Cardiac magnetic resonance (CMR) imaging has a wide range of clinical applications with a high degree of accuracy for many myocardial pathologies. Recent literature has shown great utility of CMR in diagnosing many diseases, often changing the course of treatment. Despite this, it is often underutilized possibly due to perceived costs, limiting patient factors and comfort, and longer examination periods compared to other imaging modalities. In this regard, we conducted a literature review using keywords “Cost-Effectiveness” and “Cardiac MRI” and selected articles from the PubMed MEDLINE database that met our inclusion and exclusion criteria to examine the cost-effectiveness of CMR. Our search result yielded 17 articles included in our review. We found that CMR can be cost-effective in quality-adjusted life years (QALYs) in select patient populations with various cardiac pathologies. Specifically, the use of CMR in coronary artery disease (CAD) patients with a pretest probability below a certain threshold may be more cost-effective compared to patients with a higher pretest probability, although its use can be limited based on geographic location, professional society guidelines, and differing reimbursement patterns. In addition, a stepwise combination of different imaging modalities, with conjunction of AHA/ACC guidelines can further enhance the cost-effectiveness of CMR.
Hereditary hemorrhagic telangiectasia (HHT) is a condition known for frequent and severe epistaxis, telangiectasias that form along various surfaces of the body, and potentially life-threatening arteriovenous malformations (AVMs) that may develop in major organ systems. Management of this condition begins with prompt diagnosis, followed by careful screening for systemic complications, and care to minimize morbidity associated with blood loss. We hereby describe a case of treatment-resistant HHT in a geriatric patient who suffers from recurrent and severe epistaxis warranting frequent hospitalizations and blood transfusions. The case underscores the need to recognize HHT early, begin treatment promptly, and closely follow these patients to minimize the risk of hospital readmission.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.