Echocardiogram

What is an echocardiogram?

An echocardiogram is an ultrasound scan of the heart. It is sometimes just called an 'ECHO'. Ultrasound is a very high-frequency sound that you cannot hear, but it can be emitted and detected by special machines. The scan can give accurate pictures of the heart muscle, the heart chambers, and structures within the heart such as the valves.

 

Why is an echocardiogram done?

An ECHO can be carried out for many different reasons. It may be done to check how well your heart is working after a heart attack, or to look at how well the valves are moving inside the heart. An ECHO can also help to see any fluid that may have collected around the heart.

 

What happens during the test?

You will need to undress to the waist and lie on the couch. A probe is placed on your chest (it is a bit like a very thick blunt pen). Also, lubricating jelly is put on your chest so the probe makes good contact with the skin. The probe is connected by a wire to the ultrasound machine and monitor. Pulses of ultrasound are sent from the probe through the skin towards your heart. The ultrasound waves then echo ('bounce back') from the heart and various structures in the heart.

The amount of ultrasound that echoes back depends on the density of the tissue the sound has hit. Therefore, the different structures send back different echoes. For example, ultrasound travels freely through fluid so there is little echo from blood in heart chambers. But, heart valves are dense tissues so ultrasound hitting a valve will echo back clearly.

The echoes are detected by the probe and are sent to the echocardiogram machine. They are displayed as a picture on the monitor. The picture is constantly updated so the scan can show movement as well as structure. (For example, the valves of a heart opening and closing.) The operator moves the probe around over the skin surface to get views from different angles. Some abnormalities can be seen quite clearly. For example, damaged heart valves, thickened heart muscle, some congenital heart defects, etc.

The test is painless and takes about 15-30 minutes. You may have to turn on to your side during the test so that the operator can scan the heart from different angles.

You do not need any special preparation before the test. You eat and drink normally before and after the test. Continue to take your usual medication.

 

Other forms of echocardiography

Doppler echocardiography

This can measure variations in blood flow in different parts of the heart. For example, if can detect any abnormal flow of blood next to a damaged valve. It can assess how well the heart valves are working. You do not need any special preparation before this test.

Stress echocardiogram

This test is done to see how the heart responds to 'stress' such as exercise. In this test your doctor may do an echocardiogram, as described above, during or soon after exercise. Or you may be given a medication that causes the heart to beat harder and faster.

Transoesophageal echocardiography

In this test you swallow a probe that is attached to a thin tube connecting it to an ultrasound machine. This views the heart from within the gullet (oesophagus) which lies just behind the heart. This can give a clearer view of the heart than normal echocardiography. It is done in situations where a very detailed picture is needed. For example, to assess valves before surgery is done to repair damaged valves, or to assess the extent of infection of a heart valve.

Coronary Computed Tomography Angiography (CCTA)

What are some common uses of the procedure?

Coronary computed tomography angiography (CCTA) is a heart imaging test that helps determine if plaque buildup has narrowed a patient's coronary arteries, the blood vessels that supply the heart. Plaque is made of various substances circulating in the blood, such as fat, cholesterol and calcium that deposit along the inner lining of the arteries. Plaque, which builds up over time, can reduce or in some cases completely block blood flow. Patients undergoing a CCTA scan receive an iodine-containing contrast material (dye) as an intravenous (IV) injection to ensure the best possible images of the heart blood vessels.

Computed tomography, more commonly known as a CT or CAT scan, is a diagnostic medical test that, like traditional x-rays, produces multiple images or pictures of the inside of the body.

The cross-sectional images generated during a CT scan can be reformatted in multiple planes, and can even generate three-dimensional images. These images can be viewed on a computer monitor, printed on film or transferred to a CD or DVD.

CT images of internal organs, bones, soft tissue and blood vessels typically provide greater detail than traditional x-rays, particularly of soft tissues and blood vessels.

 

What are some common uses of the procedure?

Many physicians advocate the careful use of CCTA for patients who have:

• suspected abnormal anatomy of the coronary arteries.

• low or intermediate risk for coronary artery disease, including patients who have chest pain and normal, non-diagnostic or unclear lab and ECG results.

• low to intermediate risk atypical chest pain in the emergency department.

