Nuclear Cardiology

Nuclear as well as standard stress testing is available to diagnose abnormalities of blood flow to the heart muscle, evaluate physical conditioning, and other exertion induced symptoms. The nuclear technique can also provide information regarding any heart muscle weakness and also distinguish between normal heart muscle, live heart muscle with reduced blood flow, and damaged heart muscle.

Our practice uses many of the nuclear cardiology techniques to check for the presence of heart disease and to provide the best treatments for persons with established heart disease.

What is a Nuclear Stress Test?

It is a noninvasive test which helps determine whether or not you have coronary artery disease. Chest pain or shortness of breath may be an indication of blockage of the coronary arteries. These arteries supply the heart with blood and oxygen. A stress test is ordered to detect any significant coronary blockage by monitoring the electrocardiogram, blood pressure and then pictures are taken of the heart muscle during the test. Many blockages are silent and may not be detected unless a stress test is performed. The stress test may be given in two different ways. The first and most common is walking on a treadmill. The second uses medication which stresses the heart. In a nuclear stress test, the patient will be injected with a small amount of radioactive material while he or she is at rest, and again one minute before the patient finishes exercising. After each injection, scans are taken of the heart. These scans enable the physician to more accurately identify heart disease.

What Will Happen During the Test?

You will first be brought into an examination room. A brief history and physical will be done and an intravenous line will be inserted. A small dose of radioactive tracer will then be injected. Next, you will wait to be called for pictures to be taken of your heart. You will lie flat for approximately 12 minutes while the pictures are taken. Following an electrocardiogram, you will walk on a treadmill or receive intravenous medication which simulates exercise. At peak exercise, you will be injected with a radio pharmacological agent to take pictures of your heart. You will then rest, wait, and then be called for the last set of pictures on the camera.

Who Will Be There?

At first you will meet the medical assistant, followed by the nuclear technologist. The physician works very closely with both of these specially trained professionals. The test is interpreted by a cardiologist specially trained in nuclear procedures. As there are benefits to this test, there are also risks as with any medical procedure or test. Although stress testing is very safe, approximately 1/10,000 patients may experience heart attack, stroke, or abnormal heartbeats. All necessary precautions are taken to prevent and treat these events.

What is a Radioactive Tracer?

This means that you will be exposed to a small amount of radioactive material equivalent to a few x-rays. This has not been shown to be harmful in long-term studies. However, if you are of childbearing age, or nursing a child, it is crucial that you inform the nurse, physician or technologist.

Could I Be Allergic?

Allergic reactions to radioactive medications occur very rarely. It is important to know that the radioisotope is NOT a contrast or dye. Please inform the nurse of all allergies during your visit.

Instructions for Your Stress Test

• Patients with diabetes, please identify yourself as such
• Many heart medications and blood pressure medications may need to be held until after your test in order to get the most accurate test possible. Check with your doctor to see which medications should be held in preparation for the test.
• Do not eat or drink, with the exception of water for 4 hours prior to your appointment.
• You should avoid all caffeine for 24 hours prior to your appointment. Some examples of caffeine containing substances include: tea, coffee, chocolate, Coca-Cola®, soda (even the decaffeinated forms of these products should be avoided).
• Consult with you doctor concerning any medications you are taking that may contain caffeine.
• Wear comfortable clothing, flat shoes or sneakers. Please do not wear an under wire bra or metal buttons. Please wear loose sleeves so blood pressure may be obtained and IV started.
• Please allow up to 4 hours for the test to be completed.
• If you are unable to keep your appointment, please contact the office at least 24 hours in advance.
• With regards to your medication, you will be contacted within 1-2 days prior to your appointment. If you are not contacted, please feel free to contact us after 12:00 the day before your appointment
• If your experience is favorable, and we are sure that it will be, tell two friends about us!

Information provided by National Heart Lung and Blood Institute