{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T20:35:53Z","timestamp":1765485353380,"version":"build-2065373602"},"reference-count":48,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2009,5,14]],"date-time":"2009-05-14T00:00:00Z","timestamp":1242259200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/3.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>The immense clinical and scientific benefits of cardiovascular imaging are well-established, but are also true that 30 to 50% of all examinations are partially or totally inappropriate. Marketing messages, high patient demand and defensive medicine, lead to the vicious circle of the so-called Ulysses syndrome. Mr. Ulysses, a typical middle-aged \u201cworried-well\u201d asymptomatic subject with an A-type coronary personality, a heavy (opium) smoker, leading a stressful life, would be advised to have a cardiological check-up after 10 years of war. After a long journey across imaging laboratories, he will have stress echo, myocardial perfusion scintigraphy, PET-CT, 64-slice CT, and adenosine-MRI performed, with a cumulative cost of &gt;100 times a simple exercise-electrocardiography test and a cumulative radiation dose of &gt;4,000 chest x-rays, with a cancer risk of 1 in 100. Ulysses is tired of useless examinations, exorbitant costs. unaffordable even by the richest society, and unacceptable risks.<\/jats:p>","DOI":"10.3390\/ijerph6051649","type":"journal-article","created":{"date-parts":[[2009,5,14]],"date-time":"2009-05-14T11:34:23Z","timestamp":1242300863000},"page":"1649-1664","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["The Risks of Inappropriateness in Cardiac Imaging"],"prefix":"10.3390","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2524-6288","authenticated-orcid":false,"given":"Eugenio","family":"Picano","sequence":"first","affiliation":[{"name":"Institute of Clinical Physiology, CNR, Pisa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2009,5,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1186\/1476-7120-3-13","article-title":"Economic and biological costs of cardiac imaging","volume":"3","author":"Picano","year":"2005","journal-title":"Cardiovasc. 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