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World heart day: How cardiac MR imaging plays a role in heart health

Heart disease is the leading cause of death in the United States every year.1 It is responsible for roughly one in every four deaths. Early response to heart-related symptoms may improve a patient's chance of survival. Because of this, it is important to recognize the signs of heart disease, as well as understanding the different forms of heart disease. Magnetic resonance imaging (MRI) may help to increase this understanding for physicians, though it is not the only test that might be used to assess the heart.

Know the signs

There are a few different signs of heart attack, and symptoms may vary between men and women. If a patient has any of these symptoms, they should not hesitate to contact 911. This is rather important, because early detection may improve the chances of survival.

Signs and symptoms of heart attack:2

  • Chest discomfort is one of the primary symptoms, usually in the center of the chest that either lasts more than a few minutes or go away and then return. This can feel like pressure, squeezing, fullness or pain.
  • Discomfort in the upper body can accompany a heart attack, including the arms, back, neck, jaw or stomach.
  • Shortness of breath may accompany chest discomfort or may occur on its own.
  • Other signs that could be related to a heart attack include nausea, lightheadedness or cold sweat.

Examples of heart disease

Myocarditis is an inflammation of the heart muscle, which is also known as the myocardium.3 Myocarditis can affect the heart's electrical system, in addition to the heart muscle. This condition reduces your heart's ability to pump and may cause rapid or abnormal heart rhythms (arrhythmias). Usually, myocarditis is caused by a medication, but it may also be part of a more general inflammatory condition.

Heart valve disease occurs when the heart's valves do not work correctly for any reason.4 The valves in the heart lie at the exit of each of the four heart chambers and maintain one-way blood flow through the heart. Heart valve disease can be congenital or occur during a patient's lifetime, and the cause is sometimes unknown. The classifications for heart valve disease include congenital, bicuspid aortic and acquired valve disease.

Congenital heart defects include problems with the structure of the heart, and it is often present at birth.5 Congenital heart disease is the most common type of birth defect. This condition can involve the walls, valves, arteries or veins near the heart, which can disrupt the normal flow of blood through the heart. These defects can be severe or mild. Severe defects can often be found during pregnancy or soon after birth. Parents of newborns should watch for signs of severe defects, such as rapid breathing, bluish tint to the skin, lips, and fingernails, fatigue and poor blood circulation. Many mild defects cause few or no symptoms. As such, they may not be diagnosed until children are older and may not require treatment. In some cases, congenital heart disease may start at birth, but it remains as the patients become adults.6 This can cause patients to be diagnosed later in life or have long-term treatments.

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Advancements in cardiac magnetic resonance

Cardiac MR (CMR) has a number of uses in terms of heart disease and monitoring. CMR may involve a contrast agent being injected into the patient's blood stream, depending on what the referring physician is looking for. This allows the radiologists to better differentiate between the tissues in the heart. The image produced by this may be cine, meaning it shows one cycle of the heart. This is acquired by creating an image of the different stages of the cardiac cycle over multiple cycles.

One team believes they may have a way to image the heart without the need for contrast agents, though it is still undergoing research.7 According to the team, MRI may be used to measure how the heart uses oxygen for both healthy patients and those with heart disease. They are calling this new method a cardiac functional MRI (cfMRI). They can use the MR images generated during the exam to study the activity of the heart muscle. This is done using repeated exposure to CO2 to test the functionality of the heart's blood vessels, which work to deliver oxygen to the muscle. When the concentration of CO2 is changed by the breathing machine, the blood flow will change in a normal heart.

Heart disease affects so many Americans that it is important to recognize the signs of heart problems, as well as understand some of the types of heart disease. Because of this, magnetic resonance imaging may provide a valuable method to obtain additional information, and more methods are being researched as well. Hopefully, with a better understanding of heart disease and its causes, heart disease will no longer be the leading cause of death in the U.S.

References:

  1. Heart Disease Facts. cdc.govhttps://www.cdc.gov/heartdisease/facts.htm. Last accessed September 23, 2019.
  2. Warning Signs of a Heart Attack. heart.orghttps://www.heart.org/en/health-topics/heart-attack/warning-signs-of-a-heart-attack. Last accessed September 23, 2019.
  3. Myocarditis. MayoClinic.orghttps://www.mayoclinic.org/diseases-conditions/myocarditis/symptoms-causes/syc-20352539. Last accessed September 20, 2019.
  4. Heart Disease: Heart Valve Disease. MedicineNet.comhttps://www.medicinenet.com/heart_valve_disease/article.htm. Last accessed September 20, 2019.
  5. Congenital Heart Defects. medlineplus.govhttps://medlineplus.gov/congenitalheartdefects.html. Last accessed September 20, 2019.
  6. Congenital heart disease in adults. MayoClinic.orghttps://www.mayoclinic.org/diseases-conditions/adult-congenital-heart-disease/symptoms-causes/syc-20355456. Last accessed September 25, 2019.
  7. New imaging tool for diagnosing heart disease: Researchers first to develop reliable, non-invasive cardiac functional MRI. Science Dailyhttps://www.sciencedaily.com/releases/2019/05/190530101200.htm. Last accessed September 19, 2019.