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S.K. White, D.G. Jones, K.F. Fox, Echocardiography for cardiomegaly: Useful or a waste of resources?, European Journal of Echocardiography, Volume 8, Issue 3, June 2007, Page s33, https://doi.org/10.1016/j.euje.2007.03.015
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Background: It was perceived that radiographic cardiomegaly is a frequent and increasingly requested indication for echocardiogram (echo) but provides a low yield for cardiac disease. We aimed to analyse the frequency at which this request occurs and, given the clinical details supplied, whether any abnormality exposed would change future clinical management.
Methods: From our database for echo studies, reports were extracted using the search term “cardiomegaly”. Reports were then categorised by the presence of indicators of cardiac disease in the request: none; non-specific (e.g. ankle swelling); specific (e.g. abnormal ECG), then further classified by whether the echo findings were clinically relevant. In order to reduce subjectivity, analysis was undertaken independently by three specialists in cardiology. Any discrepancy was resolved by consensus.
Results: Eight thousand seven hundred and thirty-seven echo studies were performed over 3 consecutive years (2003–2005); 108 (1.24%) met search criteria and were analysed. There were only five requests for cardiomegaly alone, none of which had a clinically relevant abnormality. However, 42/66 (64%) of those with specific indicators of cardiac disease had echo abnormalities that were felt to be clinically relevant, compared to 6/37 (16%) of those with non-specific indicators.
