Early CMR imaging improves diagnosis of unexplained heart attacks

Early cardiovascular magnetic resonance (CMR) imaging can help identify the cause of heart attacks in patients who do not have blocked arteries, according to a new analysis published in JACC: Cardiovascular Imaging.

When patients experience an unexplained heart attack, known as a myocardial infarction with non-obstructive coronary arteries (MINOCA), they often undergo CMR approximately 10 days after hospital admission. One analysis found that this led to a diagnosis for 47% of patients, a number that clinicians—and patients—would love to be considerably higher.

The team behind this latest study, however, explored the potential benefit of turning to CMR after just two to four days. They tracked data from 148 patients who presented with MINOCA from December 2014 to November 2018.

Overall, early CMR helped clinicians diagnose 77% of patients—a significant increase compared to the previous study’s 47%.  

“We don’t know how much effect the improved CMR technique has, but the results suggest that with early examination more patients can get a correct diagnosis and therefore the right treatment,” principal investigator Per Tornvall, MD, PhD, a senior physician and professor at the Karolinska Institute in Sweden, said in a prepared statement. “The next step is for us to develop the CMR examination with pharmacological stress of the heart. This will enable us to study the smallest of the blood vessels and hopefully find a cause for the 23% who received no diagnosis.”

Click here to read the full study in JACC: Cardiovascular Imaging.