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When, why, and how to examine the heart during thoracic CT: Part 2, clinical applications
John F Bruzzi1, Martine Rémy-Jardin, Damien Delhaye
1Department of Radiology, Hospital Calmette, Boulevard Pr. J. Leclerq, Lille 59037, France.
Insights
CT scans of the chest can reveal crucial cardiac information, aiding in diagnosing heart conditions like cardiomyopathy and coronary artery disease that may not be clinically apparent.
Area of Science:
- Radiology
- Cardiology
- Thoracic Imaging
Background:
- Thoracic CT scans are frequently ordered for respiratory symptoms, but underlying cardiac issues can be missed.
- Conditions like cardiomyopathy, ischemic heart disease, and valvular dysfunction can present with non-cardiac symptoms.
- Thoracic diseases and surgeries can significantly impact cardiac structure and function.
Purpose of the Study:
- To highlight the value of cardiac assessment during thoracic CT.
- To demonstrate how thoracic CT can detect unsuspected cardiac conditions.
Main Methods:
- Review of clinical cases where thoracic CT provided cardiac insights.
- Analysis of how thoracic CT findings relate to cardiac structure and function.
Main Results:
- Thoracic CT can identify idiopathic and acquired cardiomyopathies.
- CT detects ischemic heart disease and valvular dysfunction.
- It reveals cardiac effects of pulmonary diseases and thoracic malignancies.
- Preoperative thoracic CT can uncover coronary artery disease.
Conclusions:
- Cardiac evaluation during thoracic CT offers vital, otherwise unavailable, clinical information.
- Thoracic CT is a valuable tool for detecting and assessing cardiac conditions.
Objective:
CT examination of the thorax is often requested for the investigation of disorders that may have an important underlying cardiac cause or association that is not clinically obvious. Conditions such as idiopathic and acquired cardiomyopathy, ischemic heart disease, and valvular dysfunction may underlie symptoms such as dyspnea, chest pain, and hemoptysis that prompt the request for CT of the thorax. Other conditions such as pulmonary thromboembolic disease, chronic obstructive airways disease, pectus excavatum, sleep apnea, and many intrathoracic malignancies may have an important effect on cardiac structure and function. Patients undergoing thoracic surgery may have unsuspected coronary artery disease that can be detected in the course of preoperative evaluation by CT; similarly, postoperative complications often have a cardiogenic basis.
Conclusion:
Examination of the heart in the course of CT of the chest often can provide important and clinically relevant information that is not otherwise easily available.
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Assessment:
1. Clinical Evaluation:
History: