Abstract
Non-cardiac pathology in CT imaging of the heart can be found in 10-60% of patients depending on the population, field of view (FOV), administration of contrast material, practicing of defensive medicine, and whether the examination is interpreted by a radiologist or a cardiologist. When large FOV is used, non-cardiac findings can be found in additional 10% of patients compared to small FOV.
Around 19-26% of secondary findings require further workup. Identification of non-cardiac findings has its merits: alternative diagnosis that may explain patients complaints (eg. pleurisy, hiatal hernia).
Its major drawbacks include low yield of clinically significant pathology, cost and radiation burden of subsequent examinations. On the other hand, in many patients even a potentially significant finding is not subject to further workup.
The vexed question whether the risk of overlooking a non-cardiac pathology (risk of litigation) is greater than the potential benefit for a patient is a topic common with other examinations (eg. CT of spine).