CARDIAC MRI – Some Procedure Details

The heart is located in the pericardium, center of the chest cavity. On the surface of the heart muscle (myocardium) are the coronary arteries, which supply the heart muscle with oxygen and nutrients. These vessels leave the aorta at its beginning and then divide at the surface of the heart into branches around the heart.

The heart consists of right and left sides. These are separated by the cardiac septum. On each side, there is an atrium and a chamber (ventricle). At the junction between them the heart valves ensure that blood flows in only one direction.

How does the circulatory system work? The circulatory system involves the heart, vessels (arteries and veins) and organs. An artery transports blood from the heart to the organs; a vein from the organs to the heart. Through the superior and inferior vena cava, deoxygenated blood from the systemic circulation enters the right atrium and then the right ventricle. From there, the blood is pumped to the lungs via the pulmonary arteries. In the lungs, the blood is enriched with oxygen. Through the pulmonary veins, this oxygen-rich blood now enters the left atrium and then the left ventricle of the heart. From there, it is pumped into the aorta and thus into the systemic circulation.

Why is a cardiac MRI performed? Magnetic Resonance imaging (MRI) of the heart has undergone rapid development in recent years. Today it plays an important role in the diagnosis, treatment planning, and risk management of patients with heart disease. With cardiac MRI the heart anatomy can be visualized in detail and structural damage s to the heart muscle or functional disorder s of the chambers and the heart valves can be identified. Due to the high spatial and temporal resolution s, as well as excellent tissue imaging, cardiac MRI can provide excellent, highly accurate imaging and characterization of both the morphology and function of heart and vascular components. Cardiac MRI is a non-invasive procedure, does not require X-rays, allows multiple follow-up examination s, for example, to diagnose myocardial diseases. It also substitute s many invasive procedures like histological analyses after biopsy removal.

Cardiac MRI is performed by means of either special late gadolinium enhancement (LGE) images (patients are given a well-tolerated MRI contrast agent and are imaged 10–20 min later), or by means of modern mapping techniques, most of which do not require a contrast agent. These techniques can detect fibrosis , scars (e.g., after myocardial infarction), or water retention (edema) in the myocardium.

What are the applications for cardiac MRI? A cardiac MRI examination can visualize the wall movements of the heart and the blood flow in the heart valves. The pericardium is always in view. It is also possible to detect circulatory disorders of the heart muscle under stress (stress MRI).

AREAS OF APPLICATION

Follow-up examination in coronary heart disease

Bypass control examinations

Suspicion of circulatory disorders under stress

Examination of the heart valves

For which diseases is a cardiac MRI performed? Cardiac MRI enable s very precise imaging of the heart and the large vessel s. The following diseases, among others, can be clarified more clearly in a cardio-MRI:

heart muscle inflammation

heart valve defects

heart failure

coronary heart disease (CHD)

myocardial infarction

cardiac blood clots (thrombi)

diseases of the great vessels of the thorax

congenital heart defects

heart tumors

What happens during a cardiac MRI? During your cardiac MRI procedure:

You will lie very still on a table

The table will slide into the MRI device

Detailed pictures of your heart and blood vessels are taken

You’ll be instructed to hold your breath for 10–15 seconds as each picture is taken

The MRI device will make loud noises

Your technologist will communicate with you using headphones

The examination usually lasts 30–60 minutes

Do I have to be fasted for a cardio MRI? Generally, you do not need to be fasted for the examination, but it is recommended that you do not eat or drink anything for 2 hours beforehand. Before a stress MRI, you should not consume any caffeinated beverages (coffee, black tea, coke, energy drinks, etc.) or eat chocolate 12 hours prior to the exam.

Why do you have to hold your breath during cardio MRI? Breathing causes the heart to move up and down with the diaphragm. This results in blurry MRI images. You will be repeatedly given a command to hold your breath for about 10–15 seconds.

How does a stress cardiac MRI work? In a stress cardiac MRI, blood flow to the heart muscles is visualized under stress. This can detect a blood flow abnormality that only occurs under stress. Unlike a normal cardiac MRI, patients undergoing a stress MRI are injected intravenously with a drug that simulates stress to the body. The drug causes the heart rate to increase. The drug only works for a short time.

EXERCISE:

1. A cardiac MRI can be performed for the following diseases: heart muscle inflammation, heart valve defect, heart failure, coronary heart disease (CHD), myocardial infarction, cardiac blood clots (thrombi), diseases of the great vessels of the thorax, congenital heart defects, heart tumors A) True B) False

2. Generally, you are fasted for the examination and you are allowed to eat or drink anything beforehand. A) True B) False

3. When is a cardiac MRI ordered? A) Bypass control examinations B) Follow-up examination in coronary heart disease C) Examination of the heart valves D) Suspicion of circulatory disorders under stress E) Instead of a stress ECG

You’ll find the answer below.

BIBLIOGRAPHY 1. www.dict.cc

2. www.heart.org

3. www.kardio-cbf.charite.de

4. www.merriam-webster.com

5. www.radiopaedia.org

6. www.siemens-healthineers.com

CARMEN LOBITZ Carmen Lobitz ist freie Trainerin, Lehrerin und MTL. Sie gründete 1998 in Berlin lobitz seminare, die unter anderem Englischseminare für Health Professionals anbieten.

Kontakt: mail@lobitz-seminare.de

www.lobitz-seminare.de

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Lösung für Exercise:

1. A)

2. B)

3. A)–D)

CARDIAC MRI – Some Procedure Details

How does the circulatory system work?

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CARDIAC MRI – Some Procedure Details

How does the circulatory system work?

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