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Cardiac Diagnostic Testing

As per state of Ohio guidelines during the COVID-19 pandemic, the following recommendations will be made concerning appropriateness of ordering and performing outpatient transesophageal echocardiograms, echocardiograms and stress tests at Kettering Health Network sites.

The echocardiogram or stress test provides essential information that may guide further patient management decisions in situations where there is:

  • Threat to the patient’s life if surgery or procedure is not performed 
  • Threat of permanent dysfunction of an extremity or organ system 
  • Risk of metastasis or progression of staging 
  • Risk of rapidly worsening severe symptoms (time sensitive)   

Please note that one of the following diagnoses alone is NOT a justification for ordering these tests. The diagnosis MUST be paired with the clinical belief that there is a reasonable possibility that failure to obtain the test could result in one of the above negative patient outcomes.  Providers will be expected to order tests based on their best clinical judgment and will defer elective testing in stable patients at this time.

Below is a list of diagnoses that may qualify for and echocardiogram or stress test if they meet the following criteria:

Echocardiogram Diagnoses:

Atrial fibrillation or flutter

Amyloidosis

Aortic stenosis

Aortic regurgitation/insufficiency

Chest pain

CHF

Cardiomyopathy (multiple types)

Coronary artery disease (CAD)

Cor pulmonale

Dyspnea

Dizziness

Edema

Endocarditis suspected

Left ventricular hypertrophy

Hypertrophic cardiomyopathy

Pericarditis

Pericardial effusion

Mitral stenosis

Mitral regurgitation or insufficiency

Murmur

Myocarditis

Prosthetic valve evaluation (any type)

Pulmonary embolism

Pulmonary hypertension

Pulmonic stenosis

Pulmonic regurgitation or insufficiency

Rheumatic fever

Sarcoidosis

Stroke

Shortness of breath

Syncope

Tricuspid valve regurgitation or insufficiency

Tricuspid stenosis

Stress Testing Diagnoses:

Angina

Aortic stenosis

Aortic regurgitation/insufficiency

Atrial fibrillation or flutter

CABG (coronary artery bypass grafting)

Chest pain

CHF

Chronotropic incompetence

Cardiomyopathy (multiple types)

Coronary artery disease (CAD)

Chest pain

Dyspnea

Dizziness

Hypertrophic cardiomyopathy

Mitral stenosis

Mitral regurgitation or insufficiency

Murmur

Myocarditis

Pulmonary embolism

Pulmonary hypertension

Pulmonic stenosis

Pulmonic regurgitation or insufficiency

Sarcoidosis

Syncope

Tricuspid valve regurgitation or insufficiency

Tricuspid stenosis

March 29, 2020