2D TTE |
Affordable, widely accessible, assesses valvular
apparatus and RV strain analysis. |
Limited by poor acoustic windows and
lower spatial resolution. |
Identifies tricuspid regurgitation through a
“dagger-shaped” profile. |
3D TTE |
Enhances visualisation of valve leaflets and subvalvular
apparatus, aids in operative planning. |
Shares similar limitations with
2D TTE regarding acoustic windows. |
Allows simultaneous assessment of
all valve leaflets. |
TOE |
Improved visualisation of the pulmonic valve and valves
with suboptimal windows. |
Image quality may be compromised by poor
acoustic windows. |
Recommended for comprehensive valvular assessment
when transthoracic imaging is inconclusive. |
Cardiac CT |
Facilitates operative planning, visualises coronary
arteries, assesses RV dimensions and valvular damage. |
Exposure to
radiation and contrast. |
Useful postoperatively for assessing pulmonic
prosthetic valve thrombosis. |
Cardiac MRI |
Improved visualisation of valves, accurate
measurement of regurgitant volumes and chamber sizes, identification of
myocardial metastasis. |
Higher cost and contrast exposure compared to
echocardiography. |
Emerging as a prominent modality for CaHD
identification. |
ECG |
Can indicate sinus tachycardia and nonspecific ST and
T-wave changes. |
Not specific for CaHD; findings are generally
non-specific. |
Reduction in QRS voltage is a less frequent
finding. |
CXR |
Can show right heart chamber prominence and pleural
effusions in severe right-sided valve disease. |
Non specific;
metastatic pleural plaques may be identified late in the disease course. |
Offers a non-invasive initial assessment tool. |
PET |
Highly sensitive and specific for myocardial metastasis
detection. |
High cost and limited availability. |
Utilises
radioactively-labelled somatostatin analogs for detecting neuroendocrine
neoplasms. |