An MRA (magnetic resonance angiogram) is often used to see if there’s anything wrong with the heart and associated structures.

If someone has an MRA, the report will include what the ejection fractions are for each ventricle.

This made me wonder if an MRA could detect and diagnose congestive heart failure, since I was thinking that a very low ejection fraction (such as under 35 percent) might mean CHF.

“MRI is the gold standard for determining ejection fraction,” says cardiologist and internal medicine specialist Norman E. Lepor, MD, who’s with Cedars Sinai in Beverly Hills, CA.

MRI stands for magnetic resonance imaging, so the MRA is a type of MRI.

Dr. Lepor adds that MRI is an intrinsic three-dimensional imaging modality. He further explains, “Echocardiography [ultrasound] is the modality most commonly used to determine ejection fraction.

“CHF is a clinical diagnosis that is based on symptoms and biomarkers such as BNP levels. Remember, half of patients with CHF have preserved ejection fractions.”

What would be abnormal on the findings?

Dr. Lepor explains, “Finding on MRI or echo can include enlargement of the heart chamber sizes, reduced ejection fraction in some patients, thickening of ventricular muscle thickness, leaky or stenotic [narrowed] heart valves, abnormal estimated pulmonary artery pressures, abnormal blood flow patterns from the left atrium to the left ventricular consistent with either diastolic or systolic dysfunction.”

An MRA to show heart function is an expensive procedure and is not used to screen for congestive heart failure.

Instead, it’s ordered by a cardiologist as a diagnostic procedure after the doctor finds, during an examination, something concerning and wants to pursue the cause.

In addition to ejection fraction values and the possibility of congestive heart failure, an MRA will show other details that can help a cardiologist understand what’s going on with the patient’s heart, such as any abnormally enlarged structures.

Having performed over 4,000 coronary angiograms and angioplasties, Dr. Lepor has focused on prevention and treatment of coronary heart disease. 
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.  


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