MACI Services Nuclear Medicine Stress Test

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	Nuclear Medicine Stress Test

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	A nuclear medicine stress test looks at the heart muscle under resting conditions and is compared to how it looks under stress conditions (exercise). The test can give information about the perfusion (blood flow) to the heart muscle, whether there is any damaged or dead muscle tissue, the size of the heart's chambers and how well the heart is pumping blood to the rest of the body.

	What should I expect?
	A nuclear medicine stress test typically lasts about 3-4 hours. You will be asked to sign a consent form before beginning the test. The stress test consists of two parts: rest and stress.

	Rest:
	The nuclear medicine technologist will thoroughly explain the stress test to you and answer any questions you may have before beginning the test. An IV will be started in your arm and an injection will be given. This injection consists of a small amount of radioactive tracer that will circulate through your body to your heart. The tracer will not harm your body or your heart in any way and will not give you any side effects. The tracer allows us to look at your heart. Because of the way your body excretes the excess tracer, it is necessary to wait 45-60 minutes after the injection. During this waiting period you will be asked to drink some water which will help clear out the excess tracer. After that time, your first set of images will be taken of your heart. These are called the “resting” images that look at your heart before stress or exercise.

	Stress:
	After the resting images are taken then your heart is stressed. The heart can be stressed in two different ways: exercise or pharmalogical. Your doctor will decide which one of these tests is best for you. The doctor or nurse practitioner will be monitoring you during the stress test. Before the stress test begins, electrocardiogram (EKG) leads will be placed on your chest so your heart rate and EKG can be monitored at all times during your stress. Your blood pressure will also be taken during the test.

	1) Exercise: You will be walking on a treadmill for this test. The time you will spend on the treadmill will vary from patient to patient. It is based on your target heart rate. Once your target heart rate is reached, a second radioactive tracer will be injected through your IV and it will circulate to your heart. This will allow us to look at your heart under stress. Because of the way your body excretes the excess tracer, it is necessary to wait 45-60 minutes after the injection. During this waiting period you will be asked to eat something. You can bring with you something to eat or go out to eat. After that time, your second set of images will be taken of your heart. These are called the “stress” images that look at your heart after stress or exercise.

	2) Pharmacological: There are two different pharmacological medicines that can be used to stress. Your doctor will determine which one is best for you.

	a) Persantine: You will be lying on a table during this test. Persantine is a medication that stresses your heart by dilating blood vessels in your heart, allowing your heart to handle an increased amount of blood flow. During this test, you may experience a “flushed” feeling in your face, have jaw, neck or chest tightness, develop a headache or experience a slight drop in your blood pressure. Once your heart is stressed, a second radioactive tracer will be injected through your IV and it will circulate to your heart.
	This will allow us to look at your heart under stress. Any symptoms you may have experienced will diminish after we give our reversal medication, aminophyline, which will contract your blood vessels back to where they were. Because of the way your body excretes the excess tracer, it is necessary to wait 45-60 minutes after the injection. During this waiting period you will be asked to eat something. You can bring something to eat or go out to eat. After that time, your second set of images will be taken of your heart. These are called the “stress” images that look at your heart after stress or exercise.

	b) Dobutamine: You will be lying on a table during this test. Dobutamine is a medication that stresses your heart by increasing your heart rate. The amount of dobutamine we inject is based on your target heart rate. During this test, you may experience shortness of breath, pain or tightness in your chest or a slight increase in your blood pressure. Once your target heart rate is reached, a second radioactive tracer will be injected through your IV and it will circulate to your heart. This will allow us to look at your heart under stress. Because of the way your body excretes the excess tracer, it is necessary to wait 45-60 minutes after the injection. During this waiting period you will be asked to eat something. You can bring with you something to eat or go out to eat. After that time, your second set of images will be taken of your heart. These are called the “stress” images that look at your heart after stress or exercise.

	When the test is complete, the two images taken before and after stress are processed and are compared to each other.

	Risks:
	The risk of exercise depends on the condition of your heart and your general level of health. The risks include: Fainting Chest pain. An irregular heartbeat Heart Attack. There is a slight risk that death may result if a heart attack occurs during the test.
	Source: www.webmd.com