Are you having back pain with any of the following?

  • Severe pain, weakness or tingling in your leg(s).
  • Difficulty stopping urination or loss of control of bladder or bowels.
  • Unexplained fever, nausea or vomiting.
  • A history of cancer or unexplained weight loss.

We understand that you are experiencing one or more of the health issues that might be impacting your back pain.

We recommend that you discuss these health issues with your doctor before proceeding with this program.

Once you are cleared by your doctor to do this program, we hope it helps you find relief from your back pain.

Provider photo for Jeremy Swartzberg

Jeremy Swartzberg, MD

Hospital Medicine

Welcome to My Doctor Online, a web site that my colleagues and I developed to make it easier for you to take care of your healthcare needs. On this site you will find answers to many of your questions about my clinical practice. Also included are several online features that will allow you to e-mail me, check your laboratory results and refill prescriptions. I hope you find its content informative and useful.

My Offices

Oakland Medical Center
Appt/Advice: 510-752-1190

See all office information »

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Overview

Cardiac magnetic resonance imaging (MRI) is a safe, noninvasive test that we use to diagnose heart problems. A special scanner creates detailed images of the heart without inserting a scope, tube, or device into your heart. Unlike a CT scan, an MRI does not use radiation (X-rays).

During the test:

  • You lie on your back inside a tunnel-like machine.
  • A strong magnetic field and radio waves produce still and moving images.
  • Detailed images are produced of the blood vessels and of the heart as it beats and moves through its pumping sequence.

We may give you contrast dye through an intravenous line. This highlights the blood flowing through your blood vessels and helps us see any scar tissue in the heart muscle.

Cardiac MRI allows us to examine:

  • Size and thickness of the heart chambers
  • Heart pumping function
  • Blood vessels surrounding the heart
  • Damage from a heart attack
  • Masses in or around the heart
  • Heart valve disease
  • Congenital abnormalities of the heart 

Why It Is Done

Cardiac MRI can help us diagnose heart problems or monitor existing heart conditions.

Cardiac MRI helps us to assess how severe the condition is, and plan the best treatment for you. We also use cardiac MRI to monitor existing heart disease. 

Cardiac MRI can help examine these heart functions.

How well the heart pumps. We can tell how much blood the heart pumps with each beat. MRI can show damaged areas that impact pumping and help us find causes of abnormal pumping.

Possible damage to the heart muscle. We can determine whether there is damage to the heart muscle from a heart attack or other causes. The images can show heart areas that do not move normally, are scarred, or do not receive enough blood.

The size and thickness of the heart chambers. Several heart conditions affect the thickness of heart chambers and heart muscle.

Congenital heart disease. We can diagnose and monitor heart defects that were present at birth.

Heart valve problems. The heart’s 4 valves open and close with each heartbeat. This keeps blood flowing in the right direction through the heart and out to the body. Cardiac MRI can help us detect leaky or narrowed heart valves.

Inflammation of the heart lining. Cardiac MRI can produce detailed pictures of the pericardium, the thin sac that surrounds the heart. We can detect a condition in which the pericardium becomes inflamed or irritated (pericarditis).

Masses or tumors in or around the heart. MRI can detect rare cases when a tumor develops in the heart

How You Prepare

You should follow these important steps before your cardiac MRI scan.

Tell us if you’ve had previous surgeries or metal devices or objects implanted. Heart valve replacements and heart stents are safe with cardiac MRI. However, the MRI machine is NOT safe for people with: 

  • Pacemakers and defibrillators, which can malfunction or be damaged.
  • Inner ear (cochlear) implants, which can be damaged.
  • Metal brain aneurysm clips, which can move out of place because of the strong magnetic field.

Let us know if you become fearful or anxious in small, confined spaces (claustrophobia). Having a cardiac MRI requires you to stay within a tunnel-shaped machine for 30 to 90 minutes. We can give you medicine to help you relax. If you decide to take relaxing medication, please arrange for someone to drive you home after the MRI.

