Introduction

Clinical indications for cardiac magnetic resonance imaging: A practical approach

Cardiac magnetic resonance (CMR) is a highly versatile technique, with the ability to assess both cardiac structure and function comprehensively. Following a brief introduction to the technique itself and relevant aspects of patient safety, the role of CMR in various clinical contexts will be reviewed.

The focus will be on:

  • the more common clinical applications of CMR
  • specific scenario’s where CMR provides incremental value to other imaging modalities
  • a practical guide to decide if ordering a CMR scan will add clinical benefit 

Evidence-based approach to the patient with asymptomatic coronary artery disease

Coronary artery disease (CAD), which is defined by atherosclerosis of the epicardial arteries, is characterised by progressive inflammation of the arterial wall leading to the formation of lipid rich plaques in the vessel wall. Clinical manifestations occur when these atheromata either impede blood flow or, when plaque events such as erosion, fissuring or rupture lead to partial or complete thrombotic vessel occlusion. Conversely, the plaques may be quiescent for variable periods of time and thus patients may be asymptomatic.

Update in heart failure management 

The prevalence of heart failure is estimated at 1-2% of adults. The prevalence increases with advancing age, with a prevalence of up to 10% in those above the age of 70 years

Revascularisation for left ventricular dysfunction secondary to ischaemia: The why, how and who?

There has been a shift in the cardiovascular disease profile which is reflected in data from numerous studies: the Global Burden of Disease 2017 demonstrated ischaemic heart disease ranked top four amongst all underlying causes of heart failure according to age standardised prevalence rates regardless of sex or geographic region;3 this is reiterated by the Inter-CHF and Heart of Soweto Studies which revealed hypertension, dilated cardiomyopathy, rheumatic heart disease and CAD as the predominant causes of heart failure in African countries

Certification

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Heart Matters Vol 13 No 1 - February 2022