Heart MRI Testing

Heart MRI Testing –A Powerful Test to Monitor Coronary Artery Disease

I would like to start off by say I think there is too much diagnostic testing going on. Tests are being ordered when cardiologist should be treating the patient symptoms. New research from the European Society of Cardiology explains that most patients with suspected coronary disease undergo invasive procedures without having preliminary effective screening.

But let’s say you have coronary artery disease(CAD) or looking for CAD. What would be the best test to monitor progressions? Let’s look at the options and discuss the drawbacks.

1. ECG: Well it is a one-time snap shot of your heart and will show if you may have had a previous heart attack or if you have a type of arrhythmia present. Further investigation will be definitely required.

2. Stress test: Great to see your fitness level and see how your heart rhythm responds to exercise. The drawback is that it will only show advanced stages of coronary artery disease. Patient could get a clean bill of health with disease present.

3. Myocardial Perfusion Scan: Also known as a MIBI scan or Thallium scan. Great test to see distribution of dye which will allow us to see how the blood flows in the heart. Drawback is that it involves an immense amount of radiation and of course there is radioactive material in your blood stream. My issue with this test is when patients are being prescribed this test when they have no symptoms of coronary artery disease.

4. Angiography: can be non-invasive as a CT (computed tomography) scan or invasive where the interventional cardiologist may perform an intervention such as a stent right away. Drawbacks are yes it does involve radiation but does provide good education to coronary blood flow as it is the gold standard. Not everyone can get this test and a lot of people may jump to this test (invasive test) and obstructive coronary disease is found to be present in less than 40% of patients undergoing invasive coronary angiography.

5. Cardiac MRI: This test allows physicians to examine the structures and function of the heart and major vessels without risks like exposure to radiation typically associated with traditional. Just that they don’t offer this test often as there can be a little wait time.

Really what is the end game? You have to ask your doctors this. Some clear examples:
1. Stent or bypass. It will not prolong your life with coronary artery disease however will improve your quality of life if you have symptoms of heart disease.
2. Medication therapy. Obviously it is well researched as to the benefits of symptom and disease management.
3. My favourite lifestyle intervention. No bias here but of course well researched to prevent and reverse disease process.

The latest study from University of Washington published in the Journal of American College of Cardiology found that invasive treatment with cholesterol drugs significantly reduced the amount of cholesterol in artery-clogging plaque. My bias of course is let’s try some different groups of lifestyle intervention. The purpose is not the drugs but the technique used, MRI (magnetic resonance imaging). MRI scanning could become a powerful new tool for assessing how well cholesterol drugs are working or for that matter whatever technique you are using. Imaging technologies traditionally used to monitor cardiovascular disease, such as angiograms and ultrasounds, show the overall size of the plaque buildup. In the new study, MRI scans were more precise, showing the amount of cholesterol within the plaque.

As always I appreciate your comments.

To your heart health success,

Diamond Fernandes

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