Cardiac findings on non-gated chest computed tomography: A clinical and pictorial review

•Several cardiac findings can be identified on chest CT without ECG gating.•We review frequently overlooked cardiac findings on non-gated chest CT.•This review will help to compile comprehensive non-cardiac non-gated chest CT reports.

The use of chest computed tomography (CT) as an imaging test for the evaluation of thoracic pathology has significantly increased during the last four decades. Although cardiopulmonary diseases often overlap in their clinical manifestation, radiologists tend to overlook the heart while interpreting routine chest CT. Recent advances in CT technology have led to significant reduction of heart motion artefacts and now allow for the identification of several cardiac findings on chest CT even without electrocardiogram (ECG) gating. These observations range from simple curiosity to both benign and malignant discoveries, to life-threatening discoveries.We here present a clinical and radiologic review of common and less common cardiac findings discovered on non-gated chest CT in order to draw the attention of radiologists and referring physicians to these possibilities.