Noninvasive right and left heart catheterization: Taking the echo lab beyond an image-only laboratory

The assessment of cardiovascular hemodynamics is an extremely important com ponent of managing patients with cardiac diseases. For years, this has been accomplished primarily through the use of right and left heart catheters p laced within the cardiac chambers. Since this is an invasive technique, it should only be used when necessary; patient discomfort, infections, and ove rall risks for physicians would be reduced if noninvasive methods were util ized when available. Echocardiography (echo) provides the greatest ability to determine cardiovascular hemodynamics noninvasively, but requires the ut most precision and care to avoid misinterpretation. When used correctly, ec hocardiographic modalities provide an even greater assessment of the cardia c patient than invasive techniques. A safer and more comprehensive interpre tation is available, and thus, echo should be considered the modality of ch oice-the new gold standard.