Before initiating amiodarone, which baseline test is recommended?

Before initiating amiodarone, which baseline test is recommended?

• A. Chest X-ray
• B. Echocardiogram
• C. MRI
• D. ECG

Answer: (A)

Amiodarone can cause serious lung toxicity, including interstitial pneumonitis and fibrosis. Having a baseline chest X-ray before starting therapy gives a clear reference of lung status and helps detect any pre-existing lung disease that could worsen or complicate toxicity during treatment. If pulmonary symptoms arise, repeating the chest X-ray can reveal new or progressive changes more quickly, guiding management. While an ECG is also important to assess baseline rhythm and QT interval, and other tests like liver or thyroid function are useful, the test most directly informative for starting amiodarone is chest X-ray because it directly informs pulmonary safety and provides a reference point for future comparison.

Amiodarone can cause serious lung toxicity, including interstitial pneumonitis and fibrosis. Having a baseline chest X-ray before starting therapy gives a clear reference of lung status and helps detect any pre-existing lung disease that could worsen or complicate toxicity during treatment. If pulmonary symptoms arise, repeating the chest X-ray can reveal new or progressive changes more quickly, guiding management.

While an ECG is also important to assess baseline rhythm and QT interval, and other tests like liver or thyroid function are useful, the test most directly informative for starting amiodarone is chest X-ray because it directly informs pulmonary safety and provides a reference point for future comparison.