At its advent, CT was too slow to image the heart. Temporal resolution improved with electron beam CT (EBCT); subsequently, the heart could be imaged, eventually leading to the discovery of prognostic information obtained from the coronary calcium score. In the early 2000s, EBCT was replaced by MDCT. In this review, we discuss the rise and fall of EBCT and explore its legacy in cardiac imaging. Although MDCT rendered EBCT obsolete, EBCT leaves a legacy in cardiac imaging regarding both diagnosis and prognosis. The creators of MDCT emulated the strengths of EBCT and learned from its weaknesses. Moreover, EBCT showed that imaging surrogates can predict outcomes, and the origins of substrate-guided treatment can be traced to EBCT.
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