Curriculum in cardiac imaging
A suggested curriculum in cardiac imaging has been established by the North American Society of Cardiac Imaging.
The original document can be viewed here.

# Physiological aspects of cardiac imaging
- Normal cardiac cycle (systole and diastole)
Systole and diastole
Ventricular function
Atrial function
Valvular function
- Systole and diastole
- Ventricular function
- Atrial function
- Valvular function
- Electrocardiography
Control of excitation and conduction in the heart
Characteristics of normal sinus rhythm
Common abnormalities in EKG
Premature atrial contraction / premature ventricular contraction
Atrial fibrillation / atrial flutter / Atrioventricular block
Current of injury (signs of myocardial ischemia and infarction)
- Control of excitation and conduction in the heart
- Characteristics of normal sinus rhythm
- Common abnormalities in EKG
Premature atrial contraction / premature ventricular contraction
Atrial fibrillation / atrial flutter / Atrioventricular block
Current of injury (signs of myocardial ischemia and infarction)
- Premature atrial contraction / premature ventricular contraction
- Atrial fibrillation / atrial flutter / Atrioventricular block
- Current of injury (signs of myocardial ischemia and infarction)
- Physiologic anatomy of cardiac muscle
- Mechanics of cardiac contraction
- Physical basis for blood flow, pressure and resistance
Ventricular volume and pressure relationship
Preload
Afterload
Practical cardiac measurements
Ejection fraction
Stroke volume
Cardiac Output
Left ventricular mass
Flow calculation (Q = V x A)
Gradient calculation (Bernoulli equation, G = 4 x PV2)
Qp/Qs ratio
Normal cardiac and pulmonary pressures
Vascular regions supplied by the coronary arteries
Standard nomenclature for topographic imaging of the heart
- Ventricular volume and pressure relationship
Preload
Afterload
- Preload
- Afterload
- Practical cardiac measurements
Ejection fraction
Stroke volume
Cardiac Output
Left ventricular mass
Flow calculation (Q = V x A)
Gradient calculation (Bernoulli equation, G = 4 x PV2)
Qp/Qs ratio
- Ejection fraction
- Stroke volume
- Cardiac Output
- Left ventricular mass
- Flow calculation (Q = V x A)
- Gradient calculation (Bernoulli equation, G = 4 x PV2)
- Qp/Qs ratio
- Normal cardiac and pulmonary pressures
- Vascular regions supplied by the coronary arteries
- Standard nomenclature for topographic imaging of the heart

# Anatomy of the heart and great vessels
- Normal morphology and structure
Embryology
Fetal circulation
Normal cardiac and peri-cardiac structures to include
Eustachian valve
Thebesian valve / coronary sinus
Right and left atrial appendages
Moderator band
Endocardial cushion
Atrioventricular valves (tricuspid and mitral)
Semilunar valves (aortic and pulmonic)
Sinus of Valsalva
Coronary arteries and major branches
Coronary veins including coronary sinus
Superior vena cava and deep mediastinal veins (e.g. azygous vein)
Pericardium
Pulmonary arteries
Pulmonary veins
Common variants
Anomalous coronary artery
Persistent left superior vena cava
Azygous continuation of the inferior vena cava
- Embryology
- Fetal circulation
- Normal cardiac and peri-cardiac structures to include
Eustachian valve
Thebesian valve / coronary sinus
Right and left atrial appendages
Moderator band
Endocardial cushion
Atrioventricular valves (tricuspid and mitral)
Semilunar valves (aortic and pulmonic)
Sinus of Valsalva
Coronary arteries and major branches
Coronary veins including coronary sinus
Superior vena cava and deep mediastinal veins (e.g. azygous vein)
Pericardium
Pulmonary arteries
Pulmonary veins
- Eustachian valve
- Thebesian valve / coronary sinus
- Right and left atrial appendages
- Moderator band
- Endocardial cushion
- Atrioventricular valves (tricuspid and mitral)
- Semilunar valves (aortic and pulmonic)
- Sinus of Valsalva
- Coronary arteries and major branches
- Coronary veins including coronary sinus
- Superior vena cava and deep mediastinal veins (e.g. azygous vein)
- Pericardium
- Pulmonary arteries
- Pulmonary veins
- Common variants
Anomalous coronary artery
Persistent left superior vena cava
Azygous continuation of the inferior vena cava
- Anomalous coronary artery
- Persistent left superior vena cava
- Azygous continuation of the inferior vena cava
- Segmental Anatomy of the Heart
Atrial situs
Ventricular situs
Identification of great vessels
Assess pulmonary arteries and veins
Identify systemic venous return
- Atrial situs
- Ventricular situs
- Identification of great vessels
- Assess pulmonary arteries and veins
- Identify systemic venous return
- Normal Adult Heart Measurements
Left ventricular wall thickness, diameter, fractional shortening and end-diastolic volume and volume index
Left atrium size
Right ventricular wall thickness and size
Right atrial size
Diameter of the thoracic aorta
- Left ventricular wall thickness, diameter, fractional shortening and end-diastolic volume and volume index
- Left atrium size
- Right ventricular wall thickness and size
- Right atrial size
- Diameter of the thoracic aorta

