Describe about Investigative Tools and their Optimal Use ?

The investigative tools that are available for diagnosis of CHD include ECG, chest X-ray, 2D and Doppler echocardiography, transoesophageal echocardiography, cardiac catheterization and cineangiography and the cardiac MRI. All tests, excepting the ECG and chest X-ray are expensive. It is therefore important to consider the cost-benefit ratio of these investigations. Echocardiography has revolutionised diagnosis of CHD and its high diagnostic yield makes this investigation very cost effective. Echocardiography has a few inherent limitations, however. It consistently fails to define certain structures such as the pulmonary artery branches beyond the hila of the lungs.

The role of diagnostic cardiac catheterization for patients with CHD has declined considerable; with the availability of high quality echocardiography. Since cardiac catheterization is an invasive procedure its performance requires careful planning so that Cardiac MRI is a useful non-invasive imaging modality that can be of incremental benefit over an echocardiogram. It holds tremendous promise; Limitations include scarce availability of equipment, and what is more important, expertise for interpretation and requirement of general anaesthesia,