scholarly journals Society for Cardiovascular Magnetic Resonance perspective on the 2021 AHA/ACC Chest Pain Guidelines

2022 ◽  
Vol 24 (1) ◽  
Author(s):  
Andrew E. Arai ◽  
Raymond Y. Kwong ◽  
Michael Salerno ◽  
John P. Greenwood ◽  
Chiara Bucciarelli-Ducci
Keyword(s):  
Cardiovascular Magnetic Resonance ◽  
Chest Pain ◽  
Magnetic Resonance

scholarly journals Myocarditis caused by salmonella enteritidis in a healthy 19-year-old male

2021 ◽  
Vol 2 (3) ◽  
Author(s):  
Ina von Scheidt ◽  
◽  
Lena Maria Friedrich ◽  
Amadeus Altenburger ◽  
Thomas Pusl ◽  
...  
Keyword(s):  
Cardiovascular Magnetic Resonance ◽  
Chest Pain ◽  
Magnetic Resonance ◽  
Angina Pectoris ◽  
Salmonella Enteritidis ◽  
Blood Cultures ◽  
Laboratory Findings ◽  
Microbiological Testing ◽  
Possible Cause

Myocarditis caused by nontyphoidal salmonellae is very rare in immunecompetent individuals. We present a case of a previous healthy 19-year-old male suffering from chest pain. Laboratory findings, ECG, echocardiogram and blood cultures led to the diagnosis of salmonella myocarditis. Cardiovascular magnetic resonance is a promising noninvasive diagnostic tool which is useful for follow-up and might help to confirm diagnosis. In patients with diarrhea and symptoms of angina pectoris, microbiological testing should include Salmonella enteritidis as possible cause for myocarditis. Keywords: Cardiovascular magnetic resonance; endomyocardial biopsy; myocarditis; salmonella enteritidis.

Role of cardiovascular magnetic resonance in an adolescent with a giant intrapericardial mass

2020 ◽  
Vol 30 (10) ◽  
pp. 1524-1526
Author(s):  
Sylvia Krupickova ◽  
Inga Voges ◽  
Raad Mohiaddin
Keyword(s):  
Cardiovascular Magnetic Resonance ◽  
Chest Pain ◽  
Magnetic Resonance ◽  
Pericardial Effusion ◽  
Vascular Malformation ◽  
Mixed Type ◽  
Coronary Fistula ◽  
Large Pericardial Effusion ◽  
Pericardial Mass

AbstractA 14 -year-old boy presented with chest pain and breathlessness. Echocardiography showed a large pericardial effusion with cardiac tamponade features and suspicion of cardiac mass. Cardiovascular magnetic resonance demonstrated a large, well-defined pericardial mass, suggesting atypical large coronary fistula with pericardial haematoma or primary cardiac/pericardial tumour such as angiosarcoma. Histology confirmed a mixed-type vascular malformation. Sirolimus therapy was initiated.

Cardiovascular magnetic resonance

2010 ◽  
pp. 197-217 ◽  
Author(s):  
Theodoros D. Karamitsos ◽  
Stefan Neubauer
Keyword(s):  
Coronary Artery Disease ◽  
Cardiovascular Magnetic Resonance ◽  
Clinical Practice ◽  
Chest Pain ◽  
Magnetic Resonance ◽  
Ease Of Use ◽  
Cardiac Anatomy ◽  
Clinical Questions ◽  
Artery Disease ◽  
Inducible Ischaemia

Over the past decade, cardiovascular magnetic resonance (CMR) has undergone significant advancement in terms of imaging capabilities, ease of use, and speed of acquisition. A study of cardiac anatomy, function, and viability can now be completed in less than 30min with superb image quality and excellent reproducibility. This has led to widespread adoption of CMR in clinical practice. New CMR specialists and dedicated CMR units are rapidly emerging. The interventional cardiologist can now use CMR to find answers to many common clinical questions (e.g. inducible ischaemia, viability, coronary artery disease versus non-coronary causes of chest pain, etc.). Moreover, with the development of combined CMR-interventional units, interventional cardiologists are becoming an integral component of this evolving technology.

