12
Diagnosis
Noninvasive Cardiac Imaging (see Table 9)
Î Patients with suspected or new-onset HF, or those presenting with
acute decompensated HF, should undergo a chest x-ray to assess
heart size and pulmonary congestion and to detect alternative cardiac,
pulmonary, and other diseases that may cause or contribute to the
patient's symptoms. (I-C)
Î A 2-dimensional echocardiogram with Doppler should be performed
during initial evaluation of patients presenting with HF to assess
ventricular function, size, wall thickness, wall motion, and valve
function. (I-C)
Î Repeat measurement of EF and measurement of the severity of
structural remodeling are useful to provide information in patients
with HF who have had a significant change in clinical status; who have
experienced or recovered from a clinical event; or who have received
treatment, including GDMT, that might have had a significant effect on
cardiac function; or who may be candidates for device therapy. (I-C)
Î Noninvasive imaging to detect myocardial ischemia and viability
is reasonable in patients presenting with de novo HF, who have
known CAD and no angina, unless the patient is not eligible for
revascularization of any kind. (IIa-C)
Î Viability assessment is reasonable in select situations when planning
revascularization in HF patients with CAD. (IIa-B)
Î Radionuclide ventriculography or magnetic resonance imaging can
be useful to assess LVEF and volume when echocardiography is
inadequate. (IIa-C)
Î Magnetic resonance imaging is reasonable when assessing myocardial
infiltrative processes or scar burden. (IIa-B)
Î Routine repeat measurement of LV function assessment in the absence
of clinical status change or treatment interventions should NOT be
performed. (III-B: No Benefit)