• non-acute chest pain.

• new or worsening symptoms with a previous normal stress test result.

• unclear or inconclusive stress test results.

• new onset heart failure with reduced heart function and low or medium risk for coronary artery disease.

• intermediate risk of coronary artery disease before non-coronary cardiac surgery.

• coronary artery bypass grafts.

For patients meeting the above indications, CCTA can provide important information about the presence and extent of plaque in the coronary arteries. Apart from identifying coronary artery narrowing as the cause of chest discomfort, it can also detect other possible causes of symptoms, such as a collapsed lung, blood clot in the vessels leading to the lungs, or acute aortic abnormalities. Your primary care physician or cardiac specialist, possibly in consultation with a radiologist who would perform the test, will determine whether CCTA is appropriate for you.

 

How should I prepare?

You should wear comfortable, loose-fitting clothing to your exam. You may be given a gown to wear during the procedure.

Metal objects, including jewelry, eyeglasses, dentures and hairpins, may affect the CT images and should be left at home or removed prior to your exam. You may also be asked to remove hearing aids and removable dental work. Women will be asked to remove bras containing metal underwire. You may be asked to remove any piercings, if possible.

You will be asked not to eat or drink anything for a few hours beforehand, as contrast material will be used in your exam. You should inform your physician of all medications you are taking and if you have any allergies. If you have a known allergy to contrast material, or "dye," your doctor may prescribe medications (usually a steroid) to reduce the risk of an allergic reaction. These medications generally need to be taken 12 hours prior to administration of contrast material. To avoid unnecessary delays, contact your doctor before the exact time of your exam.

Also inform your doctor of any recent illnesses or other medical conditions and whether you have a history of heart disease, asthma, diabetes, kidney disease or thyroid problems. Any of these conditions may increase the risk of an unusual adverse effect.

On the day before and day of your exam, you may be asked to avoid:

• diet pills and caffeinated drinks such as coffee, tea, energy drinks or sodas. These may increase heart rate and limit the ability of the exam to evaluate for plaque in the coronary arteries.

• Viagra or any similar medication. They are not compatible with the medications you will receive during the procedure.

On the night before the procedure, you may be asked to take a beta blocker medication to lower your heart rate to optimize the quality of the exam.

Your child may be asked not to eat or drink anything for several hours beforehand, especially if a sedative or anesthesia will be used in the exam. With sedation or anesthesia, your child probably will not be allowed to eat for several hours prior to the exam. In general, children who have recently been ill will not be sedated or anesthetized. If this is the case, or if you suspect that your child may be getting sick, you should talk with your physician about rescheduling the CT exam.

You should also inform your physician of any medications your child is taking and if he/she has any allergies, especially to intravenous (IV) or oral contrast materials (also known as dye), iodine, or seafood. The allergy information should also be discussed with the CT technologist or nurse at the time of the CT examination. If your child has a known contrast material allergy, you should inform the doctor and technologist prior to the exam.

Also inform your doctor of any recent illnesses or other medical conditions your child may have, and if there is a history of heart disease, asthma, diabetes, kidney disease or thyroid problems. Any of these conditions may influence the decision on whether contrast material will be given to your child for the CT examination.

Ask your doctor if you have questions about the instructions given to you.

Women should always inform their physician and the CT technologist if there is any possibility that they may be pregnant. See the Safety page for more information about pregnancy and x-rays.

If you are breastfeeding at the time of the exam, you should ask your doctor how to proceed. It may help to pump breast milk ahead of time and keep it on hand for use after contrast material has cleared from your body, about 24 hours after the test.

 

What does the equipment look like?

The CT scanner is typically a large, box-like machine with a hole, or short tunnel, in the center. You will lie on a narrow examination table that slides into and out of this tunnel. Rotating around you, the x-ray tube and electronic x-ray detectors are located opposite each other in a ring, called a gantry. The computer workstation that processes the imaging information is located in a separate control room, where the technologist operates the scanner and monitors your examination in direct visual contact and usually with the ability to hear and talk to you with the use of a speaker and microphone.

CCTA is very much like a normal CT scan. The only difference is the speed of the CT scanner and the use of a heart monitor to determine your heart rate.

