Non-electrocardiographically (ECG)-gated chest CT is primarily used for lung evaluation but can also reveal critical cardiovascular findings. Significant incidental cardiac findings may include chamber enlargement, cardiac shunts (both intracardiac and extracardiac), valvular disease, coronary artery disease, myocardial and pericardial abnormalities, and cardiac masses. Cardiac conditions can also cause secondary effects such as vascular changes, mediastinal lymphadenopathy, and alterations in the lung parenchyma. This chapter discusses common cardiac manifestations seen on non-ECG-gated chest CT.