Myocardial viability can be assessed by multiple techniques each of which has pros and cons. Cardiac MRI is a noninvasive and nonradiation-based technique. It looks at wall thickness, myocardial perfusion, delayed enhancement and contractile reserve.

The ability to look at all these parameters makes it extremely sensitive and specific compared to all the other competing techniques. MRI scanners are now available across the length and breadth of the country. The scan requires only 1 hour and is extremely cost-effective. I would consider cardiac MRI as the gold standard for the assessment of myocardial viability.