 

How does the procedure work?

During the examination, x-rays pass through the body and are picked up by special detectors in the scanner. Typically, higher numbers (especially 64 or more) of these detectors result in clearer final images. For that reason, CCTA often is referred to as multi-detector or multi-slice CT scanning. The information collected during the CCTA examination is used to identify the coronary artery anatomy, plaque, narrowing of the vessel, and, in certain cases, heart function. The radiologist will use the computer to create three-dimensional images and images in various planes to completely evaluate the heart and coronary arteries.

When a contrast material is introduced to the bloodstream during the procedure, it clearly defines the blood vessels being examined by making them appear bright white.

 

How is the procedure performed?

You will be given a gown to wear during the procedure.

The technologist will clean three small areas of your chest and place electrodes (small, sticky discs) on these areas. Men may require a small area of hair to be shaved on their chest to help the electrodes stick. The electrodes are attached to an electrocardiograph (ECG) monitor, which shows your heart's electrical activity during the test.

A nurse will insert an intravenous (IV) line into a vein in your arm to administer contrast material (dye) during your procedure. While in the CT scanner, you may be given a beta blocker medication through the same IV line or orally to help slow your heart rate in order to improve image quality. Nitroglycerin, to dilate and improve visualization of the coronary arteries, may also be administered as a tablet or spray underneath your tongue.

While lying on the scanning table, you may be asked to raise your arms over your head for the duration of the exam. This will help improve image quality.

Next, the table will move quickly through the scanner to determine the correct starting position for the scans. Then, the table will move slowly through the machine as the actual CT scanning is performed. Depending on the type of CT scan, the machine may make several passes.

You may be asked to hold your breath during the scanning. Any motion, whether breathing or body movements, can lead to artifacts on the images. This loss of image quality can resemble the blurring seen on a photograph taken of a moving object.

Inform your doctor if you have problems holding your breath for 5 to 15 seconds. Breathing during the scan creates blurring on the images and can result in an inconclusive exam.

When the examination is completed, you will be asked to wait until the technologist verifies that the images are of high enough quality for accurate interpretation.

Your intravenous line will be removed.

Including all preparations, the CCTA scan usually takes about 15 minutes if the heart rate is slow and steady. It may take longer if the baseline heart rate is fast and beta-blocker is given to slow it down. If the beta-blocker is given by mouth it generally will require at least one hour to take effect. If the medication is injected into a vein (intravenously), it may still require multiple doses and up to 20 minutes to reach the slower heart rate.

 

What will I experience during and after the procedure?

Other than the needle stick when the IV line is placed, most CT exams are fast, easy and painless.

Though the scanning itself causes no pain, there may be some discomfort from having to remain still for several minutes and with placement of an IV. If you have a hard time staying still, are very nervous or anxious or have chronic pain, you may find a CT exam to be stressful. The technologist or nurse, under the direction of a physician, may offer you some medication to help you tolerate the CT scanning procedure.

For exams (excluding head and neck) your head will remain outside the hole in the center of the scanner. The scanner is approximately 24 inches wide, therefore, your entire body will be "inside" the scanner at one time such as with MRI.

If an intravenous contrast material is used, you will feel a pin prick when the needle is inserted into your vein. You will likely have a warm, flushed sensation during the injection of the contrast materials and a metallic taste in your mouth that lasts for at most a minute or two. You may experience a sensation like you have to urinate; however, this is actually a contrast effect and subsides quickly.

The medication given to slow the heart rate has been known to cause some patients to feel dizzy when they stand suddenly due to a lowering of blood pressure. Therefore, you will often be asked to sit up slowly on the table prior to standing. The dizziness is slight and only happens rarely. You may also have your blood pressure taken before the exam, during and following the examination if medications are given.

When you enter the CT scanner room, special light lines may be seen projected onto your body, and are used to ensure that you are properly positioned. With modern CT scanners, you will hear only slight buzzing, clicking and whirring sounds as the CT scanner's internal parts, not usually visible to you, revolve around you during the imaging process.

You will be alone in the exam room during the CT scan, unless there are special circumstances. For example, sometimes a parent wearing a lead shield may stay in the room with their child. However, the technologist will always be able to see, hear and speak with you through a built-in intercom system.

