How Do I Prepare For A Nm Cardiac Stress Test
It is important that you let staff at the hospital or radiology practice where you are having the test done know if you are pregnant or if you are breast-feeding.
Women who are breast-feeding and people who are the primary or sole carer of small children will need to make special preparations after the test, such as to stop breast-feeding for a short time and/or to avoid close contact with young children. This is due to the small amount of radioactivity released from the body after the test. You should discuss this with your referring doctor or the NM practice where you will have the test carried out. See InsideRadiology: nuclear medicine for further information for breast-feeding patients and those in close contact with children about the precautions to take after nuclear medicine tests.
To prepare for the stress part of the test, it is recommended that you dress appropriately for physical exercise in loose comfortable clothing and comfortable footwear, as the stress test might involve walking on a treadmill or riding an exercise bike. The stress test might consist of using a medication to increase blood flow to the heart.
If you are already taking a regular prescription of dipyridamole or Persantin to prevent strokes, then this might not be used to stress the heart for the purpose of this test. If it is used as a stress agent, your regular dose of Persantin might need to be temporarily stopped for a short period before the study.
What Are The Risks Of A Stress Myocardial Perfusion Scan
Risks of the scan may include:
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The exercise part of the test may lead to rare instances of abnormal heart rhythms, chest pain, or heart attack due to the stress on the heart caused by the exercise.
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The needle used to put in the IV may cause some pain. The injection of the radioactive tracer may cause some slight discomfort. Allergic reactions to the tracer are rare.
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If your heart is stressed using medicine, you may feel anxious, dizzy, nauseous, shaky, or short of breath or chest pain for a brief period.
You may want to ask your healthcare provider about the amount of radiation used during the procedure and the risks related to your particular situation.
There may be other risks depending on your specific medical condition. Be sure your healthcare provider knows about all of your medical conditions.
Make a list of questions you have about the procedure. Be sure to discuss these questions with your healthcare provider before the procedure. Bring a family member or friend to the appointment to help you remember your questions and concerns.
Certain factors may interfere with or affect the results of this test. These include:
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Use of medicines containing theophylline
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Caffeine intake within 48 hours of the procedure
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Smoking or using any form of tobacco within 48 hours of the procedure
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Certain heart medicines, such as those that slow the heart rate
What Is The Difference Between A Nuclear Stress Test And A Regular Stress Test
October 18, 2019 By Yenny Rojas
Stress tests monitor your hearts electrical activity and are used to determine whether or not you have a heart complication. The difference between a standard stress test and a nuclear stress test lies in the method and equipment and, therefore, the depth of assessment of possible heart conditions.
Your doctor may request a stress test to evaluate your hearts function and/or blood flow, and to help identify any heart abnormalities.
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How Much Does It Cost For A Nuclear Stress Test
The average cost of undergoing a nuclear stress test is $1,200 if one is not covered by health insurance policies. The cost can be substantially higher up to $5,000 if one prefers to get the nuclear stress test done at renowned center or center which does not participate with insurance provider. The stress test involving electrocardiogram and echocardiogram can range between $650 to $800. But, the nuclear stress test can range between $ 1,500 to 5,000. Fees for Nuclear stress test includes physician fee, facility fees and cost of material used for test. Average physician fee range is $ 120 to $ 500. Facility fee can be $ 800 to $ 4,600.
What Is A Nuclear Stress Test & How Much Does It Cost
A nuclear stress test is one of the important tests to evaluate the cause of chest pain and short of breath at rest or after exercise. Such complaints may be associated with low or high blood pressure, complaints of frequent dizziness and weakness at rest as well as after performing a strenuous activity. Nuclear stress test is also recommended for individuals suffering with heart diseases involving abnormal or irregular heart-beats, cardiomyopathy and heart valve abnormalities. The test is also performed to evaluate status of heart function in patient with history of past heart attack.
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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.
Stress Test Without Exercise
If a person is unable to exercise, the doctor may use a certain medication to trigger the same process.
In this case, they will attach electrodes to the chest and deliver the medication into the persons arm through an IV line. The medication will take 1520 minutes to deliver.
The medication will stimulate the heart. It may cause effects similar to those that occur during exercise, such as flushing or shortness of breath.
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What Are The Risks Of A Nm Cardiac Stress Test
The main risks of the test relate to the stress component.
If you are having an exercise stress test, there is a small risk of sustaining a heart attack or cardiac ischaemia if you have significant coronary artery disease and you work too hard on the treadmill or exercise bike. Your heart will be monitored to identify any abnormal ECG changes and the attending NM specialist will moderate the exercise to minimise this risk.
Dobutamine is a short-acting medication that is designed to increase the pumping capacity of the heart, mainly by increasing the heart rate and, to a lesser extent, increasing the strength of the cardiac contractions. It might result in the sensation of palpitations , which is normal. Some patients might experience light-headedness and nausea. There is a risk of inducing a fast and abnormal cardiac rhythm , which could adversely affect heart function requiring urgent therapy. These cardiac rhythm disturbances are unlikely with the doses of dobutamine used. If you have significant coronary artery disease, there is also a small risk of inducing a heart attack .
Occasionally, the target heart rate cannot be reached with the maximum allowable dose of dobutamine. You might then be given a second medication called atropine, again in small doses. Atropine can cause the symptom of dry mouth, and might cause confusion in some patients. It is also not to be given if you have the eye condition, glaucoma.
Why Might I Need A Stress Myocardial Perfusion Scan
Your doctor may order a stress myocardial perfusion scan for:
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Chest pain, either new onset or occurring over a period of days or longer
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To diagnose coronary artery disease , which is the narrowing of the coronary arteries
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After a heart attack to assess heart muscle damage
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To assess blood flow to areas of the heart muscle after coronary artery bypass surgery, angioplasty, or stent placement.
