Can cardiac MRI technology distinguish between viral and congenital causes of heart failure?

Can cardiac MRI prove if heart failure in a 14-year boy (EF < 25%) is caused by a virus or is congenital?

Submitted by Hani from Nablus West Bank on 07/11/2017

by Benjamin Y. Cheong, MD

Cardiac magnetic resonance imaging (MRI) is regarded as one of the gold standards in the assessment of heart disease. In the hands of a qualified practitioner, cardiac MRI can provide very high quality data in the assessment of cardiac function (ejection fraction); detection of underlying congenital heart disease (such as abnormal connection between different cardiac chambers, or absence of particular heart chamber); and assessment of valvular function (if there are leaking valves).

More importantly, cardiac MRI can also evaluate / characterize the heart muscle (myocardium) in order to assess if there is any prior injury, such as in the setting of viral cardiomyopathy (myocarditis). Ideally, it should be performed with and without contrast (gadolinium).

The duration of the cardiac MRI varies. Depending on the amount of images taken, the study can last between 60 to 90 minutes. It requires the subject (patient) to remain still in the scanner to obtain accurate images.