If you’ll need a sedative to help you relax for the test, do not eat for 6 hours before taking it. This helps you avoid nausea. You may drink clear liquids up to 2 hours before taking a sedative.

Although MRI machines do not use radiation, it is important to tell us if you are pregnant or may be pregnant.

Do not wear jewelry, hairpins, eyeglasses, hearing aids, or other metallic objects near the MRI machine. For example, hearing aids and eyeglasses can be damaged.

Tell us if you have:

  • Asthma or are allergic to any medications or foods.  
  • Severe kidney disease or are on dialysis. 

If you have one of these conditions, the contrast dye (gadolinium) for MRI may not be safe for you. The dye does not contain iodine.

What to Expect

Knowing what to expect during a cardiac MRI can help you feel more comfortable.

An MRI scanner is a long, narrow machine that creates a strong magnetic field around you. While you’re in the machine, radio waves manipulate the atoms in your body. The machine’s powerful antenna receives signals from the body that are then processed by a computer into images.

After registration, a nurse or technologist brings you to the holding room to prepare you for the test. You’ll be asked to fill out a questionnaire to make sure it is safe for you to go into the MRI scanner.

Before the scan, we’ll: 

  • Ask you to wear a hospital gown. 
  • Clean a few areas on your chest and apply sticky electrode patches to the skin. 
  • Connect these small patches to an electrocardiogram (ECG/EKG) machine that records your heart’s electrical activity during the scan.
  • Place a strap across your abdomen to monitor your breathing.
  • Start an intravenous (IV) line, if contrast dye will be used. 
  • Place part of the scanning apparatus (cardiac coil) on your chest.

How It Is Performed

During the cardiac MRI, you:

  • Will lie on a sliding table that goes inside the tunnel-like machine. If you’re claustrophobic, you can receive medicine to help you relax.
  • May feel a cool sensation during the contrast dye injection (if used). The dye rarely causes allergic reaction such as hives or itchy eyes. Tell us immediately if you have an allergic reaction.
  • May wear earplugs to help reduce the loud thumping and humming noises during the test.
  • Will be asked to hold your breath for short time periods while each picture is taken. Movement can blur the images, so it is important to stay still.

We operate the MRI scanner from the next room, where we can see you through a glass window and communicate with you through a speaker. 

Depending on how many images must be taken, cardiac MRI takes 30 to 90 minutes.

After the MRI:

  • You can resume your normal activities immediately.
  • We may give you special instructions if you received a sedative. 

Risks

The magnetic field and radio waves used during cardiac MRI are not harmful. Cardiac MRI does not involve radiation, so there is no risk of cancer or other radiation-related complications.

The MRI machine can damage or cause malfunction in some implanted medical devices, such as pacemakers or defibrillators, if they contain metal.

Rarely, side effects from the MRI contrast dye can include:

  • Headaches
  • Nausea
  • Other mild effects
  • More serious complications, in people with very poor kidney function 

Your Care with Me

If you think you may be having a heart attack, or if you have chest pain or pressure that lasts more than 5 minutes, call 911 or seek other emergency services immediately.

If you have emergency symptoms as described above, do not use this website to e-mail your doctor, but instead call us immediately.

If you are having symptoms that concern you, your first contact will typically be with your personal physician, who will evaluate your health and symptoms.

If cardiologist’s care is needed, your personal physician will facilitate the process of scheduling an appointment in my department. If appropriate, she or he might call me or one of my colleagues while you are in the office so we can all discuss your care together. If we decide you need an appointment with me after that discussion, we can often schedule it the same day or soon thereafter.

During your office visit, we will discuss your medical and family history and I will perform a physical exam. I will explain the findings of your exam and answer any questions or concerns you may have. We will discuss treatment options, and together we will create a treatment plan that is right for you.

If you have been seen before by a cardiologist outside of Kaiser Permanente, please bring those medical records with you. Also, please bring with you all your containers with any prescription medications and any over-the-counter medications you are taking.

Coordinating Your Care

Having all of our Kaiser Permanente departments located together or nearby, including pharmacy, laboratory, radiology, and health education, makes getting your care easier for you.

