Echocardiography is the central imaging examination in cardiology. It is free of direct adverse effects, widely available, and relatively cheap. Due to the increased use of echocardiographic examinations, concerns regarding the appropriateness are rising. Aim of the report at hand is to describe the use of echocardiography in Austria. Additionally, we review the international literature on the appropriateness of echocardiography.

We set the use of the transthoracic echocardiography in context with the scientific literature. To this end we compared important recommendations of different guidelines from several organisations. Finally, we reviewed studies that quantified the appropriateness of echocardiographic examinations.

The weighted average age- and sex-standardised rate of transthoracic echocardiography (institutes and resident doctors) over all districts was 58.7 examinations per 1,000 population. Repeated echocardiographic examinations within one year are often related to inappropriate use. Some districts had notable differences in the ratio of overall examinations compared to repeated examinations. With an increase in the number of overall examinations there is a tendency for a higher percentage of repeated examinations, especially for regions with very high rates of echocardiography usage.

The fact that the percentage of repeated examinations grows exponentially with an increased rate of overall examinations may indicate inappropriate use. A detailed analysis of the data would result in a better impression of the appropriateness of echocardiographic examinations in Austria. For instance, an analysis of the rate of examinations in connection with indications that are often inappropriate might be useful. Since the aim is to improve medical care, a discussion with the stakeholders should be conducted.