POSTER PRESENTATION Open Access

Diagnostic yield of early versus late outpatientCardiac MRI in suspected acute coronarysyndrome in patients with normal coronaryarteriesDaniel Swarbrick*, Rajiv Das, Nicholas M Child

From 16th Annual SCMR Scientific SessionsSan Francisco, CA, USA. 31 January - 3 February 2013

BackgroundCardiac MRI (CMR) is increasingly recognized as a valu-able imaging modality for the investigation of patientswith suspected acute coronary syndrome found to havenon obstructive coronary arteries on angiography. Studieshave shown that early CMR within 48 hours can facilitatediagnosis of important differential diagnoses, particularlymyocarditis. We attempted to demonstrate whether laterscanning, after 6 weeks, would still have a similar pick uprate for these diagnoses, compared with earlier CMRwithin 6 weeks.

Methods64 patients with suspected acute coronary syndromereferred for coronary angiography at a tertiary cardiaccentre who had normal coronary arteries enrolled to thestudy and were entered into a prospective registry. Allunderwent cardiac MRI. Axial black blood, multiplanarcines, STIR and delayed enhancement sequences weretaken. The first 32 patients had cardiac MRI performedafter 6 weeks, and the subsequent 32 had MRI performedwithin 6 weeks. The two groups were compared withrespect to diagnoses made on MRI, as well as demo-graphics and baseline troponin concentrations.

Results32 patients underwent CMR scanning after 6 weeks, at anaverage of 50.5 days. The final diagnoses were myocardialinfarction (36%), myocarditis (13%), Takotsubo cardio-myopathy (6%) and non-diagnostic (45%). The subsequent32 patients underwent CMR within 6 weeks, at an average

of 22.6 days. The final diagnoses in this group weremyocardial infarction (19%), myocarditis (41%), Takotsubocardiomyopathy (13%), non-diagnostic (25%) and hyper-trophic cardiomyopathy (single case).

ConclusionsOutpatient CMR performed on patients with suspectedacute coronary syndrome but with normal coronaryarteries later than 6 weeks has a lower diagnostic yieldcompared to early outpatient CMR within 6 weeks. Thepick up rate for myocarditis on CMR within 6 weeks iscomparable to that in previous studies of CMR per-formed within 48 hours of admission, suggesting that itis feasible to perform scans during this time withoutcompromising diagnostic yield.

FundingNo external funding was received.

Published: 30 January 2013

doi:10.1186/1532-429X-15-S1-E67Cite this article as: Swarbrick et al.: Diagnostic yield of early versus lateoutpatient Cardiac MRI in suspected acute coronary syndrome inpatients with normal coronary arteries. Journal of CardiovascularMagneticResonance 2013 15(Suppl 1):E67.

Cardiothoracic, Freeman Hospital, Newcastle upon Tyne, UK

Swarbrick et al. Journal of Cardiovascular MagneticResonance 2013, 15(Suppl 1):E67http://www.jcmr-online.com/content/15/S1/E67

© 2013 Swarbrick et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the CreativeCommons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, andreproduction in any medium, provided the original work is properly cited.