Choosing Wisely

CMR Tests for Chest Pain and Cardiac Screening

When you need this imaging test—and when you don’t

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CMR is a test that takes pictures of your heart and blood vessels. It is a kind of MRI (magnetic resonance image). Doctors use this test to look for heart disease or to see how well the heart is working.

But CMR may not be the best test for you.

  • It may not give enough information.
  • Some simpler tests may work as well.
  • The test has some risks.

One kind of CMR is called a stress CMR. A drug is injected to create a stress-like condition. The test shows how your heart does when it’s working harder.

CMRs can cost $1,200 or more, depending on your insurance and where you live.

Benefits of CMR tests:

CMR gives more detail than most tests. It can help if other test results aren’t clear. It is better at finding damage to the heart muscle. And it is generally very safe and does not use radiation.

Risks of CMR tests:

  • Some people have bad reactions to contrast agents. These are used in CMR and other tests to improve the detail of the pictures.
  • The drug used in a stress CMR can lead to temporary changes in blood pressure or heart rate. There’s a very small risk of heart attack, as in other stress tests.

Think twice about having the test. The Society for Cardiovascular Magnetic Resonance (SCMR) offers these guidelines:

CMR for coronary artery disease

These arteries take blood and oxygen to your heart.

You probably don’t need CMR if you don’t have symptoms of coronary artery disease.

But if you do have symptoms, CMR may help find:

  • Blockages in these arteries.
  • Heart muscle damage.
  • Other, less common abnormalities of these arteries.

CMR when you have chest pain

When you first report chest pain, your doctor should order an EKG or exercise stress test, even if blocked coronary arteries are suspected.

Stress CMR may be helpful if:

  • Your EKG or exercise stress test results are not normal.
  • You can’t exercise.
  • You have a moderate-to-high risk of heart disease because of high blood pressure, diabetes, or other conditions.

CMR during a possible heart attack

You should not have a stress CMR if you might be having a heart attack. (Symptoms include severe chest pain, shortness of breath, nausea, heavy sweating, being very tired, or a pounding or racing heart.)

The drug used in a stress CMR could make your heart attack worse. And the test delays the treat­ment you really need. If an ER doctor orders a stress CMR, ask why you need it.

You can have a CMR after your heart attack is treated. The test can help show if your heart has been damaged.

CMR with a coronary stent

It is safe to have CMR with a coronary stent. However, the stent causes “blind spots” on the pic­tures of these arteries and can hide a new blockage.

It may be helpful to have stress CMR or an angiogram instead, because these tests will give your doctor more information.

Stress CMR before low-risk surgery that doesn’t involve the heart

You should not have stress CMR if you have a low risk for heart problems. There are no benefits to having the test.

You can have stress CMR if:

  • You have a medium or high risk of heart problems.
  • You can’t exercise.

Your doctor may order a stress CMR to make sure it is safe to have surgery. Talk to your doctor about the pros and cons.


Advice from Consumer Reports

This report is for you to use when talking with your healthcare provider.  It is not a substitute for medical advice and treatment. Use of this report is at your own risk.

© 2015 Consumer Reports. Developed in cooperation with the Society for Cardiovascular Magnetic Resonance. To learn more, please visit