Pre‑Surgery Cardiac Testing for Congenital Heart Defects: Modalities & Indications

Standard Preoperative Cardiac Workup

Electrocardiogram (ECG)

• Rhythm, conduction, hypertrophy, ischemia screening

Echocardiogram (TTE/TEE)

• Chamber size/function, valve anatomy, shunts, pulmonary pressures
• Primary tool for structural assessment

Cardiac MRI

• Superior tissue characterization, 3D anatomy, flow quantification
• No ionizing radiation – preferred for children/young adults

Cardiac Catheterization

• Hemodynamics: pressures, saturations, Qp:Qs
• Coronary anatomy (if age‑appropriate)
• Interventional potential (stent, balloon, device closure)

Chest X‑Ray

• Heart size, pulmonary vasculature, lung parenchyma, hardware

Laboratory & Pulmonary Tests

• CBC, electrolytes, renal/hepatic panel, coagulation, type & screen
• BNP/NT‑proBNP for ventricular strain
• PFTs if respiratory comorbidity suspected

Test selection individualized by defect complexity, planned surgery, and patient age.