Patient-Friendly Summary of the ACR Appropriateness Criteria?: Dyspnea-Suspected Cardiac Origin (Ischemia Already Excluded)

Dyspnea is a sense of discomfort when breathing and can be a sign of underlying heart or lung conditions. Imaging is used to evaluate dyspnea that may be due to a heart condition after reduced blood flow to the heart (ischemia) has been ruled out. Dyspnea can result when one or more of the valves that help blood flow from the heart to the body malfunction. To diagnose or monitor dyspnea related to this, ultrasound (US) echocardiography transthoracic (done over the chest) resting or chest x-ray is usually appropriate. US echocardiogram transesophageal (done through the esophagus), US echocardiogram transthoracic stress, CT heart with contrast, MRI heart without and with contrast, and MRI heart without contrast may be appropriate. For dyspnea that may be due to irregular heartbeat, US echocardiography transthoracic resting or MRI heart without and with contrast is usually appropriate. US echocardiography transesophageal, CT heart with contrast, MRI heart without contrast, and PET and CT using fluorine-18-2-fluoro-2-deoxy-D-glucose imaging heart may be appropriate. For pericardial disease (sac surrounding the heart inflamed from fluid buildup), US echocardiography transthoracic resting, chest x-ray, CT heart with contrast, or MRI heart without and with contrast is usually appropriate. US echocardiography transthoracic, CT chest with contrast, CT chest without contrast, CT angiography chest with contrast, and MRI heart without contrast may be appropriate. See the full appropriateness criteria for this topic at https://acsearch.acr.org/docs/69407/Narrative/.