Skip to main content
SpringerLink
Log in

Use of Magnetic Resonance Imaging for Evaluation of Patients with Chest Pain

  • Chapter
  • First Online:
Short Stay Management of Chest Pain

Part of the book series: Contemporary Cardiology ((CONCARD))

  • 402 Accesses

Abstract

As a noninvasive test without radiation exposure that allows for excellent tissue characteristics, magnetic resonance imaging (MRI) may aid in the triage of patients with acute chest pain (CP) in the emergency department (ED) but, use to date has been limited by the sparse number of studies attempting to define its roles as well lack of availability. The American Heart Association (AHA) guidelines on acute coronary syndrome (ACS) recommend a noninvasive approach for patients with severe comorbidities and a low likelihood of ACS (Gibler et al., Circulation, 11, 2699–710, 2005). Cardiac magnetic resonance (CMR), in addition to diagnosing ischemic heart disease by showing subtle wall motion abnormalities, reversible myocardial damage, edema, and necrotic myocardium, can aid in the assessment of patients who present with atypical symptoms or define alternative diagnoses (Saremi, Radiology, 282(1), 17–32, 2017; Baritussio et al., Int J Cardiovasc Imaging, 34, 67–80, 2018). CMR may have a role in the triage of patients presenting to the ED with CP, especially to reduce hospital admissions and costs (Kwong and Arai, Crit Pathw Cardiol, 3(1), 25–31, 2004; Shapiro et al., Top Magn Reson Imaging, 19, 25–32, 2008).

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Broncano J, Bhalla S, Caro P, Hidalgo A, Vargas D, Williamson E, et al. Cardiac MRI in patients with acute chest pain. Radiographics. 2021;41(1):8–31.

    Article  PubMed  Google Scholar 

  2. Kwong RY, Arai AE. Detecting patients with acute coronary syndrome in the chest pain center of the emergency department with cardiac magnetic resonance imaging. Crit Pathw Cardiol. 2004;3(1):25–31.

    Article  PubMed  Google Scholar 

  3. Chung SM. Safety issues in magnetic resonance imaging. J Neuroophthalmol. 2002;22(1):35–9.

    Article  PubMed  Google Scholar 

  4. Patenaude Y, Pugash D, Lim K, Morin L, Diagnostic Imaging C, Lim K, et al. The use of magnetic resonance imaging in the obstetric patient. J Obstet Gynaecol Can. 2014;36(4):349–63.

    Article  PubMed  Google Scholar 

  5. Ponrartana S, Moore MM, Chan SS, Victoria T, Dillman JR, Chavhan GB. Safety issues related to intravenous contrast agent use in magnetic resonance imaging. Pediatr Radiol. 2021;51(5):736–47.

    Article  PubMed  Google Scholar 

  6. Carr JJ. Magnetic resonance contrast agents for neuroimaging. Safety issues. Neuroimaging Clin N Am. 1994;4(1):43–54.

    CAS  PubMed  Google Scholar 

  7. Gibler WB, Cannon CP, Blomkalns AL, Char DM, Drew BJ, Hollander JE, et al. Practical implementation of the guidelines for unstable angina/non-ST-segment elevation myocardial infarction in the emergency department: a scientific statement from the American Heart Association Council on Clinical Cardiology (Subcommittee on Acute Cardiac Care), Council on Cardiovascular Nursing, and Quality of Care and Outcomes Research Interdisciplinary Working Group, in Collaboration With the Society of Chest Pain Centers. Circulation. 2005;111(20):2699–710.

    Article  PubMed  Google Scholar 

  8. Agewall S, Beltrame JF, Reynolds HR, Niessner A, Rosano G, Caforio AL, et al. ESC Working Group position paper on myocardial infarction with non-obstructive coronary arteries. Eur Heart J. 2017;38(3):143–53.

    PubMed  Google Scholar 

  9. Shapiro MD, Guarraia DL, Moloo J, Cury RC. Evaluation of acute coronary syndromes by cardiac magnetic resonance imaging. Top Magn Reson Imaging. 2008;19(1):25–32.

    Article  PubMed  Google Scholar 

  10. Ingkanisorn WP, Kwong RY, Bohme NS, Geller NL, Rhoads KL, Dyke CK, et al. Prognosis of negative adenosine stress magnetic resonance in patients presenting to an emergency department with chest pain. J Am Coll Cardiol. 2006;47(7):1427–32.

    Article  PubMed  Google Scholar 

  11. Heitner JF, Klem I, Rasheed D, Chandra A, Kim HW, Van Assche LM, et al. Stress cardiac MR imaging compared with stress echocardiography in the early evaluation of patients who present to the emergency department with intermediate-risk chest pain. Radiology. 2014;271(1):56–64.

    Article  PubMed  Google Scholar 

  12. Kefer J, Coche E, Legros G, Pasquet A, Grandin C, Van Beers BE, et al. Head-to-head comparison of three-dimensional navigator-gated magnetic resonance imaging and 16-slice computed tomography to detect coronary artery stenosis in patients. J Am Coll Cardiol. 2005;46(1):92–100.

    Article  PubMed  Google Scholar 

  13. Gerber BL, Coche E, Pasquet A, Ketelslegers E, Vancraeynest D, Grandin C, et al. Coronary artery stenosis: direct comparison of four-section multi-detector row CT and 3D navigator MR imaging for detection--initial results. Radiology. 2005;234(1):98–108.

