Heart Screening and Imaging

At the Oklahoma Heart Institute, we are proud to be the first cardiovascular magnetic resonance imaging (MRI) department in the United States. Our heart institute has more than 20 years of study and experience in the field of cardiovascular MRIs, and we perform more than 3,000 studies per year. We were also the first MRI center in the world to perform a clinical research study on MRI patients with pacemakers and implantable cardioverter defibrillators. Patients now routinely receive medically necessary MRI scans when previously it was a strict contraindication.

A cardiovascular MRI is a non-invasive test that is used to evaluate the structure and function of the heart and blood vessels. MRIs use large magnets and radiofrequency waves to produce high-quality still and moving images of the body’s internal structures. Because MRIs don’t use X-rays to create images, you will not be exposed to potentially harmful radiation.

Heart MRI scans allow our cardiovascular imaging specialists to obtain images of larger areas (such as the chest or entire cardiovascular system) from many different angles. Your physician may recommend an MRI heart scan if they require information about your cardiovascular system that cannot be obtained through other tests.

Indications

• Etiology of Cardiomyopathies (LV/RV)
• Valve disorders (qualitative/quantitative)
• Pericardial disease
• Myocarditis
• Masses
• Congenital heart disease
• EP applications
• Myocardial viability
• Stress MRI (perfusion or dobutamine)
• Poor quality echocardiograms
• Aortic diseases
• Aortic arch branch vessel disease
• Cartoid artery disease
• Renal artery disease
• Mesenteric disease
• Iliofemoral, popliteal and infrapopliteal disease
• Anomalous coronary arteries
• Coronary artery graft patency
• Pulmonary emboli
• Venus evaluation

Contraindications:

• Pre-6100 series Starr-Edwards
• First trimester of pregnancy
• Neurostimulators
• Cochlear implants
• Bone growth stimulators
• Intracranial aneurysm clips

Relative Contraindications:

• End stage renal disease (in patients requiring contrast)
• Implanted cardiac devices (pacemakers, ICDs…)
• Claustrophobia
• Body habitus
• Foreign body near vital structures

What to expect during a cardiovascular MRI

During your cardiovascular MRI, you will be positioned on a moveable exam table inside of the MRI scanner. The scanner is a tube with an opening on each end. This test will require you to remain completely still and inside of the scanner, but you will be able to communicate with your technologist at all times. Occasionally you will be asked to hold still or hold your breath, as motion can decrease the quality of images. 

If a contrast material (gadolinium) is needed, a health professional will administer it through an intravenous (IV) line. These contrast materials help physicians identify irregularities in the heart and surrounding vessels. The material is different from other vascular contrast and does not contain iodine. It does not affect kidney function, but if you have kidney disease a quick blood test will be done.

The length of the MRI scan varies depending on what kind of information your doctor has requested, but typically ranges from 30-90 minutes. The exam is completely painless. A mild sedative may be given to patients who experience anxiety or have difficulty staying still during the procedure.

Typically, the results of your examination will be available to your doctor within 24-48 hours. Your doctor will then communicate the results of the study directly to you.

Here are a few other things to remember before your MRI:

• Arrive at least 30 minutes prior to your appointment time: There are many questions we need to ask prior to the MRI scan to help determine whether or not it is safe for you to undergo the MRI study. You will also need to recount your medical history to ensure a quality study. Tell the technologist if you have any metal within your body, and if you have kidney disease.
• Ask for a sedative: If you are claustrophobic, or are uncomfortable in closed in places, tell your physician so that arrangements can be made to make you more comfortable.
• Request music to listen to: Music may help you to relax while you are in the scanner. Spotify and Pandora are available to use.
• Do not wear metal: Leave all of your jewelry at home.
• Dress lightly or in layers: It can get warm in the MRI scanner. This will allow you to undress easily to a comfortable level.
• If you have a cough: Consider taking a cough suppressant. You may be reminded not to cough or move during the scan.

About our contrast agent, gadolinium

Gadolinium is a chemical element that has paramagnetic properties. It looks clear like water and is non-radioactive and contains no iodine. It is commonly injected into a vein and is used to brighten blood vessels and to differentiate normal from abnormal tissue. Gadolinium has been used for years in adults and children in the United States and throughout the world without any serious complications in tens of thousands of patients. The FDA declared gadolinium safe for use in cardiovascular MRI in 1988. A few side effects, such as mild headache, nausea and local burning can occur.

An allergic reaction is very rare (less than one in a thousand). Gadolinium must be used with caution in patients with kidney disease because of the potential rare complication called nephrogenic systemic fibrosis (NSF). The FDA issued a black box warning in May 2007 regarding the use of gadolinium in patients with kidney disease. It can found on the FDA website. Gadolinium should be used in pregnant patients or nursing mothers only when the benefits outweigh the risk. Gadolinium used in cardiovascular MRI is many times safer than the iodine type contrast used in invasive angiography or CT scans.

