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Related Concept Videos

Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

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Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
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Imaging Studies for Cardiovascular System V: CT01:28

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Cardiac computed tomography (CT) scanning is an advanced cardiac imaging technique that utilizes CT technology, with or without intravenous (IV) contrast, to produce accurate cross-sectional virtual slices of specific areas of the heart, coronary circulation, and major blood vessels such as the aorta, pulmonary veins, and arteries. The computer processes these slices to generate three-dimensional images. Multidetector CT (MDCT) is a rapid form of CT scanning that captures multiple slices...
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Imaging Studies for Cardiovascular System II:Types of Echocardiography01:20

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Echocardiography plays a role in assessing cardiac health and detecting heart conditions, with various types providing critical insights for diagnosis and treatment.
Types of Echocardiography
Transthoracic Echocardiography (TTE)
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Imaging Studies for Cardiovascular System IV: CMRI01:21

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Cardiovascular magnetic resonance imaging, or CMRI, is a non-invasive diagnostic test that employs a magnetic field and radiofrequency waves to create precise images of the heart and arteries. It provides comprehensive information about cardiac anatomy, function, perfusion, and tissue characterization without ionizing radiation.IndicationsCMRI diagnoses various heart conditions, including tissue damage from heart attacks, ischemic heart disease, myocarditis, aortic issues (tears, aneurysms,...
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Imaging Studies for Cardiovascular System I:Echocardiography01:17

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Cardiac imaging studies encompass a wide range of noninvasive and minimally invasive techniques designed to visualize the heart's structure and function in detail. One such technique is echocardiography, which uses high-frequency ultrasound waves to produce detailed images of the heart, known as echocardiograms.
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Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT01:25

Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT

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Calcium-Scoring CT ScanA calcium-scoring CT scan, also known as coronary artery calcium (CAC) scan, detects calcium deposits in the coronary arteries. This test assesses the risk of coronary artery disease (CAD), which can lead to cardiovascular events such as angina, heart failure, and sudden cardiac arrest.A calcium-scoring CT scan is generally recommended for individuals at intermediate risk of CAD without symptoms. It includes:Men aged 40-75 and women aged 50-75: Especially those with a...
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From Echo to Coronary Angiography: Optimizing Ischemia Evaluation Through Multimodal Imaging.

Babic Marija1, Mikic Lidija2, Ristic Marko1

  • 1Department of Cardiology, University Clinical Centre of Serbia, 11000 Belgrade, Serbia.

Medicina (Kaunas, Lithuania)
|December 31, 2025
PubMed
Summary

Optimizing myocardial ischemia evaluation involves integrating various imaging techniques, including echocardiography, CMR, SPECT, PET, and invasive coronary angiography. Choosing the right modality, or combination, ensures accurate diagnosis and effective patient management.

Keywords:
invasive coronary angiographymultimodal imagingmyocardial ischemianoninvasive functional imaging

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Area of Science:

  • Cardiology
  • Medical Imaging
  • Diagnostic Techniques

Background:

  • Myocardial ischemia evaluation relies on a range of imaging modalities.
  • Each technique offers unique strengths for assessing coronary artery disease.
  • Current guidelines recommend specific imaging based on patient risk stratification.

Purpose of the Study:

  • To review the roles of multimodal imaging in myocardial ischemia.
  • To highlight the complementary nature of noninvasive and invasive techniques.
  • To guide optimal modality selection for patient-centered care.

Main Methods:

  • Review of echocardiography, cardiac magnetic resonance imaging (CMR), SPECT, PET, and invasive coronary angiography (ICA).
  • Discussion of coronary computed tomography angiography (CCTA) for risk stratification.
  • Emphasis on adjunctive invasive hemodynamic and provocative testing.

Main Results:

  • Noninvasive functional imaging suits intermediate-to-high pre-test probability patients; CCTA for low-to-intermediate risk.
  • Stress echocardiography detects wall motion abnormalities; CMR quantifies myocardial blood flow (MBF).
  • SPECT/PET quantify ischemic burden; PET excels in MBF and microvascular disease assessment.

Conclusions:

  • ICA is the gold standard for epicardial stenosis but requires adjunctive tests for functional significance.
  • Individualized modality selection based on patient factors and data needs is crucial.
  • Integrated multimodal imaging provides a comprehensive approach to ischemia evaluation.