Uncommon but Critical Cardiac Abnormalities on Routine Chest Computed Tomography

Uncommon but critical cardiac abnormalities may be missed on routine chest computed tomography (CT) due to misinterpretation as motion artifact. The examples include paradoxical embolism through the patent foramen ovale, right ventricular lead perforation, patent ductus arteriosus with endarteritis, infective endocarditis, acute mitral regurgitation secondary to chordal rupture, acute myocardial infarction, left atrial or ventricular thrombus, and paracardiac fat necrosis. Such overlooked diagnoses may lead to an unfavorable outcome. This review provides important tips to discriminate true abnormalities from cardiac motion artifact, and discusses specific CT findings that permit identification of subtle but critical cardiac findings on routine chest CT.