Which diagnostic test would you order prior to daunorubicin administration to assess cardiac function?

• A. Audiogram
• B. Stress test
• C. Chest X-ray
• D. Echocardiogram

Answer: (D)

Daunorubicin can cause dose-related damage to the heart, so you want a reliable baseline measure of cardiac function before starting therapy. An echocardiogram fits this need best because it uses ultrasound to visualize heart structure and directly assess how well the heart is pumping, especially the left ventricular ejection fraction, along with wall motion and valvular function. This information helps establish a baseline and guides monitoring during treatment, allowing you to detect early declines in function and adjust therapy if needed.

Audiogram checks hearing and doesn’t evaluate the heart. A stress test looks at exercise capacity and ischemia, not baseline cardiac function relevant to chemotherapy cardiotoxicity. A chest X-ray can show heart size but is not sensitive or specific for assessing cardiac function or early cardiotoxic changes.