Abstract
INTRODUCTION: Cardiac disease is a major cause of morbidity and mortality worldwide and
therapeutic advances continue to be made. Improved accuracy of diagnosis and risk
stratification is therefore important. Advanced imaging using contrast enhanced magnetic
imaging ( ceMRI) is under investigation for assessment of myocardial necrosis in both acute
and chronic settings due to ischaemic and non -ischaemic aetiologies. Consecutive patients with
an incident episode of chest pain necessitating hospital admission were recruited and
underwent ceMRI. CeMRI was considered the gold standard for determining presence of
ischaemic myocardial necrosis and used to evaluate current ECG guidelines in acute chest pain
syndromes. ST segment elevation on the presenting ECG determines the acute reperfusion
strategy but will not detect all infarcts and additional consideration of ST depression termed,
"STEMI equivalent" may reduce the burden of missed AMI. Infarct size (IS) was measured by
manual planimetry of regions of delayed hyperenhancement (DE) and then correlated with
routinely available biochemical and bioelectrical markers. The evolution of infarct size and
characteristics were then followed using at ceMRI at 4 time points out to 1 year. The role of
inflammation in MI using CRP as the marker was also investigated. Finally, additional clinical
information was provided by performing ceMRI in this group of patients and the findings are
presented.
