“Save the Last Dance” for Cardiovascular Magnetic Resonance

Despite high mortality, cardiovascular disease (CVD) is underestimated in autoimmune rheumatic diseases (ARDs), due to its atypical presentation. The multi-faceted nature of CVD in ARDs created the need of a dedicated outpatient cardio-rheumatic clinic. Clinical examination, rest/exercise ECG, echocardiography, nuclear techniques and cardiac catheterisation were used as first-line diagnostic tools. Although the currently used non-invasive modalities perform well in cardiology, they are unable to diagnose the complex CVD pathophysiology of ARDs. The application of cardiovascular magnetic resonance (CMR) offers some significant advantages. CMR is versatile and can be used to perform functional, stress-rest perfusion, fibrosis and evaluation of great, peripheral and coronary vessels patency, without the use of ionising radiation, allowing early diagnosis of CVD and prompting modifications of anti-rheumatic and cardiac treatment.