Cardiac MRI

MRI Jantung

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Cardiac MRI can provide detailed information about the type and severity of heart disease to help doctors decide the best treatment for heart problems such as coronary heart disease, heart valve problems, pericarditis, cardiac tumors, or damage from a heart attack. Cardiac MRI can help explain the results of other imaging tests such as chest x-rays and chest CT scans.

Cardiac MRI may be done in a medical imaging facility or hospital. Before the procedure, a contrast dye to highlight your heart and blood vessels may be injected into a vein in your arm. You may feel discomfort from the needle or a cold feeling when the contrast dye is injected. The MRI machine is a large, tunnel-like machine that has a table. You will lie still on the table and the table will slide into the machine. You will hear loud humming, tapping and buzzing sounds when you are inside the machine as pictures of your heart are being taken. You will be able to hear and talk to the technician performing the tests while you are inside the machine. The technician may ask you to hold your breath for a few seconds during the test.

Cardiac MRI has several risks. In rare cases, the contrast dye may harm people who have kidney or liver disease, or it may cause an allergic reaction. Researchers are studying whether multiple injections of contrast dye, defined as four or more, may cause other adverse effects. Talk to your doctor and the technicians who perform the tests whether you are or may be pregnant. Let your doctor know if you are breastfeeding as the contrast dye can pass into your breast milk. If you have to use an injected contrast dye, you may want to pump and store enough milk for one to two days after the test or you may bottle-feed your baby for that time. Tell your doctor if you have:

  • Pacemakers or other implanted devices because the MRI machine can damage these devices.
  • Metal inside your body from previous surgeries because it can interfere with the MRI machine.
  • Metal on your body from piercings, jewellery, or some transdermal skin patches because they can interfere with the MRI machine or cause skin burns. Tattoos may also cause problems because old tattoo inks may contain small amounts of the metal.

What is Cardiac MRI? 

Magnetic resonance imaging (MRI) is a safe and noninvasive test that produces detailed images of organs and tissues. “Noninvasive” means no surgery is performed and no instruments are inserted into your body.

An MRI uses radio waves, magnets, and a computer to create images of your organs and tissues. Unlike other imaging tests, MRI does not use ionizing radiation or carry a risk of causing cancer.

Cardiac MRI produces both still and moving pictures of your heart and main blood vessels. Doctors use an MRI of the heart to get pictures of a beating heart and see its structure and function. These images can help them decide how best to treat people who have heart problems.

Cardiac MRI is a common test. MRI is used to diagnose and assess numerous diseases and conditions, including:

  • Coronary heart disease
  • Damage from a heart attack
  • Heart failure
  • Heart valve problems
  • Congenital heart defects (heart defects at birth)
  • Pericarditis (a condition in which the membrane, or sac, around your heart becomes inflamed)
  • cardiac tumor

Cardiac MRI can help explain the results of other tests, such as x-rays and computed tomography scans (also called CT scans).

In some cases, doctors may perform cardiac MRI instead of invasive procedures or tests that involve radiation (such as x rays) or dyes that contain iodine (this dye may harm people with kidney problems).

Contrast agents, such as gadolinium, may be injected into a vein during a cardiac MRI procedure. Then, the substance travels to the heart and highlights the heart and blood vessels on the MRI image. This contrast agent is often used for people who are allergic to the dye used in CT scans.

People who have severe kidney or liver problems may not be able to use contrast agents. As a result, they may undergo non-contrast MRI (MRI that does not involve a contrast agent).

What to Expect Before Cardiac MRI? 

You will be asked to fill out a form before having your cardiac MRI. You may be asked about your past surgeries or whether you have any metal medical object or device inside your body.

Several implanted medical devices, such as artificial heart valves and coronary stents, are safe near the MRI machine, but others are not. For example, an MRI machine may:

  • Cause the implanted pacemaker and defibrillator to malfunction.
  • Damage the cochlear (inner ear) implant. A cochlear implant is a small electronic device that helps people with hearing loss understand speech and sounds around them.
  • Lead to clip movements in brain aneurysm due to the powerful magnetic field. This may result in serious injury

Talk to your doctor or the technicians if you have concerns about implanted devices that may interfere with the MRI.

Your doctor will tell you if you are not able to have a cardiac MRI due to medical devices. YOu should consider wearing a medical ID bracelet or necklace or carrying a medical alert card stating that you cannot have an MRI.

If you are pregnant, make sure your doctor knows before you have your MRI procedure. No known harmful effects of MRI during pregnancy have been found; however, further research on the safety of MRI during pregnancy is still required.

Your doctor or the technicians will tell you if you need to change into a hospital gown for the test. You are not allowed to bring hearing aids, credit cards, jewelry and watches, glasses, pens, removable dental work, or anything magnetic near the MRI machine.

You should also let your doctor know if you feel anxious when you are in confined spaces. Your doctor may give you medicine to help you relax. Your doctor may ask you to fast for 6 hours before you take the medicine on the day of the test.

