Don’t perform stress cardiovascular magnetic resonance (CMR) in the initial evaluation of chest pain patients with low pretest probability of coronary artery disease.
There are lower cost stress tests available for the initial evaluation of low-risk chest pain patients, particularly when they have a normal electrocardiogram and can exercise. Stress CMR can be valuable in evaluating intermediate-risk patients with abnormal electrocardiograms or who cannot exercise, or when initial test results are equivocal.
These items are provided solely for informational purposes and are not intended as a substitute for consultation with a medical professional. Patients with any specific questions about the items on this list or their individual situation should consult their physician.
The Society for Cardiovascular Magnetic Resonance (SCMR) has developed the following list of tests involving cardiovascular magnetic resonance imaging (CMR) thought to be overused or misused. This list was developed by a subcommittee of the SCMR and reviewed and approved by the SCMR Board of Trustees. The list was based primarily on appropriateness guidelines for CMR, published by both the American College of Cardiology and the American College of Radiology, with the goal of limiting the inappropriate use of expensive imaging testing in low-risk patients or where it is unlikely to add to clinical management.
SCMR’s disclosure and conflict of interest policy can be found at www.scmr.org.
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American College of Radiology; Society of Cardiovascular Computed Tomography; Society for Cardiovascular Magnetic Resonance; American Society of Nuclear Cardiology; North American Society for Cardiac Imaging; Society for Cardiovascular Angiography and Interventions; Society of Interventional Radiology. ACCF/ACR/SCCT/SCMR/ASNC/NASCI/SCAI/SIR 2006 appropriateness criteria for cardiac computed tomography and cardiac magnetic resonance imaging. J Am Coll Radiol. 2006 Oct;3(10):751–71.
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