How Is A Nuclear Stress Test Performed
Your nuclear stress test will be performed in a hospital or heart clinic. The stress test takes two to five hours and generally includes these steps:
You will undress from the waist up and wear a patient gown for modesty.
Your care team will attach sticky, painless patches, or electrodes, to your chest, arms and legs. The electrodes are attached to an EKG machine by wires. The machine records your hearts electrical activity during the test. If you have a hairy chest, your provider may shave small areas to apply the electrodes.
Your care team will also apply a blood pressure cuff to your arm.
Your care team will start an IV in your arm and inject a radioactive tracer, often thallium.
You will rest for about 10 minutes. Then, your team will take pictures of your heart. You will need to lie still on a padded table with your arms raised overhead as a large camera rotates around you to take the pictures.
You will then exercise by walking on a treadmill. You will begin to exercise harder as the treadmill gradually moves more quickly and the incline increases. If you aren’t able to exercise due to a medical condition or illness, your doctor may use a drug to simulate the effect of exercise on the heart. This is called a pharmacological nuclear stress test.
When you reach your target heart rate, your care team will inject a different radioactive tracer, often technetium sestamibi .
Your team will take more pictures with the nuclear scanner 15 to 30 minutes later.
What Are The Potential Risks For A Nuclear Stress Test
While the test involves the patient being exposed to some amount of radiation, the Nuclear Stress Test is generally considered safe. Complications are rare but not ruled out. They include:
- Allergic reactions to the radioactive dye
- Arrhythmias caused by the exertion or medication. It goes away gradually once you stop the exercise or the medication wears off.
- Heart attack. This is extremely rare.
- Chest pains or flushing. These are usually brief, but you should be sure to tell your doctor the moment they occur.
What To Expect During Your Cardiac Nuclear Stress Test
There are three main steps to a nuclear stress test.
- A technician injects a tracer into your bloodstream through a vein in your arm.
- He or she scans then your heart while you’re at rest to show how much of the tracer is taken up by the heart. This tells your doctor about the adequacy of the blood supply to the heart.
- You walk on a treadmill to increase your heart rate.
- If you aren’t able to exercise, you will receive medicine. This will either dilate the arteries in your heart or make your heart beat faster and harder, like it would during exercise.
- Your technician will give you another dose of the radioactive tracer and scan your heart a second time.
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I’ve been experiencing an intermittent vibration from the region of my heart for the last 5 months. It can occur at anytime but usually when I am at rest or sleeping. I also get PACs and tachycardia in the afternoons which occurs whenever I am standing or walking . Sometimes the vibration is triggered by a PAC. I have done the following tests- 24 hour ecg – Echocardiogram – Blood test to check electrolytes and thyroid I am 31 years old and Male. I am currently taking medication for hypertension but have been assured this is not a side effect of the med.
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Who Performs A Nuclear Stress Test
The following specialists perform nuclear stress tests:
Cardiologists and pediatric cardiologists specialize in conditions and diseases of the heart and blood vessels. Pediatric cardiologists further specialize in treating infants, children and adolescents.
Clinical cardiac electrophysiologists specialize in diagnosing and treating abnormal heart rhythms using heart and blood vessel imaging and technical procedures.
Interventional cardiologists specialize in diagnosing and treating conditions and diseases of the heart and blood vessels using nonsurgical, catheter-based procedures and specialized imaging techniques.
Cardiac surgeons specialize in the surgical treatment of conditions of the heart and its blood vessels. Cardiac surgeons may also be known as cardiothoracic surgeons.
Advanced heart failure and transplant cardiologists care for people whose heart failure no longer responds to conventional therapies and symptom management.
How Do I Get The Results Of My Test
After the cardiologist reviews your test, the results will go into your electronic medical record. Your referring physician will have access to the results and will contact you to discuss them.
This information is about testing and procedures and may include instructions specific to Cleveland Clinic. Please consult your physician for information pertaining to your testing.
Last reviewed by a Cleveland Clinic medical professional on 03/21/2019.
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What To Expect: Nuclear Stress Testing
A nuclear stress test is an advanced diagnostic tool for finding the cause of new or worsening chest pain, stratifying risk for heart disease, deciding how well treatment is progressing, and/or evaluating recovery after a heart attack. Most of the stress tests performed by Heart House physicians are done in the office. A regular stress test shows the EKG, heartrate and blood pressure while you are walking on a treadmill. A nuclear stress test shows your physician pictures of the blood flow to the heart muscle, in addition to the EKG, heartrate and blood pressure.
