If there are concerns about heart disease based on symptoms or physical findings, diagnostic tests may be performed that are safe for the developing fetus. An electrocardiogram can diagnose abnormal heart rhythm. A twenty-four-hour monitor or "loop recorder" over weeks may detect an abnormal heart rhythm. A chest x-ray can be performed with proper shielding to protect the fetus.
The most useful test is cardiac ultrasound, or echocardio-graphy, which provides information with regard to cardiac size, function, and structure, as well as blood flow patterns. An echocardiogram can evaluate heart valve abnormalities, causes of heart failure, and a multitude of other cardiac problems. Exercise stress testing and even cardiac catheterization may be performed, if necessary, without serious risks to the fetus. Only cardiac testing that uses radionu-clides (e.g., thallium) should always be avoided.
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