Abstract
This brief review intends to highlight how heterogeneous the world is regarding cardiovascular mortality and overall use of nuclear cardiology, especially in the developing world where mortality remains high. This was one of the important topics discussed during ASNC2017 in Kansas City, USA. Despite the challenges appropriate use of nuclear cardiology could be helpful to estimate risk and guide patient management bringing opportunities to the developing world. In addition we briefly list key issues which could serve as a guide to foster the development of nuclear cardiology, including the imperative need to avoid unnecessary revascularizations which might be even more challenging with increased use of non-invasive diagnosis of disease by computed tomography.