Table 1.

Alternative imaging in specific clinical scenarios

Alternative imaging in specific clinical scenariosa
Indication	Usual care	Suggested protocol
Elevated troponin and equivocal diagnosis of NSTEMI	Invasive coronary angiography	Coronary CT
Acute chest pain, negative initial troponin, intermediate risk	Invasive coronary angiography, or 24 h serial troponin + EKG	Coronary CT
Exclusion of LAA thrombus prior to urgent cardioversion	TEE	Cardiac CT with delayed phase
Emergent TAVR or SAVR planning	TEE	CTA
Prosthetic or native heart valve dysfunction or suspected endocarditis	TEE	Cardiac CT

^aCoronary and Cardiac CT provide the additional benefit of partial imaging of the lung parenchyma. If typical or atypical pulmonary findings are encountered, consultation with a radiologist with thoracic expertise is encouraged, and appropriate documentation and timely communication of these findings is essential, especially in cases not known or suspected to have the disease [18]