Which imaging modality is preferred to assess heart failure?

• A. Cardiac magnetic resonance imaging
• B. Transthoracic echocardiography
• C. Chest radiography alone
• D. CT coronary angiography

Answer: (B)

Assessing heart failure relies on imaging that can quickly show heart function and structure. Transthoracic echocardiography provides real-time, noninvasive evaluation of ventricular function, chamber sizes, and valvular disease, and it also estimates pulmonary pressures. This lets you quantify the ejection fraction, assess both systolic and diastolic function, and identify causes of symptoms—all without radiation and with broad availability. Because heart failure management hinges on how well the heart pumps and how pressure is transmitted, an echocardiogram is the most practical and informative first test.

Cardiac MRI offers precise measurements and detailed tissue information, but it is less accessible, more time-consuming, and not needed for initial assessment in most cases. Chest radiography can reveal edema or cardiomegaly but cannot reliably quantify function or filling pressures. CT coronary angiography evaluates coronary anatomy rather than overall heart function and involves radiation and contrast, making it unsuitable as the primary test for heart failure assessment.