After a CT exam, the intravenous line used to inject the contrast material will be removed by the technologist, and the tiny hole made by the needle will be covered with a small dressing. You can return to your normal activities.

 

Who interprets the results and how do I get them?

A radiologist with expertise in supervising and interpreting radiology examinations will analyze the images and send an official report to your primary care physician or physician who referred you for the exam, who will discuss the results with you.

If you are actively having chest pain, your results will be given to the emergency room doctor by the radiologist, and a preliminary result will be reported right away.

Follow-up examinations may be necessary, and your doctor will explain the exact reason why another exam is requested. Sometimes a follow-up exam is done because a suspicious or questionable finding needs clarification with additional views or a special imaging technique. A follow-up examination may also be necessary so that any change in a known abnormality can be monitored over time. Follow-up examinations are sometimes the best way to see if treatment is working or if an abnormality is stable or changed over time.

 

What are the benefits vs. risks?

Benefits

• CCTA is not invasive. An alternative test, cardiac catheterization with a coronary angiogram, is invasive, has more complications related to the placement of a long catheter into the arteries and the movement of the catheter in the blood vessels, and requires more time for the patient to recover.

• A major advantage of CT is that it is able to view bone, soft tissue and blood vessels all at the same time. It is therefore suited to identify other reasons for your discomfort such as an injury to the aorta or a blood clot in the lungs.

• Unlike conventional x-rays, CT scanning provides very detailed images of many types of tissue.

• CT examinations are fast and simple.

• CT has been shown to be cost-effective for a wide range of medical problems.

• CT is less sensitive to patient movement than MRI.

• CT can be performed if you have an implanted medical device of any kind, unlike MRI.

• No radiation remains in a patient's body after a CT examination.

• X-rays used in CT scans should have no immediate side effects.

Risks

• In some people with abnormal kidney function, the dye used in CT scanning may worsen kidney function.

• If a large amount of x-ray contrast material leaks out from the vessel being injected and spreads under the skin where the IV is placed, skin damage or damage to blood vessels and nerves, though unlikely, can result. If you feel any pain in your arm at the location of the IV during contrast material injection, you should immediately inform the technologist.

• There is always a slight chance of cancer from excessive exposure to radiation. However, the benefit of an accurate diagnosis far outweighs the risk.

• The effective radiation dose for this procedure varies. See the Safety page for more information about radiation dose.

• Women should always inform their physician and x-ray or CT technologist if there is any possibility that they are pregnant. See the Safety page for more information about pregnancy and x-rays.

• CT scanning is, in general, not recommended for pregnant women unless medically necessary because of potential risk to the baby in the womb.

• Manufacturers of intravenous contrast indicate mothers should not breastfeed their babies for 24-48 hours after contrast medium is given. However, both the American College of Radiology (ACR) and the European Society of Urogenital Radiology note that the available data suggest that it is safe to continue breastfeeding after receiving intravenous contrast. For further information please consult the ACR Manual on Contrast Media and its references.

• The risk of serious allergic reaction to contrast materials that contain iodine is extremely rare, and radiology departments are well-equipped to deal with them.

 

What are the limitations of Coronary CTA?

A person who is very large may not fit into the opening of a conventional CT scanner or may be over the weight limit—usually 450 pounds—for the moving table.

Patients who are extremely overweight or who have abnormal heart rhythms are usually not good candidates for this test because image quality may be compromised.

Although CCTA examinations are growing in use, coronary angiography is still the main method for detecting coronary artery stenosis, which is a significant narrowing of an artery that could require treatment such as a stent or bypass surgery. Unlike CTA, which is only a diagnostic test, coronary angiography can be used for both diagnosis and treatment in a single session. Patients with a high risk of coronary artery disease and typical symptoms might undergo coronary angiography instead of CCTA.

CCTA is often not useful in patients with many areas of old, calcified (hardened) plaque, which is often the case in older patients.

Patient Resource Infromation for Heart Scan

The following tests and treatment topics are the most frequently researched by site visitors. Within each topic introduction, you will find links to related articles concerning specific body areas, procedure descriptions and health conditions.

