Mace Sharon E, Baugh Christopher, Pena Margarita E, Takla Robert
Cleveland Clinic, Department of Emergency Medicine, Cleveland, OH, USA.
Cleveland Clinic Lerner College of Medicine at Case Western Reserve University, Department of Emergency Medicine, Cleveland, OH, USA.
Am Heart J Plus. 2025 Apr 10;54:100541. doi: 10.1016/j.ahjo.2025.100541. eCollection 2025 Jun.
Chest pain is a common complaint of outpatients and emergency department patients. These patients are often referred for noninvasive cardiac imaging (NCI). Problems with NCI include limited availability, lengthy test delays, test duration, radiation exposure, adverse events, NPO (holding medications, caffeine/food/liquids/tobacco), exercise requirement, limitations for certain populations, inability to assess for ischemia with no obstructive coronary artery disease (INOCA), contrast/medication/needlestick-intravenous (IV) line needed.Magnetocardiography (MCG) advantages include faster, easier test administration, radiation avoidance, less resource utilization, safer, no needlestick/IV requirement, no NPO for caffeine/food/liquids/tobacco, and no holding medications. By avoiding medications and/or exercise, MCG avoids risk of provoking myocardial injury and dangerous events (arrhythmias). No contrast or pharmacologic agents are needed with MCG, eliminating side effects/complications: tissue necrosis from extravasation, contrast-induced nephropathy, allergic reactions including life threatening anaphylaxis.
MCG comparison with NCI: exercise stress test, stress echo, dobutamine stress echocardiogram, myocardial perfusion imaging: single photon emission computed tomography (SPECT) or positron emission tomography (PET), cardiac magnetic resonance imaging (cMRI), coronary computed tomography angiography (CCTA).
Literature review: NCI versus MCG.
MCG is a rapid, safe, effective, painless and radiation-free test, does not require contrast/medication administration. MCG by avoiding provocative medications and/or exercise eliminates the risk of provoking myocardial injury and causing dangerous events such as arrhythmias. MCG avoids testing delays, has higher patient satisfaction, no NPO requirement, no holding medications or caffeine/food/liquids/tobacco, with similar sensitivity and specificity. Additional clinical research is needed to validate its utility. MCG may be a complementary modality alongside current NCI.
胸痛是门诊患者和急诊科患者的常见主诉。这些患者常被转诊进行无创心脏成像（NCI）。NCI存在一些问题，包括可用性有限、检查延迟时间长、检查持续时间、辐射暴露、不良事件、禁食（停用药物、咖啡因/食物/液体/烟草）、运动要求、对某些人群的限制、无法评估无阻塞性冠状动脉疾病（INOCA）时的缺血情况、需要造影剂/药物/静脉穿刺（IV）置管。心磁图（MCG）的优点包括检查实施更快、更容易，避免辐射，资源利用更少，更安全，无需静脉穿刺/IV置管，无需禁食咖啡因/食物/液体/烟草，无需停用药物。通过避免使用药物和/或运动，MCG避免了诱发心肌损伤和危险事件（心律失常）的风险。MCG无需造影剂或药物，消除了副作用/并发症：外渗导致的组织坏死、造影剂肾病、包括危及生命的过敏反应在内的过敏反应。
MCG与NCI的比较：运动负荷试验、负荷超声心动图、多巴酚丁胺负荷超声心动图检查、心肌灌注成像：单光子发射计算机断层扫描（SPECT）或正电子发射断层扫描（PET）、心脏磁共振成像（cMRI）、冠状动脉计算机断层血管造影（CCTA）。
文献综述：NCI与MCG。
MCG是一种快速、安全、有效、无痛且无辐射的检查，无需给予造影剂/药物。MCG通过避免使用诱发药物和/或运动，消除了诱发心肌损伤和导致心律失常等危险事件的风险。MCG避免了检查延迟，患者满意度更高，无需禁食，无需停用药物或咖啡因/食物/液体/烟草，敏感性和特异性相似。需要更多的临床研究来验证其效用。MCG可能是当前NCI的一种补充方式。
