Coronary CT Angiography (CCTA) has become established as a first-line test in the evaluation of chest pain, supported by robust evidence of prognostic impact, advances in Artificial Intelligence (AI), and technological evolution with photon-counting CT. Publications in 2025 reposition CCTA as a central platform for risk stratification and therapeutic guidance in coronary artery disease. The 10-year follow-up of the SCOT-HEART trial represents a major milestone in this process. Among 4,146 patients with stable chest pain randomized to standard care with […]

Abstract This case report presents a myocardial perfusion analysis in a 67-year-old asymptomatic male patient with known coronary artery disease (CAD) and multiple risk factors. While myocardial perfusion Imaging (MPI) with single-photon emission computed tomography (SPECT) revealed a 5% area of ischemia, the myocardial blood flow quantification assessment in a camera equipped with cadmium-zinc-telluride (CZT) detectors demonstrated a reduced global myocardial flow reserve (MFR) of 1.57. Coronary angiography confirmed extensive multivessel disease, including an 80% stenosis in the left anterior […]

Introduction In contemporary cardiovascular imaging, one of the methods that has gained significant relevance by adding diagnostic and prognostic information is speckle-tracking–derived Longitudinal Strain, particularly the assessment of left ventricular Global Longitudinal Strain (GLS). However, although GLS evaluates global myocardial deformation of the left ventricle, it is highly dependent on loading conditions, which may interfere with the accurate interpretation of its results. In this context, an emerging technique has been introduced, also derived from speckle tracking: Myocardial Work (MW). Compared […]

Introduction Advances have been made in positron emission tomography (PET) myocardial perfusion since the Food and Drug Administration (FDA) approved the use of flurpiridaz, which was shown effective in the detection of coronary artery disease (CAD) in two phase III trials, with a high diagnostic precision as compared with Single Photon Emission Computed Tomography (SPECT) scintigraphy.– Flurpiridaz is an injectable radiotracer, labeled with fluorine-18 (F-18), developed by GE HealthCare, that will be sold as “Flyrcado” in the United States from […]

Abstract Coronary artery disease (CAD) is a common cause of chest pain, frequently seen in emergency departments and during elective consultations, and remains the leading cause of death worldwide. Coronary computed tomography angiography (CCTA) has become an established diagnostic tool for evaluating stable angina and acute chest pain in patients with low or intermediate risk. In this setting, CAD-RADS (Coronary Artery Disease-Reporting and Data System) was introduced as a CCTA reporting model, first published in 2016 and updated in 2022, […]

Introduction Physical stress echocardiography is a firmly established method in the diagnosis and prognosis of coronary artery disease.– Compared to pharmacological stress echocardiography, it is physiological, does not depend on venoclysis, and is free of side effects. Physical exercise preserves the normal electromechanical response and provides valuable prognostic information about a patient’s functional status. Therefore, physical stress is the test of choice for assessment of myocardial ischemia in patients who are capable of exercise. The main differences between methods are […]

Abstract Myocardial ischemia, which is characterized by reduced oxygen supply to the myocardium, is a common manifestation of coronary artery disease (CAD), one of the leading causes of morbidity and mortality worldwide. Early and accurate detection of myocardial ischemia is essential for risk stratification, treatment planning, and improved clinical outcomes. In recent years, advances in cardiac imaging modalities have provided a more comprehensive assessment of myocardial ischemia. This article reviews recent advances in the assessment and detection of myocardial ischemia […]

Abstract Background: The calcium score is an imaging test used to evaluate cardiovascular risk by detecting coronary artery calcification (CAC). However, exposure to ionizing radiation during computed tomography (CT) has been a concern. Objective: The objective of this study was to evaluate radiation dose and the diagnostic quality of the calcium score using reduced tube voltage and iterative image reconstruction. Methods: This was a cross-sectional, observational study with patients over 18 years of age. Patients with previous coronary artery disease […]

Myocardial perfusion scintigraphy (MPS) with single-photon emission computed tomography (SPECT) is important for the diagnosis and prognostic evaluation in patients with coronary artery disease (CAD). MPS evaluates the presence, extent and degree of myocardial ischemia and/or infarction, usually through visual observation or semi-quantitative parameters. Despite its proven diagnostic and prognostic values, the relative nature of perfusion imaging may limit SPECT ability to identify patients with high-risk multivessel CAD. Limitations regarding visual or semi-quantitative assessment of regional myocardial perfusion defects may […]