Assessment of myocardial enhancement during coronary CT angiography in critically ill patients

•There are still unmet needs for the imaging, such as conditions with unknown cause that are not associated with dominant symptoms indicating primarily cardiac cause.•The contribution of the myocardial enhancement evaluation improves to determining the diagnosis of acute myocardial injury and choosing appropriate treatment.•When incorporating the myocardial enhancement assessment into the imaging algorithm, emphasis is placed on a uniform evaluation approach.•The color coded images of the myocardial enhancement in emergency situations help identify the most serious pathologies and shorten the time to adequate therapy.

There are still challenges and unmet needs for the imaging techniques, such as conditions of uncertain origin in patients with clinically serious, life-threatening conditions with unknown cause that are not associated with dominant chest pain, ECG changes or other symptoms indicating a possible primarily cardiac or coronary cause. The contribution of the myocardial enhancement evaluation of urgent cardiac CTA scans significantly improves to determining the diagnosis of acute myocardial injury and choosing appropriate treatment. When incorporating the myocardial enhancement assessment into the imaging algorithm of an emergency department, emphasis is placed on a uniform imaging procedure and a uniform evaluation approach. The color coded images of the myocardial enhancement in emergency situations helps identify the most serious pathologies and shorten the time to adequate targeted therapy in patients.