scholarly journals 087 THE USEFULNESS OF EARLY CARDIOVASCULAR MAGNETIC RESONANCE IN PATIENTS PRESENTING WITH ACUTE CHEST PAIN, POSITIVE TROPONIN AND NON-OBSTRUCTIVE CORONARY ARTERIES

Heart ◽  
2013 ◽  
Vol 99 (suppl 2) ◽  
pp. A54.1-A54
Author(s):  
V Ferreira ◽  
E Dall'Armellina ◽  
S Piechnik ◽  
T Karamitsos ◽  
J Francis ◽  
...  
Keyword(s):  
Cardiovascular Magnetic Resonance ◽  
Chest Pain ◽  
Magnetic Resonance ◽  
Coronary Arteries ◽  
Acute Chest Pain

scholarly journals Long-term clinical outcomes of troponin-positive chest pain and unobstructed coronary arteries assessed by cardiovascular magnetic resonance imaging

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
R Ananthakrishna ◽  
R Woodman ◽  
S Grover ◽  
C Bridgman ◽  
J Selvanayagam
Keyword(s):  
Heart Failure ◽  
Cardiovascular Magnetic Resonance ◽  
Chest Pain ◽  
Magnetic Resonance ◽  
Confidence Interval ◽  
Clinical Outcomes ◽  
Coronary Arteries ◽  
Hazard Ratio ◽  
All Cause Mortality

Abstract Background and introduction Troponin-positive chest pain with unobstructed coronary arteries is a distinct entity with different pathophysiological causes. We have previously reported on the incremental diagnostic capability of cardiovascular magnetic resonance (CMR) in this cohort. However, there is paucity of literature on the long-term clinical outcomes of these patients assessed with CMR. Objectives Using the unique cohort of patients previously studied, we sought to assess the long-term clinical outcomes in patients with troponin-positive chest pain and unobstructed coronary arteries, as graded by their acute CMR presentation. Methods A total of 122 consecutive patients with troponin-positive chest pain and unobstructed coronary arteries undergoing CMR assessment during the acute admission (2010–2014) were studied. The primary endpoint was major adverse cardiac event (MACE), defined as a composite of all-cause mortality and cardiovascular readmissions (heart failure, acute myocardial infarction [AMI], atrial or ventricular arrhythmia and stroke). Patients were grouped into 4 categories based on their initial CMR findings: AMI, acute myocarditis, Takotsubo cardiomyopathy and normal CMR. Results The mean age of the study cohort was 55.6±16.5 years and 56.5% were women. CMR (performed at a median of 6 days from presentation) provided a diagnosis in 87% of the patients (38% myocarditis, 28% Takotsubo cardiomyopathy and 21% AMI). Patients with a diagnosis of AMI were prescribed guideline recommended medical therapy. Over a median follow-up of 2524 days (6.9 years), 32 (26.2%) patients experienced a MACE. The all-cause mortality was 2.5%. The most common indication for cardiovascular readmissions in this cohort was heart failure (12.3%) and AMI (9%). In multivariate analysis, a CMR diagnosis of AMI (hazard ratio = 2.6; 95% confidence interval = 1.2, 5.7; p=0.019) and peak troponin (hazard ratio = 1.0003; 95% confidence interval = 1.00003, 1.0006; p=0.028) were significantly associated with MACE after adjusting for age and gender. In addition, CMR diagnosis of AMI was significantly associated with a lower event-free survival rate compared with a diagnosis of non-AMI (adjusted hazard ratio = 2.57, p=0.019) (Figure). Conclusions The long-term prognosis of patients with troponin-positive chest pain and unobstructed coronary arteries is not benign. CMR diagnosis of AMI is a significant predictor of MACE even in the absence of significant coronary artery obstruction and despite guideline recommended post AMI therapy. Figure 1 Funding Acknowledgement Type of funding source: None

scholarly journals Combined single-session cardiovascular magnetic resonance: stress perfusion and three-dimensional pulmonary vein angiography for stratification of atrial fibrillation patients with chest pain syndromes prior to catheter ablation

