Assessment of left ventricular function

The commonest reason for undertaking an echocardiogram is to assess left ventricular function.1 2 In accordance with NICE (National Institute for Health and Clinical Excellence) guidelines,3 this is often requested when patients have symptoms suggesting heart failure. Although clinical information and basic investigations will often identify patients with significant left ventricular systolic dysfunction,4^–6 echocardiography can quantify the severity and determine the underlying cause. Many patients with heart failure have concomitant or predominant diastolic dysfunction,7 8 which may be more difficult to detect clinically but should be suspected in patients with evidence of heart failure but normal systolic function, particularly elderly people and those with hypertension.

Echocardiography is valuable in patients with known coronary heart disease, even those without overt heart failure. Some may have important systolic dysfunction and may benefit from treatments such as β blockers, angiotensin converting enzyme inhibitors, or, in selected cases, surgical …