The Correct Answer is D!

In which of the following patients can MRI scanning be safely performed for evaluation of myocardial viability?

A. A 45-year-old man with longstanding CRF and GFR of 29 mL/min
B. 77-year-old woman with a VVI pacemaker who is pacemaker dependent
C. 60-year-old woman who had clips for ruptured cerebral aneurysm 10 years ago
D. 66-year-old man with multiple coronary stents and a descending aortic stent


Rationale:

It is important to know the relative and absolute contraindications to MRI scanning. Intracoronary and intravascular stents are not contraindications but the ferromagnetic clips used for brain aneurysms are a contraindication. Patients with renal dysfunction should not receive gadolinium, which is needed to assess viability due to the increased risk of nephrogenic systemic fibrosis. Although pacemaker devices are increasingly being imaged, this is discouraged in patients who are pacemaker dependent.

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