Magnetic resonance imaging (MRI) has been used for peering at the body's organs, but scientists say it can also tell whether chest pain is a harbinger of a future heart attack.

An MRI scan creates three-dimensional images and can predict the odds of a heart attack or heart-related death in people with chest symptoms, even after accounting for risk factors such as high blood pressure, smoking and diabetes. Intriguingly, the authors of a recent study say, the device can even pinpoint reduced blood flow to the apex of the heart, a particular signal of trouble.

The MRI pictures are clearer than conventional noninvasive heart imaging, says Dr. W. Gregory Hundley, a radiologist at Wake Forest University School of Medicine in Winston-Salem, North Carolina, and leader of the research team.

Doctors generally create an image of the heart using ultrasound technology. That test is cheap and portable, but it doesn't work very well on obese people or smokers. In fact, up to 20% of patients have pictures that are difficult to read.


Hundley's group gave MRI "stress tests" to 279 people who had cardiovascular disease and poor sound wave images. To simulate the effects of exercise, doctors gave the patients drugs that make the heart beat faster.

People whose blood flow was reduced by 40% or more had four times the risk of a heart attack or heart-related death over the next two years than those with normal results.

Hundley's group was the first to take pictures of damage to the apex—the top of the heart. People who had such damage were six times more likely than those without injury to experience more heart attacks or to die of cardiovascular illness.

Unfortunately, MRI is not for everyone. The machines don't function properly in the presence of metal plates, pacemakers or defibrillators, so some people can't undergo the test.

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