Contrast-enhanced cardiac MRI suggested myocardial infarction in 8 patients presenting with acute coronary syndrome, elevated troponin, and mild or absent coronary artery disease.
Observational (n=8)
Does contrast-enhanced cardiac MRI identify myocardial infarction in patients presenting with acute coronary syndrome and normal or mild coronary artery disease?
Contrast-enhanced cardiac MRI may be useful for identifying myocardial infarction in patients presenting with acute coronary syndrome who have normal or mild coronary artery disease on angiography.
We recently cared for several patients with chest discomfort characteristic of coronary disease, electrocardiogram (ECG) changes, and increasing troponin concentrations. Coronary angiography revealed mild or no coronary artery disease (CAD), so we evaluated these patients with contrast-enhanced cardiac MRI. Our data suggest that these patients had myocardial infarction (MI). With Institutional Review Board permission, we reviewed our angiography database for patients with normal coronary arteries or mild coronary artery disease during the period from January 2005 to November 1, 2006, to augment those cases we found clinically. Inclusion criteria included presentation with acute coronary syndrome, increased serum troponin T concentration (>0.01 μg/L), or mild or absent CAD by angiography and a contrast-enhanced cardiac MRI (CE-CMR) considered diagnostic for infarction. Patients with prior infarction, known CAD, heart failure, pulmonary embolism, or suspected pericarditis/myocarditis were excluded. Eight patients met these criteria. All angiogram results were reviewed by one of the investigators (V.M.). CE-CMR studies performed on a GE Signa CVi system …
Martinez et al. (2007) conducted an observational in Myocardial infarction with normal coronary arteries (n=8). Contrast-enhanced cardiac MRI was evaluated. Contrast-enhanced cardiac MRI suggested myocardial infarction in 8 patients presenting with acute coronary syndrome, elevated troponin, and mild or absent coronary artery disease.