Which diagnostic test is recommended during the initial evaluation of patients with heart failure?

During the initial evaluation of patients with heart failure, an echocardiogram (echo) is the recommended diagnostic test. This non-invasive imaging technique provides critical information about the heart's structure and function, allowing healthcare providers to assess parameters such as chamber size, wall motion, and ejection fraction—key indicators in diagnosing and managing heart failure. The echo helps to differentiate between various types of heart failure, such as systolic versus diastolic dysfunction, and can identify underlying causes, like valvular heart disease or hypertrophy.

In contrast, other options like CT scans, stress tests, and event monitors play different roles. A CT scan is primarily used for assessing coronary artery disease or other structural abnormalities but is not typically a first-line investigation for heart failure. A stress test evaluates the heart's performance under exertion and is more useful for diagnosing coronary artery disease. An event monitor is used for long-term rhythm assessment and is not focused on initial heart failure evaluation. Therefore, the echocardiogram stands out as the most appropriate test in the early stages of heart failure assessment.