There may be other reasons for your healthcare provider to recommend a stress myocardial perfusion scan.
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What Does A Stress Test Show
For men with symptoms like chest pain with activity or unexplained shortness of breath, an abnormal stress test points to a higher risk of CAD. But it’s more worrisome in a man who also has risk factors like older age, being overweight, or high cholesterol. “This points strongly to coronary artery disease.” Dr. Bhatt says. Confirming it could require further testing.
If you have symptoms and the test result looks normal, the risk of CAD is lower. “That person is less likely to have significant coronary artery disease,” Dr. Bhatt says. Even so, the doctor might still want to do more tests.
But it’s important to understand that a “normal” stress test can’t rule out the chance that a plaque will later rupture and block an arterythe proverbial tale of the man who passes a stress test with flying colors and then has a heart attack a week later. Stress testing detects arteries that are severely narrowed . This is what causes symptoms. Heart attacks often result from lesser blockages that rupture and form clots.
Should I Take My Medications The Day Of The Test
Please bring a copy of all of your medications, including over-the-counter medications and supplements that you routinely take, to the test appointment.
Please follow these guidelines about taking your medications the day of the test.
Your physician may also ask you to stop taking other heart medications on the day of your test. If you have any questions about your medications, ask your physician. Do not discontinue any medication without first talking with your physician.
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What Information Does A Nuclear Cardiology Stress Test Provide
The treadmill part of the test will give information concerning your physical conditioning, any EKG irregularities, and blood pressure/heart rate response. A pharmacological test will also show any EKG abnormalities under stress conditions. The stress images show the perfusion of the coronary arteries to the heart muscle. If a coronary artery is significantly blocked, blood flow is reduced and the radioactive tracer will not show or be noticeably diminished in the corresponding heart muscle. Analysis of the gamma camera images can identify the location, severity and extent of the defect of reduced blood flow to the heart.The stress images will be compared to the rest images to look at the blood flow to the heart. If there is a defect in the stress but the rest images look normal, this is called ischemia. If there are matching defects in both stress and rest images, an infarction has occurred. If there are no defects then the study is normal.
Nuclear Stress Test: Who Needs One
Nuclear stress tests are ordered by cardiologists and other types of physicians for patients that may be at risk for Coronary Artery Disease , a condition in which the arteries that supply blood to the heart muscle can become blocked, which could lead to a myocardial infarction, more commonly known as a heart attack. Risk factors such as diabetes, family history of CAD, hyperlipidemia , hypertension , and more can lead to a higher chance of CAD. Risk factors along with symptoms, such as angina , dyspnea , , among others can indicate that a patient may currently have CAD.
Nuclear stress tests can be used to diagnose the potential presence of coronary artery disease. Nuclear stress tests are usually performed in an outpatient setting, whether in a diagnostic imaging clinic, a doctors office, or a hospital radiology/nuclear medicine department.
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What Is A Nuclear Stress Test
Dr. Robert Bonow answers the question: ‘What Is A Nuclear Stress Test?’
— Question: What is a nuclear stress test , and how does it differ from either a medicine or exercise stress Test?
Answer: A nuclear stress test, what we call myocardial perfusion imaging is a test that looks at the blood flow to your heart muscle. We do that while you’re resting and also with some form of stress, either exercise or sometimes we give a medicine to simulate the effects of exercise.
The analogy here would essentially be looking at the blood flow to your heart the way that gas flows to a car engine. You know, you could have a totally healthy engine, but if you have a narrowed fuel line, you may not be able to step on the gas and get the car to accelerate properly. You have enough gas getting to the engine under resting conditions, but when you step on the gas and accelerate, if you have a narrow fuel line, you don’t have enough stuff to make the engine go at a faster clip.
In about 40 percent of patients, we don’t do that because you can’t exercise optimally to a high enough level to really make your heart work you can’t step on the gas enough. And therefore in the people who can’t exercise adequately, we give them medicine that simulates the effects of exercise. The analogy of the car engine would be: we’re not stepping on the gas, what we’re doing is something else to increase the flow to the valves in the engine to make the flow occur more, at an increased clip.
Preparing For Your Nuclear Stress Test
When preparing for the nuclear stress test, you will receive pre-procedure instructions. Do not eat or drink anything that is caffeinated or decaffeinated for at least 24 hours before the procedure. You may have a light meal 2 hours before your appointment. All medication should be taken as you would normally, unless otherwise directed by our office or your physician.
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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.
References
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What To Expect During Your Test
A nuclear stress test creates images of your heart while its at rest and during exercise, when your heart is under physical stress. Before your test begins, youll need to change into a medical gown, and electrodes will be placed on your chest. These electrodes help monitor your heart both at rest and while youre exercising. Youll also have an IV inserted in your arm so the radiotracer solution can be injected.
Next, youll exercise on a treadmill while the speed and incline are gradually increased until you reach a target level of activity. Once you reach that level of heart activity, the radiotracer will be injected and the doctor will use a diagnostic camera to capture images of your heart and blood vessels. After a period of rest, the doctor will take additional images of your heart.
At the end of your test, your doctor will evaluate both sets of images and compare them. The images show how your heart is functioning both at rest and when active, and they can also evaluate how well blood is flowing to and from your heart. By carefully examining the images, your doctor will be able to tell if your heart is functioning normally, or if there are areas where damage might be interfering with normal blood flow or heart function.
What if you arent able to exercise? Then, the doctor can inject a special medicine that increases your heart rate safely, mimicking the effect of exercise before capturing those images.