Another major benefit is our comprehensive electronic medical record system, which allows all of the doctors and clinicians involved in your care to stay connected on your health status and collaborate with each other as appropriate.

When every member of the health care team is aware of all aspects of your condition, care is safer and more effective.

If you come to an office visit
  • At the beginning of your visit, you will receive information about when you are due for your next test, screening, or immunization. We can discuss and schedule any preventive tests that you need. 
  • At the end of your visit, you may receive a document called the “After Visit Summary” that will summarize the issues we discussed during your visit. You can refer to it if you forget what we discussed, or if you just want to recheck your vital signs and weight. You can also view it online under Past Visits.
  • To help you prepare for your visit, please see additional details under Office Visit. 
If I prescribe medications

We will work together to monitor and assess how your medications are working and make adjustments over time. Prescriptions can be filled at any Kaiser Permanente pharmacy. Just let me know which pharmacy works best for you, and I will send the prescription electronically in advance of your arrival at the pharmacy.

If refills are needed in the future, you can:

  • Order them online or by phone. Order future refills from my home page or by phone using the pharmacy refill number on your prescription label.
  • Have them delivered to you by mail at no extra cost. Or you can pick up your medications at the pharmacy. If no refills remain when you place your order, the pharmacy will contact me regarding your prescription.
If lab testing or imaging is needed

For lab tests, I will use our electronic medical record system to send the requisition to the Kaiser Permanente laboratory of your choice. For imaging procedures, we will schedule an appointment with the Radiology department. When the results are ready, I will contact you with your results by letter, secure e-mail message, or phone. In addition, you can view most of your laboratory results online, along with any comments that I have attached to explain them.

If I refer you to another specialty colleague

If we decide together that your condition would also benefit from the care of other types of specialists, our staff will help arrange the appointment(s) with one or more of my specialty colleagues.

If Surgery or a Procedure Is a Treatment Option

I will recommend that you review educational information and tools to help you prepare for your procedure or surgery. The information will often help you decide whether surgery is right for you. If you decide to have a surgery or procedure, the information will provide details about how to prepare and what to expect.

If we proceed with surgery, I will have my Surgery Scheduler contact you to determine a surgery date and provide you with additional instructions regarding your procedure. Once your surgery is scheduled, a medical colleague of mine will contact you to conduct a preoperative medical evaluation that will assure that you are properly prepared for your surgery.

If you are considering surgery or a procedure or want more information about your heart problem, please review our health tool called “Preparing for Your Procedure” (Emmi). Emmi programs are available for the following cardiology topics:

  • Anesthesia for an Adult
  • Angiogram with Possible Angioplasty
  • Atrial Fibrillation Overview
  • Aortic Valve Replacement
  • Cardiac Catheter Ablation (SVT)
  • Cardiac Catheter Ablation (VT)
  • Cardiac Pacemaker
  • Coronary Artery Bypass Surgery (CABG)
  • Defib (Cardiac Resynchronization Therapy Defibrillator)
  • Defib (Implantable Cardioverter Defibrillator)
  • Mitral Valve Repair or Replacement
  • Taking Warfarin (Coumadin®)

Convenient Resources for You

As your specialist, I have a goal to provide high-quality care and to offer you choices that make your health care convenient. I recommend that you become familiar with the many resources we offer so that you can choose the services that work best for you.

My Doctor Online is available at any time that is most convenient for you. From my home page you can:

Manage your care securely
  • View and compose secure e-mail messages.
  • Manage your prescriptions.
  • View your past visits and test results.
  • View your preventive services to see whether you are due for a routine screening or updated immunization.
Learn more about your condition
  • Read about causes, symptoms, treatments, and procedures.
  • Find interactive health tools, videos, and podcasts to help you manage your condition.
  • View programs to help you decide on or prepare for a surgery or procedure.
Stay healthy
  • Locate health education classes and support groups offered at every medical center.
  • Explore interactive programs, videos, and podcasts that focus on helping you stay healthy.
  • View your Preventive Services to see whether you are due for a routine screening or updated immunization.

If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder.

This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.

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