Cardiovascular MRI is complementary to other imaging techniques, such as echocardiography, cardiac CT, and nuclear medicine. The technique has a key role in evidence-based diagnostic and therapeutic pathways in cardiovascular disease. Its applications include assessment of myocardial ischemia and viability, cardiomyopathies, myocarditis, iron overload, vascular diseases, and congenital heart disease.

It is the reference standard for the assessment of cardiac structure and function, and is valuable for diagnosis and surgical planning in complex congenital heart disease.

Combined with vasodilator stress it has a role in detecting and characterizing myocardial ischemia due to disease affecting the epicardial vessels and microvasculature. Late gadolinium enhancement (LGE) and T1 mapping allow infarction and fibrosis to be identified for characterizing cardiomyopathy and assessing viability.

Magnetic resonance angiography may be performed with or without contrast medium and is used to assess congenital or acquired abnormalities of the coronary arteries and great vessels.