Nuclear cardiac imaging is a central aspect of modern cardiology and has become significantly more important as a result of technological innovations and new radiotracers. Myocardial perfusion imaging remains the most important nuclear medicine procedure for the functional diagnosis of coronary heart disease and is increasingly benefiting from cadmium-zinc-telluride (CZT) camera systems, PET tracers such as 18F-flurpiridaz, and hybrid imaging approaches. Furthermore, FDG-PET/CT has established itself as a diagnostically and prognostically relevant procedure for inflammatory heart diseases such as endocarditis and cardiac sarcoidosis and is now an integral part of international guidelines. Another focus is on cardiac amyloidosis, where skeletal scintigraphy enables noninvasive diagnosis of ATTR amyloidosis, while new PET tracers and PET/MRI approaches open up additional diagnostic possibilities. In parallel, the use of artificial intelligence in nuclear cardiology is gaining importance, particularly in automated image analysis, prognosis assessment and risk stratification. Overall, it is evident that modern nuclear medicine techniques enable more precise diagnostics and improved therapy management.
