Utility of rest magnetocardiography in patients presenting to the emergency department with chest pain: A case series on the CardioFlux MCG

• Published in: American heart journal plus Vol. 45; p. 100441
• Main Authors: Mace, Sharon E., Pena, Margarita, Ahee, David J., Takla, Robert
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.09.2024; Elsevier
• Subjects: Acute coronary syndrome; Chest pain; Emergency department; High-sensitivity troponin; Ischemia; Magnetocardiography; Magnetocardiography; Emergency department; High-sensitivity troponin; Ischemia; Acute coronary syndrome; Chest pain
• ISSN: 2666-6022; 2666-6022
• DOI: 10.1016/j.ahjo.2024.100441

Magnetocardiography (MCG) may provide a rapid diagnostic option for patients presenting with chest pain in the emergency department (ED). This case series presents two instances from a multicenter study, where MCG could have served as a rapid, non-invasive diagnostic tool for chest pain patients. In both cases, multiple high-sensitivity troponin (hsTn) tests yielded incorrect evidence of ischemia. In the first case, multiple positive hsTn tests led to the patient requiring 23 h of observation care, while MCG rapidly ruled out acute coronary syndrome (ACS). In the second case, MCG revealed findings indicative of cardiac ischemia where serial ECGs did not indicate ischemia and serial hsTns were normal. Subsequent cardiac catheterization confirmed 99 % stenosis in the patient's left main and left anterior descending arteries, necessitating coronary artery bypass grafting (CABG). MCG offers a rapid, painless, non-invasive, radiation free assessment for patients presenting with acute chest pain. Integrating MCG into ED workflows has the potential to improve throughput, reduce the need for subsequent patient observation or inpatient admission, and minimize or eliminate the need for other more expensive non-invasive cardiac testing. MCG avoids some of the problems associated with other methods for diagnosing ischemia. MCG does not involve radiation or the use of pharmacologic agents which have a risk for allergic reactions and anaphylaxis, or the need for an intravenous line. Stress tests are frequently contraindicated or unable to be performed in patients on various medications, may require patient cooperation and in the case of exercise stress tests, the patient's capability to exercise. MCG requires no special patient preparation. •Magnetocardiography (MCG) offers the potential for the rapid diagnosis of acute coronary syndrome (ACS) in intermediate risk patients with chest pain and has significant advantages over other non-invasive cardiac diagnostic testing modalities in the emergency department (ED) setting.MCG is particularly valuable in cases:•Where high-sensitivity troponin (hsTn) and electrocardiography (ECG) fail to detect coronary ischemia.•Where hsTns are elevated but the etiology remains unclear.•In intermediate risk patients where ACC/AHA guidelines recommend non-invasive testing (National Center for Health Statistics N., 2021).•In a clinical setting where timely dispositions may help with ED overcrowding and boarding of patients.