In order to take the pictures of your heart, you will receive an injection of a radioactive tracer through an IV. The tracer allows the Nuclear camera to take pictures of the blood flow to the heart muscle. There are no side effects from the radioactive tracer. It is not a contrast dye. It does not contain iodine and will not harm your kidneys. Nuclear stress testing, is very safe and can help your cardiologist accurately diagnosis heart disease.
Nuclear Stress Test Results
After the test, a doctor will read the scan. The types of information that may be obtained from your scan include:
- Abnormalities in your scan that may indicate blockages in the heart arteries, which may be the cause of your symptoms.
- The pumping function of your heart.
If you have had a prior scan that is available for comparison, your doctor may be able to get information about the effects of treatment on your heart.
Common results of a nuclear stress test include:
- Normal blood flow at rest and during activity or stress. This means your heart is getting enough blood to work properly, and that major blockages in the heart arteries are unlikely.
- Normal blood flow at rest, but not during activity or stress. This means that part of your heart is not getting enough blood when you exert yourself, and you may have blocked arteries, which might be the cause of your symptoms.
- Abnormal blood flow at rest and during activity or stress. This means that you may have had a heart attack in the past from blocked arteries.
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Nuclear Stress Test And Ascending Thoracic Aneurysm 48 Cm
VA scheduled me for a nuclear chemical stress test. Had been told not exercise or to lift over 20 lbs.I asked about the stress part of the test but was only answered it dilates vessels and slows heart beat.Is a stress test safe
It is my understanding that the chemical stress test is given when a physical stress test might put the patient at risk. I don’t know if it is “safe” but it was developed to be safer than the physical stress test. Good luck with your testing.
Hi, I had this particular test done 6 years ago and I’m here to tell the story. Don’t worry, you’re going to be ok!
Hi , welcome. According to this information, A nuclear stress test is generally safe, and complications are rare. As with any medical procedure, there is a risk of complications Read more here under the heading “Risks”:
is right that it was developed to be less risk and is hear to tell you that it’s okay. may also have more to share about what the test is like.
I think your concern is specific to the worry that you have a 4.8 cm aneurysm and feel that this may be too much. You may be interested in this Video Q&A with Mayo experts Video Q&A about Thoracic Aortic Aneurysms
Bummed, how long have you known that you have a aneurysm? What changes are you making to stay healthy?
Why Is A Nuclear Stress Test Performed
Your doctor may recommend a nuclear stress test to see if any areas of your heart are not getting enough blood and oxygen when stressed by exercise. A nuclear stress test is not a routine screening test. It cannot diagnose all types of or predict future heart problems by itself. It provides important information about your heart health in relation to your age, physical exam, medical history, and other tests.;
Doctors use nuclear stress tests to help diagnose or monitor the following conditions:
Coronary artery disease , a buildup of plaque on the walls of the coronary arteries that supply blood to the heart
Heart attack, death of a portion of the heart muscle usually due to coronary artery disease and a that blocks blood flow to the heart
Heart failure, an inability of a weakened heart to pump enough blood to the body. A is not recommended for people with advanced heart failure.
Your doctor may also perform a nuclear stress test to:
Assess heart damage from a previous heart attack, injury, infection, or other problem
Determine if your heart can tolerate a major surgery
Determine if your symptoms are related to CAD. Symptoms can include chest pain, dizziness, shortness of breath, , , palpitations, passing out, or feeling a pounding, racing or
Further evaluate abnormal heart test results, such as changes on a standard resting EKG
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What Happens During A Stress Test
There are three main types of stress tests: exercise stress tests, nuclear stress tests, and stress echocardiograms. All types of stress tests may be done in a health care provider’s office, outpatient clinic, or hospital.
During an exercise stress test:
- A health care provider will place several electrodes on your arms, legs, and chest. The provider may need to shave excess hair before placing the electrodes.
- The electrodes are attached by wires to an electrocardiogram machine, which records your heart’s electrical activity.
- You will then walk on a treadmill or ride a stationary bicycle, starting slowly.
- Then, you’ll walk or pedal faster, with the incline and resistance increasing as you go.
- You’ll continue walking or riding until you reach a target heart rate set by your provider. You may need to stop sooner if you develop symptoms such as chest pain, shortness of breath, dizziness, or fatigue. The test may also be stopped if the EKG shows a problem with your heart.
- After the test, you’ll be monitored for 1015 minutes or until your heart rate returns to normal.
Both nuclear stress tests and stress echocardiograms are imaging tests. That means that pictures will be taken of your heart during testing.
