Thoracic vascular imaging: thoracic aortic disease and pulmonary embolism

•. Multidetector CT has high specificity and sensitivity for imaging acute aortic syndrome (AAS), acute traumatic aortic injury (ATAI) and pulmonary embolism (PE).•. Variable presentation of AAS means high clinical index of suspicion is needed.•. Long-term complications of AAS are common and follow-up imaging is recommended.•. ATAI can be reliably diagnosed on CT with consideration of both direct and indirect signs.•. CT pulmonary angiography can diagnose PE, detect right heart dilatation and diagnose alternative causes of acute chest pain.Thoracic cardiovascular diseases account for high levels of morbidity and mortality in Western populations. This update will consider diseases affecting the aorta and pulmonary embolism; cardiac disease including coronary artery disease is outside the scope of this paper.