AHA Medical/Scientific Statement
ACC/AHA Guidelines for the Clinical Application of Echocardiography
A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Clinical Application of Echocardiography)
Developed in Collaboration With the American Society of Echocardiography Committee Members Melvin D. Cheitlin, MD, FACC, Chair; Joseph S. Alpert, MD, FACC; William F. Armstrong, MD, FACC; Gerard P. Aurigemma, MD, FACC; George A. Beller, MD, FACC; Fredrick Z. Bierman, MD, FACC; Thomas W. Davidson, MD, FAAFP; Jack L. Davis, MD, FACC; Pamela S. Douglas, MD, FACC; Linda D. Gillam, MD, FACC; Richard P. Lewis, MD, FACC; Alan S. Pearlman, MD, FACC; John T. Philbrick, MD, FACP; Pravin M. Shah, MD, FACC; Roberta G. Williams, MD, FACC Task Force Members James L. Ritchie, MD, FACC, Chair; Melvin D. Cheitlin, MD, FACC; Kim A. Eagle, MD, FACC; Timothy J. Gardner, MD, FACC; Arthur Garson; Raymond J. Gibbons, MD, FACC; Richard P. Lewis, MD, FACC; Robert A. O'Rourke, MD, FACC; Thomas J. Ryan, MD, FACC
- I. Introduction, General Considerations, and Scope
- II. Murmurs and Valvular Heart Disease
- III. Chest Pain
- IV. Ischemic Heart Disease
- V. Cardiomyopathy and Assessment of Left Ventricular Function: Echocardiographic Parameters
- VI. Pericardial Disease
- VII. Cardiac Masses and Tumors
- VIII. Diseases of the Great Vessels
- IX. Pulmonary Disease
- X. Systemic Hypertension
- XI. Neurological Disease and Other Cardioembolic Disease
- XII. Arrhythmias and Palpitation
- XIII. Echocardiography in the Critically Ill
- XIV. Two-Dimensional Doppler Echocardiography in the Adult Patient With Congenital Heart Disease
- XV. Echocardiography in the Pediatric Patient
It is clearly important that the medical profession plays a significant role in critically evaluation of the use of diagnostic procedures and therapies in the management or prevention of disease. Rigorous and expert analysis of the available data documenting relative benefits and risks of those procedures and therapies can produce helpful guidelines that improve the effectiveness of care, optimize patient outcomes, and impact the overall cost of care favorably by focusing resources on the most effective strategies.
The American College of Cardiology (ACC) and the American Heart Association (AHA) have jointly engaged in the production of such guidelines in the area of cardiovascular disease since 1980. This effort is directed by the ACC/AHA Task Force on Practice Guidelines. Its charge is to develop and revise practice guidelines for important cardiovascular diseases and procedures. Experts in the subject under consideration are selected from both organizations to examine subject-specific data and write guidelines. The process includes additional representatives from other medical practitioner and specialty groups as appropriate. Writing groups are specifically charged to perform a formal literature review, weigh the strength of evidence for or against a particular treatment or procedure, and include estimates of expected health outcomes where data exist. Patient-specific modifiers, comorbidities, and issues of patient preference that might influence the choice of particular tests or therapies are considered as well as frequency of follow-up and cost-effectiveness.
These practice guidelines are intended to assist physicians in clinical decision making by describing a range of generally acceptable approaches for the diagnosis, management, or prevention of specific diseases or conditions. These guidelines attempt to define practices that meet the needs of most patients in most circumstances. The ultimate judgment regarding care of a particular patient must be made by the physician and patient in light of all of the circumstances presented by that patient.
The Committee on Clinical Application of Echocardiography was chaired by Melvin D. Cheitlin, MD, FACC, and included the following members: Joseph S. Alpert, MD, FACC, William F. Armstrong, MD, FACC, Gerard P. Aurigemma, MD, FACC, George A. Beller, MD, FACC, Fredrick Z. Bierman, MD, FACC, Thomas W. Davidson, MD, FAAFP, Jack L. Davis, MD, FACC, Pamela S. Douglas, MD, FACC, Linda D. Gillam, MD, FACC, Richard P. Lewis, MD, FACC, Alan S. Pearlman, MD, FACC, John T. Philbrick, MD, FACP, Pravin M. Shah, MD, FACC, and Roberta G. Williams, MD, FACC.
The committee is composed of both university-affiliated and practicing physicians and those with specific echocardiographic expertise and senior clinicians who use the technique. Two general physicians (one general internal medicine and one family practitioner) also served on the committee.
The document was reviewed by three outside reviewers nominated by the ACC and three outside reviewers nominated by the AHA as well as other individuals from the American Society of Echocardiography, Society of Pediatric Echocardiography, American College of Physicians, and American Academy of Family Physicians.
The executive summary and recommendations are published in the March 15, 1997, issue of Journal of the American College of Cardiology. The full text is published in Circulation. Reprints of both the full text and the executive summary and recommendations are available from both organizations. The document will be reviewed 2 years after publication and yearly thereafter and considered current unless the task force revises or withdraws it from distribution. The document was endorsed by the American Society of Echocardiography.James L. Ritchie, MD, FACCChair, ACC/AHA Task Force on Practice Guidelines
"ACC/AHA Guidelines for the Clinical Application of Echocardiography" was approved by the American College of Cardiology Board of Trustees in October 1996 and by the American Heart Association Science Advisory and Coordinating Committee in December 1996.
When citing this document, the American College of Cardiology and the American Heart Association request that the following citation format be used: Cheitlin MD, Alpert JS, Armstrong WF, Aurigemma GP, Beller GA, Bierman FZ, Davidson TW, Davis JL, Douglas PS, Gillam LD, Lewis RP, Pearlman AS, Philbrick JT, Shah PM, Williams RG. ACC/AHA guidelines for the clinical application of echocardiography: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Clinical Application of Echocardiography).
A single reprint of the full text of "ACC/AHA Guidelines for the Clinical Application of Echocardiography" is available by calling 800-242-8721 (US only) or writing the American Heart Association, Public Information, 7272 Greenville Avenue, Dallas, TX 75231-4596. Ask for reprint No. 71-0102. To obtain a reprint of the executive summary and recommendations published in the March 15, 1997, issue of the Journal of the American College of Cardiology, ask for reprint No. 71-0103. To purchase additional reprints: up to 999 copies, call 800-611-6083 (US only) or fax 413-665-2671; 1000 or more copies, call 214-706-1466, fax 214-691-6342, or E-mail firstname.lastname@example.org. To make photocopies for personal or educational use, call the Copyright Clearance Center, 508-750-8400.
© 1997 American College of Cardiology and American Heart Association, Inc.
© 1998 American Heart Association, Inc. All rights reserved.
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