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Nuclear Stress Test

Cardiac Perfusion Scan

Do NOT take any of these medications for 24 hours prior to your test (click to open)

Beta Blockers:

Toprol XL
Metoprolol
Tartrate
Metoprolol
Succinate
Lopressor
Atenolol
Tenormin
Propranolol
Bystolic
Nadolol
Pindolol
Propanolol
Sotalol
Sectral
Normodyne
Betapace
Corzide
Tenoretic
Trandate
Ziac
Betagen
Blocadren
Coreg
Carvedilol
Bisoprolol
Acebutolol
Zebeta
Inderal
Labetalol

Calcium Channel Blockers:

Procardia
Nicardipine
Felopidine
Nifedipine
Veralan
Cardura
Cardene
Lotrel
Verapamil
Isoptin
Calan
Diltiazem
Cardizem
Tiaz

Other meds:

Imdur
Isordil
Isosorbide
Nitroglycerin patch
Nitroglycerin pills
Cialis
Viagra
Levitra

In addition to the above medications, do not take any of the following medications for 48 hours prior to your test:

Aminophylline
(Theophylline)
Theodur
Aggrenox
Excedrin
Diprydamole
Persantine
Anacin
Fiorocet
Fiorinal
Hycomine
Norgesic
Vivarin

3. Oral diabetic medications should NOT be taken the morning of your test.
4. Insulin instructions will be given on an individual basis. Please check with the
doctor or nurse at the time of scheduling.

How can I prepare for the test?

  • Do not smoke or eat a heavy meal 4 hours before this test.
  • Do not have any caffeine, such as coffee, tea or chocolate, for 24 hours before the test.
  • Wear flat, comfortable shoes (no bedroom slippers) and loose, lightweight shorts or sweatpants. Walking or running shoes are best.

What should I tell my Doctor?

  • You have joint problems in your hips or legs that may make it hard for you to exercise.
  • You have a heart valve problem, such as severe aortic stenosis.
  • You take medicine for an erection problem, such as sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra). You may need to take nitroglycerin during this test, which can cause a serious reaction if you have taken a medicine for an erection problem within the past 48 hours.
  • You have had bleeding problems, or if you take aspirin or some other blood thinner.
  • You are or might be pregnant.
  • You are breastfeeding. Don’t use your breast milk for 1 to 2 days after the scan. Use formula instead.

What happens during the test?

There are two parts of this test:  Resting scan & Stress scan

Resting or baseline scan

  • Electrodes will be attached to your chest to keep track of your heartbeats.
  • Your arm will be cleaned. You will have a tube, called an IV, going into your arm. A small amount of the radioactive tracer will be put in the IV.
  • You will lie on your back or your stomach on a table with a large camera positioned above your chest. The camera records the tracer’s signals as it moves through your blood. The camera does not produce any radiation, so you are not exposed to any additional radiation while the scan is being done.
  • You will be asked to remain very still during each scan, which takes about 5 to 10 minutes. The camera will move to take more pictures at different angles. Several scans will be taken.

Stress scan

Stress scan using medicine

  • Electrodes will be attached to your chest and continuous EKG tracings will be recorded.
  • Medicine will be put in your IV. It will make your heart work harder. You may get a headache and feel dizzy, flushed, and nauseated from the medicine, but these symptoms usually do not last long.
  • Your heartbeat and blood pressure will be checked.
  • Your symptoms such as chest pain and shortness of breath will be checked.
  • A few minutes after you get the medicine, another small amount of radioactive tracer is injected. You may be given something to reverse the medicine used to make your heart work harder.
  • You will wait for 30 to 40 minutes and then have another resting scan. See the “Resting or baseline scan” section.

Stress scan using exercise

You will walk on a treadmill to make your heart work harder. During this test:

  • Electrodes will be attached to your chest and continuous EKG tracings will be recorded
  • Your heart rate and blood pressure are recorded.
  • You might be asked to use numbers to say how hard you are exercising. The higher the number, the harder you think you are exercising.
  • You will continue to exercise until you or your doctor feels you need to stop.

You will then have another scan. See the “Resting or baseline scan” section.

If a resting scan had not been done before the exercise scan, you may be asked to return to get this scan on another day or a few hours later.

What happens after the test?

  • You can go back to your usual activities right away.
  • You will probably be able to go home right away.
  • Drink plenty of fluids for the next 24 hours to help flush the tracer out of your body. If you have kidney, heart, or liver disease and have to limit fluids, talk with your doctor before you increase the amount of fluids you drink.

What is a Nuclear Stress Test?

A Nuclear Stress Test or Cardiac Perfusion Scan measures the amount of blood in your heart muscle at rest and after your heart has been made to work hard.

During the scan, a camera takes pictures of your heart after a radioactive tracer is injected into a vein in your arm. The tracer travels through the blood and into your heart. As the tracer moves through your heart, areas that have good blood flow absorb the tracer. Areas that do not absorb the tracer may not be getting enough blood or may have been damaged by a heart attack. The pictures show this difference.

Two sets of pictures may be made during the test. One set is taken while you are resting. Another set is taken after your heart has been made to work harder (called a stress test). The heart can be stressed by using medicine or exercise

This test is also known by other names, including myocardial perfusion scan, myocardial perfusion imaging, thallium scan, and sestamibi cardiac scan.

Why should I get this test?

A Nuclear Stress Test is often done to find out what may be causing chest pain or pressure. It may be done after a heart attack to see if areas of the heart are not getting enough blood or to find out how much your heart has been damaged from the heart attack.

What else should I know?

  • No electricity passes through your body during the test. There is no danger of getting an electrical shock.
  • During the tests, tell your doctor if:
    • You have chest pain or pressure.
    • You are very short of breath.
    • You are lightheaded.
  • You have other symptoms
  • Anytime you’re exposed to radiation, there’s a small chance of damage to cells or tissue. That’s the case even with the low-level radioactive tracer used for this test. But the chance of damage is very low compared with the benefits of the test.
  • Most of the tracer will leave your body through your urine or stool within a day. So be sure to flush the toilet right after you use it, and wash your hands well with soap and water. The amount of radiation in the tracer is very small. 
  • You should avoid close physical contact with pregnant women and children ages 12 and younger for 12 hours following each part of this test. 

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It’s also a good idea to keep a list of the medicines you take. Ask your doctor when you can expect to have your test results.

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