Our cardiologists and imaging specialists offer calcium score, a specialized X-ray that provides pictures of your heart to help detect and measure plaque buildup lining the walls of your coronary arteries. Plaque buildup narrows the arteries, restricts blood flow to the heart and ultimately can lead to a heart attack if left unchecked. By detecting plaque buildup early, your doctor can provide a treatment plan to help you reduce your chances of a heart attack or stroke.

Before the scan, a technician will attach sensors (electrodes) to your chest These sensors connect to a device that records your heart activity and helps take X-ray pictures between heartbeats when the heart muscles are relaxed. You will then lie on your back on a table that slides into a CT scanner and hold your breath for a few seconds while cardiac images are collected. After the procedure, you can drive yourself home and resume your normal activities. This test lasts only 10-15 minutes. 

If you are 40 years or older and are at an increased risk for heart disease, you should consider a CT cardiac calcium score. You are at an increased risk if you:

• Are diabetic
• Are overweight or lead an inactive lifestyle
• Are a past or present smoker
• Have a family history of heart disease
• Have a history of high cholesterol, diabetes or high blood pressure

We can help you manage your heart health by starting with a heart scan to detect potential issues before they happen. Heart scan can also motivate you to make important lifestyle changes and follow treatment plans for a lifetime of good heart health.

Call 918-592-0999 to schedule a $99 cardiac calcium score today. No referrals are required . Below are additional preventative lifesaving screenings we offer. Ask about bundling them for an added discount.

Nuclear cardiology is a non-invasive imaging technique that evaluates your heart health using sophisticated gamma camera equipment. These tests involve an intravenous injection of radioactive material to measure coronary blood flow. 

At the Oklahoma Heart Institute, our nuclear cardiology laboratories were the first Intersocietal Commission for the Accreditation of Nuclear Medicine Laboratories (ICANL) in the state of Oklahoma. We sought accreditation to show our commitment to high quality nuclear cardiac imaging. Our labs have set forth strict protocols that ensure accurate testing, patient safety and correlation with clinical symptoms and previous diagnostic tests.  

Nuclear cardiology studies are interpreted by a select group of formally trained non-invasive cardiologists. All interpreting cardiologists have attained the training and requirements to be licensed as authorized users of radiopharmaceuticals as outlined by the State of Oklahoma and the American Society of Nuclear Cardiology.

Our nuclear cardiology tests include:

• Exercise stress testing: This test is designed to help your physician determine how well your heart works under pressure. During this test, you will be hooked up to an EKG machine and several sticky pads (sensors) will be placed on your skin. Your heart rate and breathing will be checked before you begin exercising. Then you will slowly start walking on a treadmill. As the test progresses, the speed and grade of the treadmill will be increased, and your vital signs will be monitored. You may request to stop this test at any time. Afterwards, your heart rate and blood pressure will be checked.  A physician may recommend this test to those currently experiencing chest pain, to help diagnose coronary artery disease or to determine a safe level of exercise.
• Gated blood pool SPECT imaging: This imaging test involves labelling the red blood cells in your blood with a radiopharmaceutical and then measuring the amount of blood in the heart during different parts of the heartbeat. This is the analysis of the amount of radioactive blood pooling in the heart chambers at different times of an average cardiac cycle. Our gated pool SPET imaging tests include left and right ventricular ejection fraction and multigated acquisition (MUGA) scans.
• Myocardial perfusion imaging: This procedure gives your physician the ability to view the flow of blood to the heart muscle. This helps them determine if your heart is receiving enough blood, if you have coronary artery disease, and if additional testing is required. First, the arteries in the heart are dilated or enlarged by means of exercise or prescription medication. Then, a trace amount of radioactive imaging agent is then injected. A special camera is then used to take images of your heart and see if there are any parts of your heart that are not getting enough blood. This will be compared with another image of your heart at rest, with you lying comfortably on your back with arms extended above your head. If you have healthy coronary arteries, there will be little to no difference between the two images.

To learn more about our nuclear cardiology services, please call us.

The multigated acquisition scan, or MUGA scan, is a highly accurate imaging test used to evaluate the pumping function of the ventricles or lower chambers of the heart. During this test, a small amount of radioactive tracer is injected into a vein. A special gamma camera detects the radiation released by the tracer to produce computer-generated images of the beating heart.

Also known as a gated blood pool test, the MUGA scan takes the following measurements:

• Left ventricular ejection fraction (LVEF) –  How much blood is being pumped out of the left ventricle of the heart (the main pumping chamber) with each contraction.
• Right ventricular ejection fraction (RVEF) – How much blood is being pumped out of the right ventricle of the heart (the main pumping chamber) with each contraction.

During the procedure, the patient lies still while the camera takes multiple images of the heart at different phases of the cardiac cycle. The entire process typically takes about 1-2 hours. The amount of radiation used is relatively low and considered safe for most patients, although it is not recommended for pregnant women unless absolutely necessary. Ultimately, MUGA gated blood pool SPECT scan is a valuable diagnostic tool for cardiologists to assess heart function and plan appropriate treatments.