
Suspected cardiac murmur – to look for valve pathology, HOCM, VSD.
History of heart disease.
History of rheumatic fever.
History of cardiac valve disease / valve surgery.