EP Europace ◽  
2019 ◽  
Vol 21 (12) ◽  
pp. 1809-1816
Author(s):  
Sabrina Oebel ◽  
Ingo Paetsch ◽  
Clara Stegmann ◽  
Simon Kircher ◽  
Philipp Sommer ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cardiovascular Magnetic Resonance ◽  
Chest Pain ◽  
Magnetic Resonance ◽  
Pulmonary Vein ◽  
Three Dimensional ◽  
Stress Perfusion ◽  
Single Session ◽  
Pain Syndromes ◽  
Adenosine Stress Perfusion

Abstract Aims  To determine the clinical utility of a combined single-session cardiovascular magnetic resonance (CMR) imaging protocol integrating adenosine stress perfusion and three-dimensional pulmonary vein angiography for stratification of atrial fibrillation (AF) patients referred for pulmonary vein isolation (PVI) and complaining about chest pain syndromes. Methods and results  The preprocedural CMR examination (adenosine stress perfusion, late gadolinium enhancement, and three-dimensional pulmonary vein angiography) was performed in 357 consecutive AF patients with chest pain syndromes referred for PVI. Stress perfusion results were used for stratification: ischaemia positive patients underwent invasive coronary angiography, ischaemia negative patients underwent PVI, and follow-up/outcome data were collected (combined primary endpoint of cardiac death/non-fatal myocardial infarction). The integrated CMR protocol had a high success rate (356/357, 99.7%), a short total examination duration (<30 min in all patients), and delivered high-quality three-dimensional pulmonary vein angiography in all patients undergoing PVI (324/324, 100%). Variants of pulmonary vein anatomy were identified in 33% of all patients (117/357). Stress positivity (28/356, 8%) had a high positive predictive value for identification of obstructive coronary artery disease (86%), while stress negativity carried a low short-term event rate following PVI (cumulative 1-year event-free survival rate, 99.6%). Conclusion  Combined single-session CMR as a routine diagnostic workup for AF patients with chest pain syndromes prior to PVI proved to represent a time-efficient and effective stratification tool.

scholarly journals Feasibility of fast cardiovascular magnetic resonance strain imaging in patients presenting with acute chest pain

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0251040
Author(s):  
Johannes H. Riffel ◽  
Deborah Siry ◽  
Janek Salatzki ◽  
Florian Andre ◽  
Marco Ochs ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Cardiovascular Magnetic Resonance ◽  
Chest Pain ◽  
Coronary Artery ◽  
Magnetic Resonance ◽  
Obstructive Coronary Artery Disease ◽  
Acute Chest Pain ◽  
Final Diagnosis ◽  
Strain Imaging ◽  
Artery Disease

Background Cardiovascular magnetic resonance (CMR) is the current reference standard for the quantitative assessment of ventricular function. Fast Strain-ENCoded (fSENC)-CMR imaging allows for the assessment of myocardial deformation within a single heartbeat. The aim of this pilot study was to identify obstructive coronary artery disease (oCAD) with fSENC-CMR in patients presenting with new onset of chest pain. Methods and results In 108 patients presenting with acute chest pain, we performed fSENC-CMR after initial clinical assessment in the emergency department. The final clinical diagnosis, for which cardiology-trained physicians used clinical information, serial high-sensitive Troponin T (hscTnT) values and—if necessary—further diagnostic tests, served as the standard of truth. oCAD was defined as flow-limiting CAD as confirmed by coronary angiography with typical angina or hscTnT dynamics. Diagnoses were divided into three groups: 0: non-cardiac, 1: oCAD, 2: cardiac, non-oCAD. The visual analysis of fSENC bull´s eye maps (blinded to final diagnosis) resulted in a sensitivity of 82% and specificity of 87%, as well as a negative predictive value of 96% for identification of oCAD. Both, global circumferential strain (GCS) and global longitudinal strain (GLS) accurately identified oCAD (area under the curve/AUC: GCS 0.867; GLS 0.874; p<0.0001 for both), outperforming ECG, hscTnT dynamics and EF. Furthermore, the fSENC analysis on a segmental basis revealed that the number of segments with impaired strain was significantly associated with the patient´s final diagnosis (p<0.05 for all comparisons). Conclusion In patients with acute chest pain, myocardial strain imaging with fSENC-CMR may serve as a fast and accurate diagnostic tool for ruling out obstructive coronary artery disease.

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