Imaging techniques in cardiology 1: echocardiography, CT, MRI, SPECT

1. Big picture

Cardiac imaging answers four exam questions:

1. Structure: chamber size, hypertrophy, valves, pericardium, masses → mainly echocardiography, also cardiac magnetic resonance imaging (CMR) and cardiac computed tomography (CT).
2. Function: ejection fraction, wall motion, diastolic function, right ventricular function → echocardiography first, CMR most accurate for volumes.
3. Coronary anatomy: stenosis, coronary anomalies, calcium → coronary CT angiography (CCTA).
4. Perfusion/ischemia/viability: is myocardium underperfused but alive? → stress echo, SPECT, stress CMR, PET.

Modern chronic coronary syndrome workup is risk-based