Name of the Procedure:

Cardiac Magnetic Resonance Imaging (MRI) for Morphology and Function without Contrast Material(s), followed by Contrast Material(s) and Further Sequences; with Stress Imaging

Summary

Cardiac MRI is a non-invasive imaging procedure used to visualize the structure and function of the heart. Initially, images are taken without contrast material, followed by the administration of contrast material to enhance visualization. The procedure may include stress imaging to assess how well the heart functions under stress.

Purpose

Cardiac MRI is used to diagnose and monitor various heart conditions. It helps in assessing the heart's anatomy, identifying abnormalities, and evaluating the function of heart chambers and valves. The stress imaging component helps determine how well the heart handles physical stress, which is crucial for diagnosing conditions like coronary artery disease.

Indications

• Suspected coronary artery disease
• Cardiomyopathy (heart muscle disease)
• Heart valve disease
• Congenital heart defects
• Myocardial infarction (heart attack)
• Unexplained chest pains
• Abnormal findings from other diagnostic tests

Preparation

• Fasting for at least 4-6 hours prior to the procedure.
• Avoid caffeine and nicotine 24 hours before the test.
• Inform your doctor of any medications or allergies.
• Pre-procedure assessments may include blood tests and a detailed medical history review.

Procedure Description

1. The patient changes into a hospital gown and removes all metal objects.
2. The patient lies on the MRI table, and electrodes are placed on the chest to monitor heart activity.
3. Initial MRI scans are performed without contrast material.
4. Contrast material is injected into a vein to improve image clarity.
5. Additional MRI scans are taken.
6. For the stress imaging part, the patient is given a medication that makes the heart work harder, simulating exercise.
7. Further MRI scans are conducted to capture images of the stressed heart.
8. Throughout the procedure, the patient lies still and follows breathing instructions.

Duration

The entire procedure usually takes between 60 to 90 minutes.

Setting

Cardiac MRI is performed in a hospital radiology department or an outpatient imaging center equipped with an MRI machine.

Personnel

• Cardiologist
• Radiologist
• MRI Technician
• Nurse

Risks and Complications

• Discomfort from lying still for an extended period
• Allergic reaction to contrast material (rare)
• Feelings of claustrophobia in the MRI machine
• Potential arrhythmia or chest discomfort during stress imaging

Benefits

• Detailed and accurate images of heart structure and function
• Non-invasive with no radiation exposure
• Enhanced detection of heart abnormalities
• Provides valuable information for treatment planning

Recovery

• Most patients can resume normal activities immediately.
• Hydrate well to help flush out the contrast material.
• Follow-up appointments may be scheduled to discuss results and plan further management.

Alternatives

• Echocardiography: Less detailed images but readily available.
• Computed Tomography (CT) Cardiac Imaging: Involves radiation exposure.
• Nuclear Stress Test: Provides functional information but involves radiation.
• Each alternative has its pros and cons in terms of detail, radiation exposure, and availability.

Patient Experience

During the procedure, the patient may feel coolness from the contrast injection and slight discomfort from lying still. Stress imaging medication may cause temporary symptoms like a racing heart. After the procedure, there is typically no pain, and normal activities can generally be resumed immediately. Comfort measures include communication with the MRI technician and earplugs to reduce noise from the MRI machine.