# Techniques for imaging the heart and great vessels
- Radiography
- Computed tomography
Indications
Coronary calcium scoring
Cardiac CT
Coronary CTA
Physics and cardiac imaging considerations including ECG gating techniques
Coronary artery calcium scoring
Coronary CTA
Aortic CTA
Pulmonary CTA
Advantages and Limitations
- Indications
Coronary calcium scoring
Cardiac CT
Coronary CTA
- Coronary calcium scoring
- Cardiac CT
- Coronary CTA
- Physics and cardiac imaging considerations including ECG gating techniques
Coronary artery calcium scoring
Coronary CTA
Aortic CTA
Pulmonary CTA
- Coronary artery calcium scoring
- Coronary CTA
- Aortic CTA
- Pulmonary CTA
- Advantages and Limitations
- Magnetic resonance imaging
Indications
Physics and imaging considerations, including pulse sequences, ECG-gating techniques, and respiratory compensation strategies
Wall motion studies
Myocardial perfusion and viability scanning
Valvular disease assessment
Blood flow quantification
Coronary MRA
MR of the aorta
Pulmonary MRA
Atherosclerotic plaque evaluation
Advantages, Limitations and contraindications
- Indications
- Physics and imaging considerations, including pulse sequences, ECG-gating techniques, and respiratory compensation strategies
Wall motion studies
Myocardial perfusion and viability scanning
Valvular disease assessment
Blood flow quantification
Coronary MRA
MR of the aorta
Pulmonary MRA
Atherosclerotic plaque evaluation
- Wall motion studies
- Myocardial perfusion and viability scanning
- Valvular disease assessment
- Blood flow quantification
- Coronary MRA
- MR of the aorta
- Pulmonary MRA
- Atherosclerotic plaque evaluation
- Advantages, Limitations and contraindications
- Cardiac Scintigraphy (including PET)
Indications
Physics and cardiac imaging considerations
Multiple-gated acquisition (MUGA)
Myocardial perfusion and viability scanning
Shunt evaluation
Advantages and Limitations
- Indications
- Physics and cardiac imaging considerations
Multiple-gated acquisition (MUGA)
Myocardial perfusion and viability scanning
Shunt evaluation
- Multiple-gated acquisition (MUGA)
- Myocardial perfusion and viability scanning
- Shunt evaluation
- Advantages and Limitations
- Other (working understanding)
Echocardiography (transthoracic and transesophageal)
Indications
Technique including standard views and use of color Doppler
Advantages and Limitations
Cardiac and coronary catheter angiography
Indications
Technique including standard views and transcatheter tools (e.g. intraluminal ultrasound)
Advantages and Limitations
- Echocardiography (transthoracic and transesophageal)
Indications
Technique including standard views and use of color Doppler
Advantages and Limitations
- Indications
- Technique including standard views and use of color Doppler
- Advantages and Limitations
- Cardiac and coronary catheter angiography
Indications
Technique including standard views and transcatheter tools (e.g. intraluminal ultrasound)
Advantages and Limitations
- Indications
- Technique including standard views and transcatheter tools (e.g. intraluminal ultrasound)
- Advantages and Limitations

# Congenital heart disease: Basic
- Cyanotic versus acyanotic presentations
- Most common lesions:
Ventricular septal defect
Patent ductus arteriosus
Atrial septal defect
Tetralogy of Fallot
Pulmonary stenosis
Obstruction of the aorta (aortic coarctation and interruption of the aorta)
Transposition of the great vessels (D- vs. L-transposition)
Endocardial cushion defect
Aortic valvular disease
Total anomalous pulmonary venous connection and Partial anomalous pulmonary venous connection
Truncus arteriosus
Vascular rings
- Ventricular septal defect
- Patent ductus arteriosus
- Atrial septal defect
- Tetralogy of Fallot
- Pulmonary stenosis
- Obstruction of the aorta (aortic coarctation and interruption of the aorta)
- Transposition of the great vessels (D- vs. L-transposition)
- Endocardial cushion defect
- Aortic valvular disease
- Total anomalous pulmonary venous connection and Partial anomalous pulmonary venous connection
- Truncus arteriosus
- Vascular rings
- Situs Anomalies and (asplenia and polysplenia)

