Abstract 1333: Advanced Cardiac Imaging Uncovers Diagnosis in Patients With Persistent Chest Pain
Background: Persistent chest pain (PCP) is often a diagnostic dilemma in women. The use of cardiac magnetic resonance imaging (CMRI) for advanced diagnostic assessment in female patients with PCP is a non-ionizing radiation option, but the diagnostic utility in this population is unknown. We examined the role of CMRI in the diagnosis for women with PCP.
Methods: At a tertiary chest pain center, we analyzed 113 consecutive patients who had prior cardiac evaluations for PCP and underwent CMRI. CMRI included anatomic, functional, adenosine stress perfusion and delayed enhancement imaging.
Results: The population demographics included a mean age of 55 + SD years with an average BMI of 25±4.5. Overall, 43% had hypertension, 4% had diabetes and 3% were smokers. Among these women, 80/113 (70%) demonstrated abnormal CMR results (Figure⇓). The majority of these patients demonstrated findings consistent with subendocardial perfusion abnormalities consistent with microvascular angina. Of note, 3 patients (4%) were diagnosed with potentially life-threatening congenital coronary anomalies or hypertrophic obstructive cardiomyopathy not detected in prior cardiac evaluations.
Conclusions: Among women with PCP referred for tertiary medical center evaluation, CMRI is frequently abnormal. CMRI is useful for advanced diagnostic assessment in patients with PCP by detection of diagnoses with important therapeutic implications.