Magnetic Resonance Imaging (MRI) - Cardiac (Heart)

What is Cardiac MRI?

Magnetic resonance imaging (MRI) is a noninvasive medical test that physicians use to diagnose and treat medical conditions.

MRI uses a powerful magnetic field, radio frequency pulses and a computer to produce detailed pictures of organs, soft tissues, bone and virtually all other internal body structures. MRI does not use ionizing radiation (x-rays).

Detailed MR images allow physicians to evaluate various parts of the body and determine the presence of certain diseases. The images can then be examined on a computer monitor, transmitted electronically, printed or copied to a CD.

 

What are some common uses of the procedure?

  • • evaluating the anatomy and function of the heart chambers, valves, size and blood flow through major vessels, and surrounding structures such as the pericardium (the fluid filled sac that surrounds the heart).
  • • diagnosing a variety of cardiovascular (heart and/or blood vessel) disorders such as tumors, infections, and inflammatory conditions.
  • • evaluating the effects of coronary artery disease such as limited blood flow to the heart muscle and scarring within the heart muscle after a heart attack.
  • • planning a patient's treatment for cardiovascular disorders.
  • • monitoring the progression of certain disorders over time.
  • • evaluating the anatomy of the heart and blood vessels in children and adults with congenital heart disease.
  • • evaluating the effects of surgical changes, especially in patients with congenital heart disease.

 

How should I prepare?

You may be asked to wear a gown during the exam or you may be allowed to wear your own clothing if it is loose-fitting and has no metal fasteners. Guidelines about eating and drinking before an MRI exam vary with the specific exam and also with the imaging facility. Unless you are told otherwise, you may follow your regular daily routine and take food and medications as usual. Some MRI examinations may require you to receive an injection of contrast material into the bloodstream. The radiologist,technologist or a nurse may ask if you have allergies of any kind, such as an allergy to iodine or x-ray contrast material, drugs, food, or the environment, or if you have asthma. The contrast material most commonly used for an MRI exam contains a metal called gadolinium. Gadolinium can be used in patients with iodine contrast allergy, but may require pre-medication. It is far less common for a patient to have an allergy to a gadolinium-based contrast agent used for MRI than the iodine-containing contrast for CT. However, even if it is known that the patient has an allergy to the gadolinium contrast, it may still be possible to use it after appropriate pre-medication. Patient consent will be requested in this instance. For more information on adverse reactions to gadolinium-based contrast agents, please consult the ACR Manual on Contrast Media. You should also let the radiologist know if you have any serious health problems, or if you have had any recent surgeries. Some conditions, such as severe kidney disease, may prevent you from being given gadolinium contrast for an MRI. If you have a history of kidney disease or liver transplant, it will be necessary to perform a blood test to determine whether the kidneys are functioning adequately. Women should always inform their physician or technologist if there is any possibility that they are pregnant. MRI has been used for scanning patients since the 1980s with no reports of any ill effects on pregnant women or their unborn babies. However, because the unborn baby will be in a strong magnetic field, pregnant women should not have this exam in the first trimester of pregnancy unless the potential benefit from the MRI exam is assumed to outweigh the potential risks. Pregnant women should not receive injections of gadolinium contrast material except when absolutely necessary for medical treatment. See the Safety page for more information about pregnancy and MRI. If you have claustrophobia (fear of enclosed spaces) or anxiety, you may want to ask your physician for a prescription for a mild sedative prior to your scheduled examination. Infants and young children usually require sedation or anesthesia to complete an MRI exam without moving. Whether a child requires sedation will depend on the child’s age and the type of exam being performed. Moderate and conscious sedation can be provided at most facilities. A physician or nurse specializing in the administration of sedation or anesthesia to children should be available during the exam to ensure your child's safety. You will be given special instructions for how to prepare your child for the sedation or anesthesia.