During a nuclear stress test:
During a stress echocardiogram:
List Of Cons Of Chemical Stress Test
1. Heart Attack The biggest con of this type of test can be very high. It can result in a sudden heart attack. Although having a heart attack during the test is very rare it is still possible. Technicians closely monitor patients while they are being tested.
2. Chest Pain Chest pain is not exclusive to this test it can happen with either type of the stress test. The chest pain can be an indicator that the heart is under stress and it is completely normal during this type of test however there are some indications that the chest pain can be more severe with this type of test because the stress is induced unnaturally.
3. Increased Anxiety For many people the idea of being pumped with chemicals to stress their heart is a huge stressor. The heightened anxiety about the test can actual skew the test results to make them seem like your heart is in worse condition than it really is. The fear of the test alone can be enough to elevate the negative response of the testing and give a false report.
4. Unnatural MethodThe goal of the chemical stress test is to mimic what would normally happen to your heart during exercise. Some opponents to this kind of testing believe that the unnatural nature of the testing is not actually a good or realistic measure of the actual stress that naturally occurs in the heart. Some opponents of this type of testing believe that this test puts more strain on the heart than is necessary.
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Did The Radioactive Firefighter Need That Stress Test
Who knew that a having a nuclear stress test might put you at risk for suspicion of terrorism?
No, I am not making this up. A famous medical blogger, known as the Skeptical Scalpel, cited this bizarre news report of a CT firefighter who was stopped by the state police. The unsuspecting public servant was just driving by inconspicuously when a patrol care pulled him over. Yes, in this case, the driver could rightly say he had done nothing wrong.
A sensitive device in the patrol car detected radiation as the motorist drove past. It turns out that the firefighter had undergone a nuclear stress test earlier that day. First off, I had no idea that police had sensitive radiation detectors, and secondly, I did not know that patients who had nuclear stress tests were that hot. Lets move on.
The ever skeptical, Skeptical Scalpel, direct messaged me:
Did this man need a stress test?
His post went on to question the rightness of stress testing in non-symptomatic patients. He wondered about the over-testing of American patients and the role such practices play in advancing medical costs. He asked for my opinion. I started to write a comment on his blog, but then I thought it had gone on too long not to share here.
Here is my answer:
Hold on there mister blogger.
Why would an asymptomatic patient get any stress test in the first place?
Why so negative my friend?
How Long Does A Nuclear Stress Test Take
Typically, your appointment will take about 2-4 hours. Some of this time is spent in preparation for the test, and in waiting for the tracer in the bloodstream to be taken up by the heart.
The time required for performing the stress test and acquiring the images is about 60 min, but the actual exercise will take between 7 to 12 minutes.
In some cases, the testing may be broken up into two days.;
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The Tests Arent Useful Before Minor Surgery
There are different types of tests, but they are all meant to find out the same thing: how your heart performs when it is working hard or under stress. In an exercise stress test, you walk or jog on a treadmill with electrodes attached to your chest. Images of your heart are taken while you exercise. An imaging stress test uses heart ultrasound to take pictures of your heart. This is done first while you are at rest. Next, more pictures are taken while your heart is working hard or being stressed. Anuclear cardiology test uses a small amount of a radioactive substance to take pictures of your heart while it is being stressed.
Heart stress tests can show if you have significant heart disease. Serious heart disease could put you at risk of having a heart attack oranother serious complication during surgery. The test results may lead to special care before, during, or after surgery. The test results may also prompt your care providers to delay the surgery or change to a less invasive kind.
But the risk of heart complications from a breast biopsy, eye or skin surgery, a hernia operation, or other same-day surgeries is very low. The risk is so low for minor surgeries that even most people with heart disease do well. If you feel well and are physically active, your chance of having significant heart disease is low. So you usually dont need a stress test, even for major surgeries.
How Is A Nuclear Stress Test Different From Other Stress Tests
There are many kinds of stress testing for the heart. A plain stress test, which is performed on a treadmill with an EKG , checks the electrical connections of the heart. Another is a stress echocardiogram, which shows blood flow and opening and closing of the different valves between the atrial and ventricle chambers of the heart.
Each of these are important tests that have their own part to play when diagnosing possible coronary artery disease, just as a nuclear stress test has its place as well. ;A nuclear stress test should be used when its necessary to measure the volume of blood flow to your heart while youre at rest as well as when your heart has been stressed through exercise. Your doctor will determine which type is best for your condition, and many times more than one type of test is necessary.
Here at Independent Imaging, we have a nuclear medicine lab staffed with highly trained and skilled technicians, cardiac nurses, and radiologists ready to perform a diagnostic cardiac stress test in Palm Beach County for you. We will explain all the details and answer any questions or concerns you may have regarding your test.
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