Which clinical test is required before initiation of amiodarone treatment?

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

Answer: (A)

Baseline assessment before starting amiodarone focuses on identifying potential organ toxicities, especially to the lungs. Amiodarone can cause serious pulmonary toxicity, which can be progressive and potentially life-threatening. A chest X-ray provides a baseline image of the lungs and is routinely used to detect preexisting lung disease and to monitor for early changes during therapy. While ECG is useful to assess rhythm and conduction status, it does not specifically address the risk of amiodarone’s pulmonary toxicity. MRI is not a routine requirement for initiation, and an eye exam, though relevant for long-term ocular effects, is not the immediate screening test to establish before starting treatment. Therefore, obtaining a chest X-ray is the most appropriate baseline test prior to initiating amiodarone.