Imaging Recommendations for Reassessing Heart Space in Pectus Excavatum

Initial Imaging Evaluation

The American College of Radiology recommends chest radiography (PA and lateral views) as the first imaging study to provide basic assessment of cardiac size, position, and pulmonary vasculature patterns, with a strength of evidence based on multiple citations 1, 3
The American College of Radiology suggests that transthoracic echocardiography (TTE) should be performed concurrently with chest radiography to assess cardiac function, structure, and any compression effects, with a strength of evidence based on multiple citations 1, 3

Cardiac MRI without and with IV contrast is recommended by the American College of Radiology when more detailed assessment of cardiac function is needed, with a citation from 2017 3
The American College of Radiology recommends cardiac MRI for evaluation of interventricular dependence, with a citation from 2025 2

Stress imaging tests are generally not indicated unless there are specific concerns about coronary artery disease, according to the American College of Radiology, with citations from 2017 1, 3
The American College of Cardiology and American Heart Association suggest that cardiac catheterization is unnecessary for diagnosis and should be reserved only for interventional procedures, with a citation from 2008 4