Table 1: Strengths and Weaknesses of Different Cardiac Imaging Modalities in Women.

Imaging Modality	Strengths	Limitations
Echocardiography	Widely available Low cost No exposure to radiation Highest safety during pregnancy and lactation	High operator dependency Poor acoustic windows (i.e. prominent breast or breast implants) Risk of vomiting and aspiration with transoesophageal echocardiography Limited tissue characterisation
Cardiac magnetic resonance	High spatial resolution Independent from acoustic window Gold standard for volumes and function Good tissue characterisation No exposure to radiation Safe at 1.5 T during pregnancy Gadolinium contrast can be used during breastfeeding without interruptions	Relatively expensive Not widely available During pregnancy lateral decubitus should be used to avoid caval compression Gadolinium-contrast should be avoided especially during the first trimester
Nuclear imaging	Independent from acoustic window Possibility to assess perfusion and metabolism	Exposure to radiation Lower spatial resolution Breast attenuation artifacts
CT	Independent from acoustic window High spatial resolution Iodinated contrast agents can be used during pregnancy and breastfeeding if clinically indicated	Exposure to radiation Relatively expensive