    Article  PubMed  Google Scholar 

  14. Muller MF, Fleisch M, Kroeker R, Chatterjee T, Meier B, Vock P. Proximal coronary artery stenosis: three-dimensional MRI with fat saturation and navigator echo. J Magn Reson Imaging. 1997;7(4):644–51.

    Article  CAS  PubMed  Google Scholar 

  15. Kim WY, Danias PG, Stuber M, Flamm SD, Plein S, Nagel E, et al. Coronary magnetic resonance angiography for the detection of coronary stenoses. N Engl J Med. 2001;345(26):1863–9.

    Article  CAS  PubMed  Google Scholar 

  16. Kessler W, Achenbach S, Moshage W, Zink D, Kroeker R, Nitz W, et al. Usefulness of respiratory gated magnetic resonance coronary angiography in assessing narrowings > or = 50% in diameter in native coronary arteries and in aortocoronary bypass conduits. Am J Cardiol. 1997;80(8):989–93.

    Article  CAS  PubMed  Google Scholar 

  17. Nikolaou K, Huber A, Knez A, Becker C, Bruening R, Reiser M. Intraindividual comparison of contrast-enhanced electron-beam computed tomography and navigator-echo-based magnetic resonance imaging for noninvasive coronary artery angiography. Eur Radiol. 2002;12(7):1663–71.

    Article  PubMed  Google Scholar 

  18. Tornvall P, Gerbaud E, Behaghel A, Chopard R, Collste O, Laraudogoitia E, et al. Myocarditis or “true” infarction by cardiac magnetic resonance in patients with a clinical diagnosis of myocardial infarction without obstructive coronary disease: a meta-analysis of individual patient data. Atherosclerosis. 2015;241(1):87–91.

    Article  CAS  PubMed  Google Scholar 

  19. Abu Mouch S, Roguin A, Hellou E, Ishai A, Shoshan U, Mahamid L, et al. Myocarditis following COVID-19 mRNA vaccination. Vaccine. 2021;39(29):3790–3.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Rafiee MJ, Babaki Fard F, Friedrich MG. COVID-19, myocardial edema and dexamethasone. Med Hypotheses. 2020;145:110307.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Dastidar AG, Rodrigues JC, Ahmed N, Baritussio A, Bucciarelli-Ducci C. The role of cardiac MRI in patients with troponin-positive chest pain and unobstructed coronary arteries. Curr Cardiovasc Imaging Rep. 2015;8(8):28.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Madhavan M, Prasad A. Proposed Mayo Clinic criteria for the diagnosis of Tako-Tsubo cardiomyopathy and long-term prognosis. Herz. 2010;35(4):240–3.

    Article  CAS  PubMed  Google Scholar 

  23. Shiga T, Wajima Z, Apfel CC, Inoue T, Ohe Y. Diagnostic accuracy of transesophageal echocardiography, helical computed tomography, and magnetic resonance imaging for suspected thoracic aortic dissection: systematic review and meta-analysis. Arch Intern Med. 2006;166(13):1350–6.

    Article  PubMed  Google Scholar 

  24. Stein PD, Fowler SE, Goodman LR, Gottschalk A, Hales CA, Hull RD, et al. Multidetector computed tomography for acute pulmonary embolism. N Engl J Med. 2006;354(22):2317–27.

    Article  CAS  PubMed  Google Scholar 

  25. Stein PD, Chenevert TL, Fowler SE, Goodman LR, Gottschalk A, Hales CA, et al. Gadolinium-enhanced magnetic resonance angiography for pulmonary embolism: a multicenter prospective study (PIOPED III). Ann Intern Med. 2010;152(7):434–43, W142–3.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Revel MP, Sanchez O, Couchon S, Planquette B, Hernigou A, Niarra R, et al. Diagnostic accuracy of magnetic resonance imaging for an acute pulmonary embolism: results of the ‘IRM-EP’ study. J Thromb Haemost. 2012;10(5):743–50.

    Article  CAS  PubMed  Google Scholar 

Suggested Reading

  • Saremi F, Cardiac MR. Imaging in acute coronary syndrome: application and image interpretation. Radiology. 2017;282(1):17–32.

    Article  PubMed  Google Scholar 

  • Baritussio A, Scatteia A, Bucciarelli-Ducci C. Role of cardiovascular magnetic resonance in acute and chronic ischemic heart disease. Int J Cardiovasc Imaging. 2018;34(1):67–80.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Emergency Medicine, Wayne State University, Detroit, MI, USA

    Vijaya Arun Kumar & Brian O’Neil

Authors
  1. Vijaya Arun Kumar
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Brian O’Neil
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Brian O’Neil .

Editor information

Editors and Affiliations

  1. School of Medicine, Wayne State University, Grosse Pointe Park, MI, USA

    Margarita Pena

  2. School of Medicine, Emory University, Decatur, GA, USA

    Anwar Osborne

  3. Baylor College of Medicine, Houston, TX, USA

    W. Frank Peacock

Rights and permissions

Reprints and permissions

Copyright information

© 2022 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Kumar, V.A., O’Neil, B. (2022). Use of Magnetic Resonance Imaging for Evaluation of Patients with Chest Pain. In: Pena, M., Osborne, A., Peacock, W.F. (eds) Short Stay Management of Chest Pain. Contemporary Cardiology. Humana, Cham. https://doi.org/10.1007/978-3-031-05520-1_16

Download citation

  • DOI: https://doi.org/10.1007/978-3-031-05520-1_16

  • Published:

  • Publisher Name: Humana, Cham

  • Print ISBN: 978-3-031-05519-5

  • Online ISBN: 978-3-031-05520-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation