Pediatric cardiac MRI stress test

What is a pediatric cardiac MRI stress test?

A pediatric cardiac MRI stress test is an imaging test. We do cardiac MRI stress tests with machines that have heart-specific equipment and software. We also use specific medications that help elevate your child’s heart rate during the test.

Doctors mostly use cardiac MRI tests to diagnose congenital heart diseases, which are heart disorders that some children are born with.

We also use cardiac MRI to identify any heart problems your child may have developed after birth, too, such as:

• Coronary artery diseases

• Pericardial diseases (diseases affecting the outside lining of the heart)

• Heart tumors

• Cardiomyopathy

• Heart valve disease

The pictures from a cardiac MRI show doctors any abnormal tissue in your child’s heart. They can also help doctors better understand results from other imaging tests your child has had, such as chest X-rays and chest CT scans.

Cardiac MRI stress tests help your child’s doctor see how these problems affect your child’s heart during exercise. This information can help doctors understand whether your child’s heart can cope well with the demands of physical or emotional exertion.

What are the benefits of a pediatric cardiac MRI stress test?

Your child may need a pediatric cardiac MRI stress test to help us evaluate their heart function and performance while under stress. This information is especially important if your child experiences coronary artery issues (problems with blood supply to the heart muscle).

Most types of cardiac imaging, such as cardiac MRI, CT or echocardiography, tell us how well your child’s heart works when they are resting. Stress MRI tells us how well your child’s heart copes with exertions such as walking, climbing stairs, playing, feeding or experiencing extreme emotions.

What are the side effects of a pediatric cardiac MRI stress test?

A cardiac MRI stress test is a safe test, but your child may experience minor side effects, such as:

• Nausea or a rash. We use a dye (contrast agent) that helps the heart and its blood vessels show up more clearly on the scan. These side effects should go away within a day.

• Discomfort. Your child might experience some brief discomfort from the medicine that we use to increase their heart rate.

If your child has asthma, please tell your child’s doctor or care team so we can use a different medication.

What are the risks of a pediatric cardiac MRI stress test?

A cardiac MRI stress test has few risks, and some important things to keep in mind include:

• MRI machines cannot be used on children with medical devices such as certain pacemakers, cochlear implants or implanted drug pumps. Please tell your child’s doctor or MRI technologist if your child has one of these, and they can advise you.

• Infants and young children often need a sedative or anesthesia to help them hold still during an MRI exam. Our pediatric anesthesia team will help prepare your child for the test in the safest way possible.

• Metal and electronic items can be unsafe to have around the MRI’s magnetic field. If your child has medical implants, jewelry or piercings, talk to the MRI technician before the test.

• Some children may experience a breathing or heart rhythm problem during a cardiac MRI stress test, although these issues are very rare. If your child experiences any problems, our trained providers are present during the test to help.

What to expect with a pediatric cardiac MRI stress test

What to expect before a pediatric cardiac MRI stress test

Our specialty-trained pediatric MRI technologists, MRI cardiologists and radiologists perform your child’s cardiac MRI stress test. These experts will help you prepare your child before the test. Your child’s cardiologist will interpret the results and explain them to you.

The cardiac MRI stress test usually takes about 45 minutes to an hour. The actual stress portion of the test will last only between 3 to 10 minutes.

Your child will need one or two IVs placed for the procedure, which will deliver the medication to raise their heart rate. Your child’s care team may also want to use a contrast dye to highlight the heart and blood vessels. You should prepare your child for this experience ahead of time if it is required for their procedure.

Your child may feel discomfort from the IV needle or a cool sensation as the contrast dye goes in. Make sure to let your child’s care team know if they have asthma or allergies to contrast material or use an inhaler.

What to expect during a pediatric cardiac MRI stress test

The MRI machine looks like a large tunnel or donut. Your child must lie still on a table that will move into the machine.

Your child may hear loud sounds from inside the machine as the MRI team takes pictures of their heart and chest. Your child will wear ear protectors and can listen to music or watch a movie during the test to distract from these sounds. They will also be able to hear and talk to the technician while they are inside the machine. The technician may ask your child to hold their breath for a few seconds during the MRI.

The doctor will let your child know when they are starting the medication through the IV. When they start this medication, your child’s heart rate will be higher than usual, so they may feel some discomfort during this portion. This part will not last more than a few minutes.

One of the cardiologists will be in the room with your child through the stress portion of the test. Two other cardiologists and a nurse will be actively and closely monitoring your child’s breathing, heart rate and blood pressure.

What to expect after a pediatric cardiac MRI stress test

During and after the test, the MRI team will verify all the images. We monitor your child until their heart rate returns to normal and they feel ready to go home, after which we remove the IV and bandage the site. This recovery time usually takes about 15 minutes.

Your child’s cardiologist and MRI team will help explain the images and next steps.

How do I prepare my child for a pediatric cardiac MRI stress test?

Before the MRI stress test, make sure to explain why the scan is needed, what it will feel like and how long it will take to your child. Your child’s care team will also provide specific instructions about what your child should eat, drink and do leading up to the test.

Because the MRI uses a magnetic field, make sure to take any jewelry or hair clips off your child before the procedure. You will also want to ensure that any stuffed animals or toys they take with them do not have any metal parts.

Our Child Life therapists are available to help make sure your child feels calm and confident before, during and after the test. They provide emotional support animals, music and other tools to keep children relaxed and comfortable.

You may go into the MRI room with your child to help comfort them, but you will also need to be screened for metal objects and implanted devices.

What questions should I ask my provider about a pediatric cardiac MRI stress test?

• How many Pediatric Cardiac MRI Stress Tests have you performed?

• Are there other diagnostic options you can use instead of a Pediatric Cardiac MRI Stress Test?

• What medication will be used for the stress portion of the test?

• Will my child need to spend the night at the hospital after a Pediatric Cardiac MRI Stress Test?

• What medications should my child stop taking before a Pediatric Cardiac MRI Stress Test?

• Can my child eat before the test? Are there any foods or drinks to avoid before the test?

• Will my child go home with any special equipment after their Pediatric Cardiac MRI Stress Test?

• How soon will I be able to see my child after their Pediatric Cardiac MRI Stress Test?

• May I be in the MRI room with my child?