# Unusual congenital heart disease: Advanced
- Double outlet right ventricle
- Single ventricle
- Cor Triatriatum
- Hypoplastic left heart syndrome
Aortic atresia
Mitral atresia
- Aortic atresia
- Mitral atresia
- Hyopoplastic right heart syndrome
Tricuspid atresia
Uhls anomaly
Right ventricular dysplasia
Pulmonary valve atresia
Ebsteins anomaly
- Tricuspid atresia
- Uhls anomaly
- Right ventricular dysplasia
- Pulmonary valve atresia
- Ebsteins anomaly
- Congenital absence of the pericardium
- Indications for and post-operative assessment of
Mustard
Senning
Rastelli
Fontan
Norwood
Jatene
Blalock-Taussig
Potts
Waterston-Cooley
Glenn
Rashkind
Ross Procedure
- Mustard
- Senning
- Rastelli
- Fontan
- Norwood
- Jatene
- Blalock-Taussig
- Potts
- Waterston-Cooley
- Glenn
- Rashkind
- Ross Procedure
- Late or Adult presentations of congenital heart disease
Mitral valve prolapse
Aortic stenosis (e.g. valvular and subvalvular)
Sinus of Valsalva aneurysm
Marfans syndrome
Bicuspid aortic valve
- Mitral valve prolapse
- Aortic stenosis (e.g. valvular and subvalvular)
- Sinus of Valsalva aneurysm
- Marfans syndrome
- Bicuspid aortic valve

# Ischemic heart disease
- Risk factors, primary prevention and screening
- Inducible myocardial ischemia
- Acute MI
- Chronic MI
- Post-MI complications
Cardiac rupture
LV aneurysm
Papillary muscle rupture
Congestive heart failure
Dresslers syndrome
- Cardiac rupture
- LV aneurysm
- Papillary muscle rupture
- Congestive heart failure
- Dresslers syndrome
- Myocardial viability
Stunned myocardium
Hibernating myocardium
Therapeutic and interventional options
- Stunned myocardium
- Hibernating myocardium
- Therapeutic and interventional options

# Valvular Heart Disease
- Aortic stenosis
Valvular aortic stenosis
Subvalvular aortic stenosis
Supravalvular aortic stenosis
Williams syndrome
- Valvular aortic stenosis
- Subvalvular aortic stenosis
- Supravalvular aortic stenosis
Williams syndrome
- Williams syndrome
- Aortic insufficiency
- Mitral stenosis / mitral insufficiency
Parachute mitral valve
- Parachute mitral valve
- Tricuspid stenosis / tricuspid regurgitation
- Miscellaneous:
Degenerative calcification
Calcified aortic stenosis
Mitral annular calcification
Myxomatous degeneration
Carcinoid syndrome
Infective endocarditis
Rheumatic heart disease
- Degenerative calcification
Calcified aortic stenosis
Mitral annular calcification
- Calcified aortic stenosis
- Mitral annular calcification
- Myxomatous degeneration
- Carcinoid syndrome
- Infective endocarditis
- Rheumatic heart disease
- Therapeutic and interventional options

# Cardiac and pericardial masses
- Primary lesions
Myxoma
Lipoma
Angiosarcoma
Rhabdomyoma
- Myxoma
- Lipoma
- Angiosarcoma
- Rhabdomyoma
- Metastasis
- Therapeutic and interventional options

# Acquired diseases of the thoracic aorta
- Aneurysms
Atherosclerotic
Marfans syndrome
Ehlers-Danlos syndrome
- Atherosclerotic
- Marfans syndrome
- Ehlers-Danlos syndrome
- Pseudoaneurysms
Mycotic
- Mycotic
- Post-traumatic and post-surgical
Dissection
Intramural hematoma
Aortitis
Atherosclerosis
Plaque
Penetrating ulcer
Therapeutic and interventional options
- Dissection
Intramural hematoma
- Intramural hematoma
- Aortitis
- Atherosclerosis
Plaque
Penetrating ulcer
- Plaque
- Penetrating ulcer
- Therapeutic and interventional options

# Cardiomyopathy
- Hypertrophic cardiomyopathy
Idiopathic hypertrophic subaortic stenosis
- Idiopathic hypertrophic subaortic stenosis
- Dilated Cardiomyopathy
Ischemic
Non-ischemic
- Ischemic
Non-ischemic
- Ischemic
- Non-ischemic
- Restrictive (also infiltrative) cardiomyopathy
Amyloidosis
Sarcoidosis
Storage diseases
Infection
Radiation
Therapeutic and interventional options
- Amyloidosis
Sarcoidosis
Storage diseases
Infection
Radiation
- Sarcoidosis
- Storage diseases
- Infection
- Radiation
- Therapeutic and interventional options

# Diseases of the Pericardium
- Acute pericarditis
- Constrictive pericarditis
- Pericardial effusion
- Pericardial cyst
- Pericardial defect
- Therapeutic and interventional options

# Miscellaneous
- Arrhythmogenic Right Ventricular Dysplasia (ARVD)
- Coronary artery / sinus of Valsalva aneurysm and fistula
- Pulmonary arterial hypertension
- Pulmonary embolism
- Cardiac transplantation
- Automatic Inplantable Cardioverter Defibrillator (AICD)
- Pacemakers
- RF ablation for atrial fibrillation

# Cardiovascular Protocols
- MR Angiography for Pulmonary Embolism
- Acute Chest Pain Imaging