Jewelry and other accessories should be left at home if possible, or removed prior to the MRI scan. Because they can interfere with the magnetic field of the MRI unit, metal and electronic items are not allowed in the exam room. These items include:

    • • jewelry, watches, credit cards and hearing aids, all of which can be damaged
    • • pins, hairpins, metal zippers and similar metallic items, which can distort MRI images
    • • removable dental work
    • • pens, pocket knives and eyeglasses
    • • body piercings

In most cases, an MRI exam is safe for patients with metal implants, except for a few types. People with the following implants cannot be scanned and should not enter the MRI scanning area:

    • • cochlear (ear) implant
    • • some types of clips used for brain aneurysms
    • • some types of metal coils placed within blood vessels
    • • nearly all cardiac defibrillators and pacemakers

You should tell the technologist if you have medical or electronic devices in your body. These objects may interfere with the exam or potentially pose a risk, depending on their nature and the strength of the MRI magnet. Many implanted devices will have a pamphlet explaining the MRI risks for that particular device. If you have the pamphlet, it is useful to bring that to the attention of the technologist or scheduler before the exam. Some implanted devices require a short period of time after placement (usually six weeks) before being safe for MRI examinations. Examples include but are not limited to:

  • • artificial heart valves
  • • implanted drug infusion ports
  • • artificial limbs or metallic joint prostheses
  • • implanted nerve stimulators
  • • metal pins, screws, plates, stents or surgical staples

In general, metal objects used in orthopedic surgery pose no risk during MRI. However, a recently placed artificial joint may require the use of another imaging procedure. If there is any question of their presence, an x-ray may be taken to detect and identify any metal objects. Patients who might have metal objects in certain parts of their bodies may also require an x-ray prior to an MRI. You should notify the technologist or radiologist of any shrapnel, bullets, or other pieces of metal which may be present in your body due to prior accidents. Foreign bodies near and especially lodged in the eyes are particularly important. Dyes used in tattoos may contain iron and could heat up during MRI, but this is rarely a problem. Tooth fillings and braces usually are not affected by the magnetic field, but they may distort images of the facial area or brain, so the radiologist should be aware of them. Parents or family members who accompany patients into the scanning room also need to remove metal objects and notify the technologist of any medical or electronic devices they may have.

 

What does the equipment look like?

The traditional MRI unit is a large cylinder-shaped tube surrounded by a circular magnet. You will lie on a moveable examination table that slides into the center of the magnet. Some MRI units, called short-bore systems, are designed so that the magnet does not completely surround you. Some newer MRI machines have a larger diameter bore which can be more comfortable for larger size patients or patients with claustrophobia. Other MRI machines are open on the sides (open MRI). Open units are especially helpful for examining larger patients or those with claustrophobia. Newer open MRI units provide very high quality images for many types of exams; however, older open MRI units may not provide this same image quality. Certain types of exams cannot be performed using open MRI. For more information, consult your radiologist. The computer workstation that processes the imaging information is located in a separate room from the scanner.

 

How does the procedure work?

Unlike conventional x-ray examinations and computed tomography (CT) scans, MRI does not utilize on ionizing radiation. Instead, radio waves redirect alignment of hydrogen atoms that naturally exist within the body while you are in the scanner without causing any chemical changes in the tissues. As the hydrogen atoms return to their usual alignment, they emit energy that varies according to the type of body tissue from which they come. The MR scanner captures this energy and creates a picture of the tissues scanned based on this information. The magnetic field is produced by passing an electric current through wire coils in most MRI units. Other coils, located in the machine and in some cases, placed around the part of the body being imaged, send and receive radio waves, producing signals that are detected by the coils. A computer then processes the signals and generates a series of images, each of which shows a thin slice of the body. The images can then be studied from different angles by the interpreting radiologist. Frequently, the differentiation of abnormal (diseased) tissue from normal tissues is better with MRI than with other imaging modalities such as x-ray, CT and ultrasound.

 

How is the procedure performed?

