Cardiac stress mri: Had one of these at... - British Heart Fou...

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Cardiac stress mri

Heartmum56 profile image
26 Replies

Had one of these at Harefield today. Didn't like the stress drug much. Some chest tightness, not really chest pain or breathlessness, but my neck and back were definitely in pain. Anyone had similar and is it a bad sign? I hate all this waiting for results.

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Heartmum56 profile image
Heartmum56
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26 Replies
Tos92 profile image
Tos92

I presume adenosine was used? It is in fact normal to experience pain during a stress MRI when the stress agent is administered. It’s usually explained beforehand that you may experience chest pain, abdominal pain, feel your heart racing, sweating and other symptoms similar to this. Stress agents are not pleasant and I had the same test last year however, it is an important test to have. As it is considered normal to experience pain with the stress agent, it does not necessarily mean that something terrible is wrong. Of course, if the symptoms last post scan, then it would be wise to seek medical attention. Waiting is often the hardest part, but I hope this provides you with some reassurance.

All the best for the results.

Tos

Heartmum56 profile image
Heartmum56 in reply toTos92

Thank you. I had been having upper back pains for a few weeks but had decided they were the result of my poor posture and too much desk work. I did not have the pain when I lay down for the scan but it came back with avengeance when they put the stuff in. It's still there now but back to how it has been. The only difference is that I'm now worrying it might be cardiac when I wasn't before!

Tos92 profile image
Tos92 in reply toHeartmum56

I have both spasms in my coronary arteries and recently found out I have microvascular angina as well. I had pain when they administered the adenosine however, it resolved after the test and my usual angina pains came back. My stress MRI was actually normal and no ischaemia was found at the time of the test as spasms can take place spontaneously. Based on that, I wouldn’t overly worry about your results yet. If it is urgent, they will get back to you sooner rather than later.

Heartmum56 profile image
Heartmum56 in reply toTos92

I don't understand. Shouldn't the MRI have picked up the microvascular angina? I think that's what they were looking for for me today.

Tos92 profile image
Tos92 in reply toHeartmum56

A stress MRI can help in a diagnosis, but it is not the only method of testing. Unfortunately, my stress MRI was not performed by an INOCA specialist so he was not looking for MVA at the time. There is also a specialised technology that I’ve recently been made aware of that can show disease in the micro vessels but I don’t think this is widespread. You may find the below link helpful. This is the same Professor that gave me my recent diagnoses and will be managing my treatment plan.

bhf.org.uk/informationsuppo...

I hope you can get some answers soon.

Milkfairy profile image
MilkfairyHeart Star in reply toHeartmum56

You are correct, cardiac perfusion MRIs can detect microvascular dysfunction in many cases but not coronary vasospasms.

Cardiac MRIs are performed by and intrepreted Imaging Cardiologists.

Specialised computer algorithms are used to help with this intrepretation.

I have met and kept in contact with Jennifer Waller who tells her story about her microvascular angina being diagnosed. Her story was first published on the BHF website nearly 10 years.

There has since the article was written been great advances in developing techniques in how to diagnose ischaemia/ angina non obstructive coronary arteries INOCA/ANOCA.

There is also a trial taking place iCorMicA which is trying to correctly diagnose microvascular angina.

I have had 3 cardiac perfusion MRIs, one of which was requested by the Prof in the article who was my Cardiologist before he retired from the NHS.

He also arranged for one of his Interventional Cardiology colleagues to perform my functional angiogram in 2014 to confirm my diagnosis of vasospastic angina.

The cardiac MRIs are not always pleasant. I felt as though an elephant was sitting on my chest and I couldn't breathe in.

I hope you don't have to wait too long for your results.

https://academic.oup.com/eurheartj/article/41/37/3504/5867624
Fanfab1 profile image
Fanfab1 in reply toHeartmum56

My stress mri with adenosine was looking for ischemia and microvascular - cleared of both. I didnt respond before as I loathe adenosine with a passion - I think I’ve had it on a nuclear med scan, an angiogram and the MRI, awful effects but clear quickly. If there was anything hugely concerning they’d let you know sooner than later. But waiting is pants.

Bunkular profile image
Bunkular in reply toHeartmum56

Unfortunately no, the stress MRI doesn't pick up MVAs as a rule because the coronary microvascular system by their nature are mostly too small to show up with a problem. Besides, coronary microvascular artery problems haven't been researched for very long and have virtually been ignored until recently.

Milkfairy profile image
MilkfairyHeart Star in reply toBunkular

A perfusion cardiac MRI can detect microvascular dysfunction.

Microvascular dysfunction is thought to be due to the inability of the small blood vessels to dilate or stay dilated in response to extra demands like exercise.

Adenosine is used during a perfusion MRI mimics exercise, if microvascular dysfunction is present there will be a lack of blood supply to the heart. This can be detected by a cardiac perfusion MRI.

There has been research going on into microvascular dysfunction for sometime, 30 years or more.

Unfortunately neglected as until recently many Cardiologists thought there was no point in diagnosing a heart condition that has no proven treatment options.

Known as clinical nihilism.

Another issue is that microvascular angina tends to be more common in women.

The Women's Ischemia Syndrome, WISE trial was started in 1999.

pubmed.ncbi.nlm.nih.gov/103...

Are you aware of this consensus

document?

academic.oup.com/eurheartj/...

You might be interested in this website, it has lots of the latest research articles into this area of Cardiology.

internationalheartspasmsall...

