Choosing appropriate imaging techniques

In this chapter, a logical approach to choosing among the various cardiac imaging techniques is proposed. Imaging modalities most commonly employed in the evaluation of cardiac disease are chest roentgenography, cardiac angiography, radionuclide imaging, ultrasonography, computed tomography, and magnetic resonance imaging. Electrocardiography and electrophysiologic studies, though crucial in the evaluation of cardiac electrical abnormalities, are technically not imaging modalities. The decision algorithm requires a basic knowledge of the imaging modalities themselves, including their indications and contraindications, which have been described in the preceding chapters. Most important, however, the treating physician should formulate a clear clinical question which will guide selecting an appropriate imaging test. Most cardiac clinical scenarios can be thought of in terms of questions of structure, function, or both.