ventriculography

Ventriculography is the part of a catheterization in which contrast dye is squirted directly into a pumping ventricle — usually the left — and an X-ray movie watches the dye-filled chamber squeeze and relax. In effect it is a contrast cast of the chamber in action, showing its shape, size, and how vigorously its walls move from one beat to the next.

From this cine the cardiologist reads several things at once. The overall ejection fraction can be estimated from how much the dye-filled silhouette shrinks during contraction. Regional wall motion is seen directly — a segment scarred by a past heart attack may move weakly, not at all, or even bulge outward as an aneurysm. Dye spilling backward into the left atrium during contraction reveals and grades mitral regurgitation, and the chamber's shape can expose conditions such as hypertrophic cardiomyopathy or apical ballooning.

Because ventriculography adds a dye load and a brief volume challenge to the heart and uses radiation, it is performed selectively. Today much of what it once provided — ejection fraction, wall motion, valve leakage — is obtained non-invasively by echocardiography or MRI, so a formal ventriculogram is done less routinely and chiefly when the patient is already on the catheterization table and the information is needed.