Other Stress Tests:
Stress Echo

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What Is Nuclear Medicine Stress Test?
A Nuclear Medicine Stress Test is similar to a standard Treadmill Stress Test. However, it provides us with additional information about your heart by using an isotope (Cardiolite or Thallium) to evaluate coronary blood flow.

This procedure gives us the information similar to the one provided by a standard Treadmill Stress Test. It also provides the following data:
  • Irregular heart rhythms
  • Decreased supply of blood and oxygen to the heart
  • Whether you had any heart attacks in the past
  • Amount of time it takes the heart to recover after exercise

What Preparation Is Needed?
Please follow these precautions before coming to a Treadmill Stress Test:
  • Do not eat or drink anything except water four hours prior to test.

  • No caffeine or smoking at least 4 hours prior to test.

  • If you are taking any medications, please consult us about the following:
    • How to adjust insulin and food intake prior to the test.

    • Whether to take your regular medications the morning of the test.

    • If you are taking Beta Blockers, ask us whether you can stop the medication for 72 hours before coming to a procedure (as recommended).

  • Do not apply lotions, oils or powders to the chest area.

  • Wear comfortable clothing (shorts or pants with shirt or blouse) and walking or jogging shoes.

How Nuclear Medicine Stress Test Is Performed?
If you have to undergo this test, you can expect the following:
  1. This procedure is performed in two phases with each phase lasting 30-60 minutes.

  2. You may be required to return the following day to complete the second phase.

  3. An intravenous line will be started in order to inject a very small dose of the isotope at the peak of exercise. The isotope is not harmful to the patient or the heart.

  4. Electrodes are placed on the chest to record an electrocardiogram.
  5. We will ask you to exercise on the treadmill, gradually increasing the speed and incline.

  6. The exercise phase usually lasts for up to 15 minutes depending upon your level of ability.

  7. We will be looking for changes in the EKG pattern and any symptoms that the patient may experience, such as:
    • Changes to the heart rate
    • Changes in blood pressure
    • Changes in the EKG pattern
    • Irregular heart rhythm
    • Change in your appearance
    • Other symptoms

  8. The test will be stopped if:
    • You achieve a target heart rate
    • You become too tired
    • You experience chest pain or shortness of breath
    • You feel dizzy
    • You develop unsteady gait
    • EKG shows alarming changes
    • You heartbeat becomes seriously irregular
    • Your blood pressure rises or falls beyond acceptable limits

  9. Once the target rate is reached, a special camera will take pictures of the heart. This phase usually lasts 20-40 minutes.

  10. During the imaging phase, you lie flat with both arms above his head.

  11. A second set of pictures may be required at a later time.

  12. The pictures taken by the camera will reveal the specific areas of the heart that are not getting enough blood and oxygen.

  13. The second set of pictures will be taken at rest to help identify the areas of the heart that have recovered but are still not getting enough blood and oxygen.

  14. An area that has not recovered may indicate scar tissue from a heart attack.

Risk Factors
Side effects of thallium are rare and may include:
  • rashes
  • low blood pressure
Other rare risks involve:
  • A metallic taste may appear in your mouth for a brief period after the tracer is injected.

  • Because these tests stress the heart, chest pain is a common experience during the test.

  • There is a very small risk of heart attack as a result of the stress to your heart.

  • A minimal amount of radiation exposure is experienced during the procedure. The exposure is about the same as that of a CT scan or a Barium X-ray. The radioactive tracer is safe.

  • Nuclear Medicine Test is not used if you are pregnant (or you think you might be) or if you are a nursing mother. Be sure to notify us prior to the test if this is the case.

Useful Links
  1. Myocardial Perfusion Scan
    This article provides a basic level introduction into nuclear medicine stress test. It is well structured, organized into practical categories such as purpose, preparation, advantages/disadvantages, etc.

  2. Thallium Stress Test
    American Heart Association provides a brief description of the nuclear medicine stress test. It discusses steps involved in performing the procedure and explains what happens if you cannot do the exercise.
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