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ST. PETER’S HEALTH PARTNERS MRI exams of the heart do require patients • Cochlear or ear implant abstain from coffee, tea, nicotine or other • Electronic or magnetically activated stimulants four hours prior to the test. implant or stimulator If a patient is claustrophobic or anxious, a sedative may be administered in advance or normal medication dosages may be increased. The patient should make • Metal fragments in the eyes or near a vital organ • Prosthesis or artificial limb • Pregnant arrangements for transportation to Not all of the above circumstances will and from the hospital. preclude your patient from having an Under normal circumstances, your patients will be able to resume their normal activities after the exam. Generally, the exam takes between 30 and 90 minutes, depending on the specific diagnostic requirements and MRI. Our team will work with you to determine their suitability for the exam. Our radiologists, technical staff, and nursing staff are board-certified and cardiac-trained. St. Peter’s Hospital is a nationally recog- for more time if multiple body parts are nized facility for cardiovascular care, and being studied. has achieved numerous awards and accolades for clinical performance and the quality of its patient care. The hospital Candidates for MRI? has been named a Top 100 Cardiovascular Because of the powerful strength of the Hospital 10 times. magnetic fields used during the scan, certain conditions may preclude some patients from the exam. For your patient’s safety, please check with a member of our team if they have had brain, eye or A Guide for Physicians Our Experienced Team patient cooperation. Patients should allow Which Patients Are Not CARDIAC MRI For More Information If you have questions, need information, or would like to refer a patient, please call us at (518) 525-1852. other recent surgeries, or if any of the following apply: • Cardiac pacemaker • Intracranial aneurysm clip 315 South Manning Boulevard Albany, New York 12208 (518) 525-1852 sphp.com | sphcs.org How Will A Cardiac MRI Help With Diagnosis? A cardiac MRI is a comprehensive, non-invasive diagnostic exam that • Myocardial infarction complications - Valvular Disease Atrial Arrhythmias aneurysms and thrombus formation • Detection, quantification, serial effect • Pulmonary vein evaluation for RF on LV function and mass ablation planning and complication • Peak velocity, pressure gradient, monitoring Heart Failure • Determination of etiology - ischemic vs. non-ischemic cardiomyopathy • Assessment of LV/RV size and function with precise quantification is safe and does not use ionizing Non-Ischemic Cardiomyopathies radiation. A routine cardiac MRI • Evaluation of dilated cardiomyopathy exam consists of dynamic evaluation of cardiac morphology and function, edema imaging, perfusion, and delayed enhancement/scar imaging. Answering Your Clinical Questions Each exam is individualized and tailored to the specific disease process and clinical question. Accurate quantitation of ejection fraction, myocardial mass, volumes, and in the setting of normal coronaries • Hypertrophic cardiomyopathy - risk stratification with extent of hypertrophy, myocardial fibrosis, and quantification planimetry, regurgitant fraction • Valve masses A cardiac MRI exam requires many short Congenital Heart Disease important for obtaining high-quality, • Diagnosis and treatment monitoring • Cardiac and great vessel morphology • Coronary artery origin evaluation for anomalies (no contrast) • Intracardiac shunts (ASD/VSD) with shunt fraction quantification (Qp:Qs) of sub-aortic gradient Ventricular Function • Infiltrative disease - sarcoid, amyloid, • Most accurate determination of hemochromatosis with T2* iron ventricular function quantification • Serial determination of LV function • Myocarditis for chemotherapy, valve disease, pulm • Arrhythmogenic right ventricular HTN, etc. (no contrast required) cardiomyopathy • Eosinophilic cardiomyopathy periods of breath holding, which are very diagnostic images. The technologist will practice this with your patient prior to beginning the exam. If your patient is unable to adequately hold their breath, the image acquisitions will be adjusted accordingly but will result in decreased quality. It is also extremely important that your patient remain very still throughout the exam, as any movement will affect image quality. In fact, motion during a single image acquisition may affect many other images and sequences, requiring that a portion of the exam be repeated. flow can be calculated. A cardiac MRI • Noncompaction How Should Patients Prepare for a Cardiac MRI? can help establish a diagnosis and assist Cardiac Masses Usually, no special preparation is needed for in treatment planning. The following are common indications for cardiac MRI: Ischemic Heart Disease • Viability assessment prior to revascular- ization (probability of functional recovery) • Location and extent of infarct including transmurality, area at risk, microvascular obstruction (areas of no-reflow) • Characterization - benign versus malignant, extent of invasion a cardiac MRI. Patients may eat normally and can take their medications as usual. • Differentiating tumor versus thrombus If your patient is taking a diuretic and is Pericardial Disease should consider taking the diuretic after • Pericardial constriction vs. restrictive cardiomyopathy • Effusion characterization and effect on LV function scheduled for a morning MRI exam, they the scan is complete.