MRI examinations may be performed on outpatients or inpatients. You will be positioned on the moveable examination table. Straps and bolsters may be used to help you stay still and maintain the correct position during imaging. Devices that contain coils capable of sending and receiving radio waves may be placed around or adjacent to the area of the body being studied. Electrocardiogram (ECG) leads (small sticky patches) will likely be placed on your chest to help the machine synchronize the image acquisition with the beating of your heart. Men may require a small area of hair to be shaved from the chest in order to ensure that the small ECG patches will stick well. A respiratory gating belt, a device that helps the computer know how you are breathing at any given time, may be placed around your upper abdomen. Additionally, a small pulse monitor may be placed on your finger. You will be given breathing instructions and will be asked to hold your breath numerous times during the examinations. If a contrast material will be used in the MRI exam, a physician, nurse or technologist will insert an intravenous (IV) catheter, also known as an IV line, into a vein in your hand or arm. A saline solution may be used to inject the contrast material. The solution will drip through the IV to prevent blockage of the IV catheter until the contrast material is injected. You will be placed into the magnet of the MRI unit and the radiologist and technologist will perform the examination while working at a computer outside of the room. If a contrast material is used during the examination, it will be injected into the intravenous line (IV) after an initial series of scans. Additional series of images will be taken during or following the injection. When the examination is complete, you may be asked to wait until the technologist or radiologist checks the images in case additional images are needed. Your intravenous line will be removed. MRI exams generally include multiple runs (sequences), some of which may last several minutes. The entire examination is usually completed in less than 90 minutes once imaging has started, but may be shorter or longer depending on what the initial image shows. If a child has been sedated or anesthetized for an MRI exam, recovery time ranges from approximately 30 minutes to two hours after the exam is completed.

 

What will I experience during and after the procedure?

Most MRI exams are painless. However, some patients find it uncomfortable to remain still during MR imaging. Others experience a sense of being closed-in (claustrophobia). Therefore, sedation can be arranged for those patients who anticipate anxiety, but fewer than one in 20 require medication.

During cardiac MRI, your heart beat will be monitored and you will be asked to hold your breath for short periods of time while images are recorded.

It is normal for the area of your body being imaged to feel slightly warm, but if it bothers you, notify the radiologist or technologist. It is important that you remain perfectly still while the images are being obtained, which is typically only a few seconds to a few minutes at a time. You will know when images are being recorded because you will hear and feel loud tapping or thumping sounds when the coils that generate the radiofrequency pulses are activated. Some centers provide earplugs, while others use headphones to reduce the intensity of the sounds made by the MRI machine. You will be able to relax between imaging sequences, but will be asked to maintain your position without movement as much as possible.

You will usually be alone in the exam room during the MRI procedure. However, the technologist will be able to see, hear and speak with you at all times using a two-way intercom. Many MRI centers allow a friend or parent to stay in the room as long as they are also screened for safety in the magnetic environment.

Children will be given appropriately sized earplugs or headphones during the exam. MRI scanners are air-conditioned and well-lit. Music may be played through the headphones to help you pass the time.

In some cases, intravenous injection of contrast material may be performed. The intravenous needle may cause you some discomfort when it is inserted and you may experience some bruising. There is also a very small chance of irritation of your skin at the site of the IV tube insertion. Some patients may sense a temporary metallic taste in their mouth after the contrast injection.

If you have not been sedated, no recovery period is necessary. You may resume your usual activities and normal diet immediately after the exam. On very rare occasions, a few patients experience side effects from the contrast material, including nausea and local pain. Similarly, patients are very rarely allergic to the contrast material and experience hives, itchy eyes or other reactions. If you experience allergic symptoms, notify the technologist. A radiologist or other physician will be available for immediate assistance.

 

Who interprets the results and how do I get them?

A radiologist, a physician specifically trained to supervise and interpret radiology examinations, will analyze the images and send a signed report to your primary care or referring physician, who will share the results with you. Follow-up examinations may be necessary, and your doctor will explain the exact reason why another exam is requested. Sometimes a follow-up exam is done because a suspicious or questionable finding needs clarification with additional views or a special imaging technique. A follow-up examination may also be necessary so that any change in a known abnormality can be monitored over time. Follow-up examinations are sometimes the best way to see if treatment is working or if an abnormality is stable or changed over time.

 

What are the benefits vs. risks?