Bunkular profile image
Bunkular in reply toMilkfairy

Thank you. I'll check those out.

Cruiser25 profile image
Cruiser25

I had my stress MRI with contrast last July to check my chest pain I felt resting after exercise. In my case they were checking for inducible ischaemia or narrowing of the arteries at rest after exercise...weirdly I haven't felt these pains since after the MRI? It was concluded I'm fine and they're quite pleased with me, especially after I'd had 7 stents placed after my HA.

The MRI test is considered the gold standard test and is really pricey with the add-ons, compared with other testing, but really does show what's going on at stress. I too felt discomfort, my stressed breathing was my worst part, but it passed quickly, did bring up some feelings of the HA tho.

Hopefully you're on the up and up, good luck.

Gaz22 profile image
Gaz22

I had some chest pain for hours when I had a CT angiogram from the dye when I told the doctor he said it was a reaction to the dye not had a problem before with the dyes so it's in the back of my mind will it happen next time

Tos92 profile image
Tos92 in reply toGaz22

I’m also allergic to the contrast dye. I recently had another CT scan and they assessed that it was best not to go ahead with the dye due to previous side effects and the CT was performed without the dye. Before any CT scan, the normal procedure is that they assess you and they will take down your history with the contrast dye first before proceeding. So try not to worry about it and always mention it to the department if they are not already aware.

Yumz199725 profile image
Yumz199725 in reply toTos92

How do you know if your allergic to the contrast dye? I had a cardiac MRI and after they injected the contrast dye to get better visualisation of the valve after I felt sooooo dizzy and looked so pale it's never affected me like that before? Could it be cause I was lying flat in the machine for 2 hours x sorry for interrupting on your reply just wondered.

Tos92 profile image
Tos92 in reply toYumz199725

After the scan, like you I was immediately dizzy. Later, I experienced a delayed reaction to the contrast where my BP dropped quite low and I had moderate vomiting for around 4-5 hours. Does your ultrasound and CT imaging department know about your reaction? If not, it is best to inform them. Sometimes these reactions are considered harmless like the dizziness but you should let the department know either way so it’s on your record x

Yumz199725 profile image
Yumz199725 in reply toTos92

I told them straight after how dizzy I felt and they kept checking my blood pressure because they said I looked pale and felt so faint had a whole bottle of water in like 30 seconds. I'm hoping kept a record of how it affected me x sorry to hear how it affected you that sounds awful 💔😳☹️.

Gaz22 profile image
Gaz22 in reply toTos92

Thanks for your reply , I will yet the department know about the reaction to the the dye before. if I have to have something similar again, Thanks

Sljp0000 profile image
Sljp0000

I had that MRI 3 months after my triple bypass last year. It showed lack of of blood flow to my left ventricle. It then led to yet another angiogram which showed none of my byoass grafts were working. Zero blood flow. My body was surviving on my native vessels which were up to 99.9% blocked! I ended up with 4 stents in 3 arteries. I hope you get the answers you need. It's clear this tests us very good at looking at blood flow to and from the heart but as said before, it's maybe not as precise for small vessel issues .

All the best

Susie

Milkfairy profile image
MilkfairyHeart Star in reply toSljp0000

Actually this test is very accurate at detecting the flow of blood in the small blood vessels. The small vessels are responsible for supplying the majority of the blood supply to the heart muscle itself.

bhf.org.uk/informationsuppo...

ncbi.nlm.nih.gov/pmc/articl....

Sljp0000 profile image
Sljp0000 in reply toMilkfairy

Interesting. That could be why I'm still alive then. Xx

Milkfairy profile image
MilkfairyHeart Star in reply toSljp0000

Yes, the body is clever it also grows new blood vessels in the heart if an artery is completely blocked.

Known as angiogenesis, the body's natural bypass.

Sljp0000 profile image
Sljp0000 in reply toMilkfairy

Good to know. I'm worried about restenosis at the moment.

Quaddie profile image
Quaddie

I found the heart mri With stress dye an ideal too. I was scared it could cause a small heart attack although the scan lady assured me it wouldn't they could stop anything untoward happening . Which I was diagnosed with abroad. Got all muddled towards the end if the hour with the in and out breathing. It needed ro be done so just did it. Wish you well.

Jane_Patrick profile image
Jane_Patrick

I had this done. Found it really uncomfortable and worse than my actual heart attack!

Results all good though and heart healthy so discomfort (which I was warned about beforehand) was worth it.

Good luck.

XmasEve24 profile image
XmasEve24

Hello - Women often experience heart pain differently to men i.e not in their chest. All my pain was in my back between my shoulder blades. It got progressively worse over a period of about 3/4 years and usually in the early hours at rest. The pain that got me to the gp was when it went down my arms and into my jaw. An angiogram showed I needed an emergency double bypass. There is a very useful book by Angela Maas ‘ A Woman’s Heart’ available from Amazon. She is a female cardiologist - well worth a read. Good luck 😊

Milkfairy profile image
MilkfairyHeart Star in reply toXmasEve24

Prof Angela Maas' book is a great read. It can't be over shared!

You maybe interested in this article which was published by a leading researcher into women and heart disease, her PhD student and a woman heart patient advisor.

The leading author was the first woman to be appointed as a Professor of Interventional Cardiology, in the UK, only a few years ago.

academic.oup.com/eurheartj/...

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