- Cardiac MRI
- Myocardial viability assessment prior to coronary artery bypass graft (CABG) or percutaneous coronary intervention (PCI)
- Cardiac valvular evaluation
- Evaluation for myocarditis
- Evaluation for cardiac amyloid deposition
- Evaluation for cardiac sarcoidosis
- Evaluation of hypertrophic cardiomyopathy
- Evaluation of a cardiac tumor
- Coronary artery CT angiography
- Coronary artery CT calcium scoring
- Pre-Transcatheter aortic valve replacement (TAVR) CT angiography evaluation
- Pre-Radiofrequency catheter ablation (RFCA) for chronic atrial fibrillation evaluation
- Pre-Watchman procedure evaluation of left atrial appendage
- Thoracic aortic aneurysm evaluation
Cardiac MRI is performed for assessment of many different disease processes. Patients are usually sent for cardiac MRI to evaluation for myocardial ischemia (heart attack), a non-ischemic heart disease such as an infection or inflammatory condition, valve disease, or a tumor affecting the heart. Cardiac MRI may be performed in both the inpatient and outpatient settings. Examinations are usually performed both without and then with IV contrast material, which is gadolinium based for MRI. If you have an allergy to CT contrast material (iodinated contrast material) it is still likely safe to receive MRI contrast material. It is important to have your kidney function evaluated prior to receiving MRI contrast material, which can be checked with a blood test. Patients will undergo a thorough screening process prior to MRI examination to check for history of certain prosthetic/medical device implants and for history of traumatic injury resulting in retention of metallic fragments in the body.
CT angiography of the coronary arteries is a non-invasive way to evaluate for a cause of ischemic chest pain, or not enough blood flow to the heart muscle. Evaluation is usually performed with CT contrast material, which is iodine based, after administration of nitroglycerin to cause dilation of the coronary arteries. Sometimes a beta blocking agent is administered to slow the heart rate to further optimize the scan. Coronary CT angiography is a method of risk stratifying a patient’s chest pain and can help physicians decide if further testing or intervention is required.
Coronary arter y CT calcium scoring is a test designed to evaluate the burden of calcified atherosclerosis within a patient’s coronary arteries. It can be performed alone or in combination with CT angiography of the coronary arteries.
CT angiography of the heart followed by CT angiography of the chest, abdomen, and pelvis is part of the pre-procedure evaluation before a transcatheter aortic valve replacement, or TAVR. Numerous measurements of the aortic valve, its surrounding structures, and the blood vessels leading from potential procedural access sites to the valve are taken. These measurements help determine if a patient is a candidate for TAVR, and are also important for planning a TAVR procedure.
CT of the pulmonary veins is used to assess complex 3D anatomy including number, location and angulation of pulmonary veins as well as left atrial volume prior to planned RFCA of ectopic pulmonary vein electrical sites.
Cardiac CT can also be performed as a pre procedure evaluation before Watchman device placement. The Watchman device is used to protect patients with atrial fibrillation from the risk of stroke caused by blood clots forming within the heart and then travelling to the arteries supplying the brain. Much like pre-TAVR evaluation, measurements are taken from CT angiographic images of the heart to plan a Watchman device placement procedure.
Cardiac CT angiography can also be used to precisely follow the size of an aortic aneurysm in the first portion of the aorta, the ascending aorta. Regular CT imaging of the ascending aorta is affected by the normal motion occurring with each heartbeat. The techniques common to all cardiac CT examinations limit cardiac motion on the acquired images, so a cardiac CT study including the ascending aorta provides a very accurate measurement of this difficult to image blood vessel. Accurate measurements are important, because the risk of an aortic aneurysm rupture increases as aneurysm size increases.