Benefits

  • • MRI is a noninvasive imaging technique that does not involve exposure to ionizing radiation.
  • • MRI images of the heart are better than other imaging methods for certain conditions. This advantage makes MRI an invaluable tool in early diagnosis and evaluation of certain cardiac abnormalities, especially those involving the heart muscle.
  • • MRI has proven valuable in diagnosing a broad range of conditions, including cardiovascular anatomical anomalies (e.g., congenital heart defects), functional abnormalities (e.g., valve failure), tumors and conditions related to coronary artery disease and cardiomyopathy.
  • • MRI imaging can be used during certain interventional procedures, such as catheter-based ablation procedures to treat irregular heart rhythms, including atrial fibrillation. The use of MRI imaging can substantially shorten the time required to perform these procedures, resulting in better accuracy.
  • • MRI enables the discovery of abnormalities that might be obscured by bone with other imaging methods.
  • • The contrast material used in MRI exams is less likely to produce an allergic reaction than the iodine-based contrast materials used for conventional x-rays and CT scanning.
  • • Cardiac MRI allow evaluation of the structures and function of the heart and major vessels without risks of exposure to radiation which may be associated with more invasive procedures or some of the other non-invasive tests.
  • Risks
  • • The MRI examination poses almost no risk to the average patient when appropriate safety guidelines are followed.
  • • If sedation is used, there are risks of excessive sedation. However, the technologist or nurse monitors your vital signs to minimize this risk.
  • • Although the strong magnetic field is not harmful in itself, implanted medical devices that contain metal may malfunction or cause problems during an MRI exam.
  • • Nephrogenic systemic fibrosis is currently a recognized, but rare, complication of MRI believed to be caused by the injection of high doses of gadolinium-based contrast material in patients with very poor kidney function. Careful assessment of kidney function before considering a contrast injection minimizes the risk of this very rare complication.
  • • There is a very slight risk of an allergic reaction if contrast material is injected. Such reactions usually are mild and easily controlled by medication. If you experience allergic symptoms, a radiologist or other physician will be available for immediate assistance.
  • • Manufacturers of intravenous contrast indicate mothers should not breastfeed their babies for 24-48 hours after contrast medium is given. However, both the American College of Radiology (ACR) and the European Society of Urogenital Radiology note that the available data suggest that it is safe to continue breastfeeding after receiving intravenous contrast

 

What are the limitations of a Cardiac MRI?

High-quality images are assured only if you are able to remain perfectly still and follow breath-holding instructions while the images are being recorded. If you are anxious, confused or in severe pain, you may find it difficult to lie still during imaging. A person who is very large may not fit into the opening of certain types of MRI machines. The presence of an implant or other metallic object sometimes makes it difficult to obtain clear images. Patient movement can have the same effect. A very irregular heartbeat may affect the quality of images obtained using techniques that time the imaging based on the electrical activity of the heart, such as electrocardiography (EKG). An irregular heartbeat or atrial fibrillation may cause artifacts in cardiac MR images. The constant motion of the heart creates challenges in obtaining clear images. These challenges can be overcome by various techniques including synchronizing the imaging with ECG tracing, synchronizing the imaging with breathing, or having you perform repeated short breath holds during imaging. MRI generally is not recommended for patients who have been acutely injured; however, this decision is based on clinical judgment. This is because traction devices and many types of life support equipment must be kept away from the area to be imaged. Furthermore, the examination takes longer than other imaging modalities (typically x-ray and CT) and the results may not be immediately available, as is often necessary in trauma situations. Although there is no reason to believe that magnetic resonance imaging harms the fetus, pregnant women usually are advised not to have an MRI exam during the first trimester unless medically necessary. Acquiring detailed images of the coronary arteries and their branches is more difficult with MRI and therefore is often done instead with cardiac cardiac CT or a more invasive procedure using a catheter placed into the blood vessels via the groin or arm. MRI typically costs more and may take more time to perform than other imaging modalities.

 

Welcome to Bharat Scans

The Bharat Scans with its motto "Service through Innovative Technology" boasts the most Advanced Imaging Systems on the planet. It is an indisputable face that diagnosis is the axis around which modern medicine revolves. Efficient patient care requires fast, accurate diagnosis

  • Bharat Scans is a complete Diagnostic center under one roof.
  • Equipped with state-of-the-art infrastructure & equipments of International standards.  
  • Lead by Professionals from Medical Fraternity of very high standards.
  • Widely Spread in the Chennai City,with more centers to come-up in the State.

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  • Very good facilities and very kind services.
  • An excellent hospitality,latest equipments,very good doctors and very well maintained scan centre in the city.
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