Table 1 Suggested timeline for CMR exams by expert consensus based on common clinical indications (not intended to be exhaustive and individual clinical circumstances need to be considered)
|  | Elective (wait 2–4 months) | Semi-urgent (1 week – 2 months) | Urgent (< 1 week) |
|---|---|---|---|
Cardiomyopathy | Suspected hypertrophic cardiomyopathy or follow-up for late gadolinium enhancement Family history of sudden death, arrhythmogenic cardiomyopathy, or other screening in clinically stable and asymptomatic patients Suspected dilated cardiomyopathy to assess LV function and etiology | Suspected infiltrative cardiomyopathy, depending on impact on treatment Follow-up of iron overload pending chelation therapy Family history of sudden death, arrhythmogenic cardiomyopathy, or other screening in symptomatic patients | Acute myocarditis with implications for immediate management (within 1–3 days) |
Ischemic heart disease | Stress perfusion in stable ischemic heart disease Viability for non-urgent revascularization | Stress perfusion in newly symptomatic patients Viability for revascularization in patients with recent symptoms | Ischemia and viability to guide urgent revascularization |
Masses | Suspected benign mass, unlikely to prompt urgent surgery or biopsy | Question of thrombus with non-diagnostic echo and no contraindication to empiric anticoagulation | Suspected malignancy, likely to prompt imminent surgery, biopsy, or chemotherapy Suspected intracardiac mass or thrombus with contraindication to anticoagulation or in patients with suspected embolic events |
Congenital heart disease | Follow-up of right ventricular function and pulmonary regurgitation in a clinically stable patient | Pre-interventional planning in a symptomatic patient | Information that can only be derived from CMR is needed for decision-making in an acutely ill patient |
Arrhythmia | Ablation planning for atrial fibrillation in clinically stable patients | Ablation planning for ventricular arrhythmias in clinically stable patients | Planning for urgent ablation in unstable patients |
Valvular disease | Follow up exams in aortic valve stenosis, or quantification of aortic, mitral, tricuspid or pulmonic regurgitation in clinically stable patients | Transcatheter aortic valve replacement (TAVR) planning pending procedural urgency | TAVR, aortic, mitral, tricuspid, or pulmonic regurgitation quantification, urgent surgery or percutaneous therapy planned |
Pericardial disease | Follow-up for pericarditis in asymptomatic and stable patients | Acute pericarditis evaluation leading to potential change in management in symptomatic patients | Pericardial constriction requiring potential urgent surgery |
Pulmonary hypertension | Evaluate right ventricular function for escalation of therapy in clinically stable patients | Evaluate right ventricular function for escalation of therapy in symptomatic patients | Â |
Aortic disease | Follow up dissection and/or aneurysms or repair/coarctation in stable patients | Monitoring of near intervention threshold aneurysms/coarctation | Suspected acute dissection (immediately) |