Kurzfassung

Objective:
To assess the diagnostic value of cardiac MRI in patients with acute chest pain, elevated cardiac enzymes, and a negative coronary angiogram.

Methods:
This study included a total of 125 patients treated in the chest pain unit during a 39-month period. Each included patient underwent MR imaging within a median of 3 days after cardiac catheterization. The MR imaging protocol comprised Cine-, oedema-sensitive, and late Gadolinium-enhancement imaging. The standard of reference was a...Objective:
To assess the diagnostic value of cardiac MRI in patients with acute chest pain, elevated cardiac enzymes, and a negative coronary angiogram.

Methods:
This study included a total of 125 patients treated in the chest pain unit during a 39-month period. Each included patient underwent MR imaging within a median of 3 days after cardiac catheterization. The MR imaging protocol comprised Cine-, oedema-sensitive, and late Gadolinium-enhancement imaging. The standard of reference was a consensus diagnosis based on clinical follow-up and the synopsis of all clinical, laboratory, and imaging data.

Results:
MRI revealed a multitude of diagnoses, including ischemic cardiomyopathy, dilated cardiomyopathy, myocarditis, Takotsubo cardiomyopathy, hypertensive heart disease, hypertrophic cardiomyopathy, cardiac amyloidosis, and non-compaction cardiomyopathy. MRI-based diagnoses were the same as the final reference diagnoses in 113/125 patients (90%), with the two diagnoses differing in only 12/125 patients. In two patients, no final diagnosis could be established.

Conclusions:
Cardiac MRI performed early after the onset of symptoms revealed a broad spectrum of diseases. Cardiac MRI delivered a correct final diagnosis in 90% of patients with acute chest pain, elevated cardiac enzymes, and a negative coronary angiogram.
Advances in knowledge: Diagnosing patients with acute coronary syndrome but unobstructed coronary arteries remains a challenge for cardiologists. Cardiac MRI performed early after catheterization reveals a broad spectrum of diseases with only a simple and quick examination protocol, and there is a high concordance between MRI-based diagnoses and final reference diagnoses» weiterlesen» einklappen