Table 1 Indication for CMR by frequency of referral
From: Cardiac MRI improves cardiovascular risk stratification in hazardous occupations
Categorya | Subtype/Description | CMR clinical question |
|---|---|---|
Ventricular ectopyb | > 2% ectopy on 24 h Holter ECG following the finding of ≥2 VEs on 12 lead ECG (25 mm/s) | ?cardiomyopathy/scar |
> 2% ectopy on 24 h Holter ECG performed for other reason | ?cardiomyopathy/scar | |
ECG appearances consistent with cardiomyopathy | Pathological TWI; LVH with marked strain pattern; bundle branch block | ?cardiomyopathy/scar |
Structural changes on echo suggestive of possible cardiomyopathyc | Chamber dilatation and mild reduction in resting systolic function | ?cardiomyopathy/scar |
Left or right ventricular hypertrophy/cardiomyopathy | ?cardiomyopathy/scar | |
Chest pain | History of chest pain and elevated troponin, +/− ischaemic ECG changes | ?myocardial infarction/?pattern more consistent with myocarditis/?inducible ischaemia |
ECG consistent with possible coronary artery disease | Q-waves, ST segment and T-wave changes, abnormal R-wave amplitude | ?myocardial infarction/?inducible ischaemia/?wall thinning/?RWMA/?ventricular aneurysm |
Abnormal findings on exercise ECG stress test | ST changes; tachyarrhythmia; bundle branch block or other conduction abnormality; development of hypotension or failure to increase SBP | ?cardiomyopathy/scar/?inducible ischaemia |
Coronary artery disease | Previously diagnosed | LV function/?RWMA/?myocardial infarction/inducible ischaemia and viability |
Bicuspid aortic valve | Previously diagnosed | ?aortopathy; valve appearance/stenosis; |
Other | Including: shortness of breath; pre-syncope; palpitations; family history of cardiomyopathy; CMR as part of cardiovascular work-up following another diagnosis - T2DM | ?cardiomyopathy/scar/?inducible ischaemia |