Some newer cardiac MRI machines are open on all sides. If you are afraid of being in tight or confined spaces, ask your doctor to find a facility that has open MRI machines.

Your doctor will tell you if you need to have someone drive you home after the test.

What to Expect During Cardiac MRI? 

Apa yang Diharapkan Selama MRI Jantung. Sumber: National Heart, Lung and Blood Institute / NIH

Cardiac MRI may be performed in a hospital or medical imaging facility. A radiologist or other doctors with special training in medical imaging may oversee the MRI test. Cardiac MRI usually takes 30 to 90 minutes — depending on how many pictures are needed to be taken. The test may be shorter if using newer MRI machines.

The MRI machine will be placed in a special room that prevents radio waves from disturbing the machine. It also prevents the MRI machine’s powerful magnetic field from interfering with other medical devices.

A conventional MRI machine looks like a long, narrow tunnel. The latest MRI machines (called the short-bore system) have wider openings and better lighting. Your doctor will help decide which type of machine is best for you. Cardiac MRI is a safe and painless procedure. You will lie on your back on a table that slides into the tunnel-like machine.

The MRI technicians will operate the machine from the next room. He will be able to see you through the glass window and talk to you through the intercom. Tell the technician if you have hearing problems.

The MRI machine makes loud humming, tapping and buzzing sounds. Some features allow you to wear earplugs or listen to music during the test. You need to stay still during the MRI. Any movement can blur the image. If you cannot lie still, you may be given medication to help you relax.

The technician may also ask you to hold your breath for 10 to 15 seconds each time while taking pictures of your heart. Researchers are studying ways that will allow someone that undergoes a cardiac MRI to still breathe comfortably during the test — while maintaining the same picture quality.

Contrast agents, such as gadolinium, may be used to highlight your blood vessels or heart in the picture. The substance is usually injected into a vein in your arm using a needle. You may feel a cool sensation during the injection and discomfort when the needle is inserted. Gadolinium does not contain iodine — meaning, it may not cause problems for people allergic to iodine.

Cardiac MRI may include a stress test to detect blockages in your coronary arteries. You may be given other medicines to increase blood flow in your heart or your heart rate.

What to Expect after Cardiac MRI? 

You may return to your normal routine after the procedure is complete.

If you take medicine to help you relax during the test, your doctor will tell you when you can return to your normal routine. The medicine may make you sleepy. It is recommended if you have someone to drive you home.

What are the Purposes of Cardiac MRI?

Magnetic Resonance Angiography. Sumber: National Heart Lung and Blood Institute (NIH)

The doctor who supervises your scan will provide your doctor with your cardiac MRI results. Then, your doctor will discuss the findings with you.

Cardiac MRI helps reveal various heart diseases and conditions, such as:

  • Coronary heart disease
  • Damage caused by a heart attack
  • Heart failure
  • Heart valve problems
  • Congenital heart defects 
  • Pericarditis (a condition in which the membrane, or sac, around your heart becomes inflamed)
  • Heart tumor

Cardiac MRI is a fast and accurate procedure that can help diagnose a heart attack. This test is performed by detecting areas of your heart that are not moving normally, have a poor blood supply, or are scarred.

Cardiac MRI can also show any blocked coronary arteries. The blockage prevents your heart muscle from getting enough oxygen-rich blood, which can lead to a heart attack.

Coronary angiography is the most common procedure to look for blockages in the coronary arteries. Coronary angiography is an invasive procedure that uses x-rays and iodine-based dyes

Researchers have found that cardiac MRI may sometimes replace coronary angiography, avoiding the need to use x-ray radiation and iodine-based dyes. The use of this type of MRI is called MR angiography (MRA).

Echocardiography (echo) is the primary test to diagnose valve heart disease. However, your doctor may also recommend cardiac MRI to assess the severity of heart valve disease.

Cardiac MRI can confirm information or provide more detailed information about heart valve disease.

This information can help your doctor plan your treatment. MRI may also be done before heart valve surgery.

Researchers are discovering new ways to use cardiac MRI. In the future, cardiac MRI may replace x-rays to guide invasive procedures such as cardiac catheterization.

Furthermore, improvements to cardiac MRI may likely lead to better methods of detecting heart disease in the future.

What Are The Risks of Cardiac MRI?

The magnetic field and radio waves used in cardiac MRI have no side effects. This method of taking pictures of organs and tissues also has no risk of causing cancer or birth defects.

Serious reactions to contrast agents used during some MRI tests are extremely rare. However, side effects may occur, such as: 

  • Headache
  • Nausea (feeling nauseous)
  • Dizziness
  • Distorted taste
  • Allergic reaction

In rare instances, contrast agents may harm people who have severe kidney or liver disease. These substances may cause a disease called nephrogenic systemic fibrosis.

If cardiac MRI includes a stress test, more medications may be used during the test. These medicines may have other side effects that are not expected during routine MRI scans, such as:

  • Arrhythmia, or irregular heartbeat
  • Chest pain
  • Shortness of breath
  • Palpitations (the feeling of your heart beating or pounding too fast or hard)

Source: StoryMD

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