Unusual use of magnetic resonance imaging in diagnosis of myocardial infarction

Panovský, Roman; Feitová, Věra; Poloková, Karin; Kincl, Vladimír; Meluzı́n, Jaroslav; Hlinomaz, Ota; Sikora, Jiří

doi:10.33678/cor.2011.160

Cited by 1 publication

(1 citation statement)

References 11 publications

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“…However, independently of IVUS or OCT results, the diagnosis should be confirmed by other methods. CMR with scar (and/or oedema) visualization is a perfect choice in these situations [ 26 , 27 ]. A subendocardial or transmural LGE pattern in a corresponding coronary artery section leads to the correct diagnosis with subsequent therapeutic consequences and patient follow-up.…”

Section: Discussionmentioning

confidence: 99%

The unique value of cardiovascular magnetic resonance in patients with suspected acute coronary syndrome and culprit-free coronary angiograms

Panovský

Borová

Pleva

et al. 2017

BMC Cardiovasc Disord

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BackgroundPatients with chest pain, elevated troponin, and unobstructed coronary disease present a clinical dilemma. The purpose of this study was to investigate the incremental diagnostic value of cardiovascular magnetic resonance (CMR) in a cohort of patients with suspected acute coronary syndrome (ACS) and unobstructed coronary arteries.ResultsData files of patients meeting the inclusion criteria in two cardiology centres were searched and analysed. The inclusion criteria included: 1) thoracic pain suspected with ACS; 2) a significant increase in the high-sensitive Troponin T value; 3) ECG changes; 4) coronary arteries without any significant stenosis; 5) a CMR examination included in the diagnostic process; 6) an uncertain diagnosis before the CMR exam; and 7) the absence of known CMR and contrast media contraindications. Special attention was paid to the benefits of CMR in determining the final diagnosis.In total, 136 patients who underwent coronary angiography for chest pain were analysed. The most frequent underlying causes were myocarditis (38%) and perimyocarditis (18%), followed by angiographically unrecognised acute myocardial infarction (18%) and Takotsubo cardiomyopathy (15%). The final diagnosis remained unclear in 6% of the patients. The contribution of CMR in determining the final diagnosis determination was crucial in 57% of the patients. In another 35% of the patients, CMR confirmed the suspicion and, only 8% of the CMR examinations did not help at all and had no influence on diagnosis or treatment.ConclusionCMR provided a powerful incremental diagnostic value in the cohort of patients with suspected ACS and unobstructed coronary arteries. CMR is highly recommended to be incorporated as an inalienable part of the diagnostic algorithms in these patients.

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Section: Discussionmentioning

confidence: 99%