Nuclear Pharmacological Stress Test
A nuclear pharmacological stress test evaluates blood flow to your heart muscle during periods of exercise (stress) and rest.
This helps doctors determine if you have a blockage in one or more arteries of the heart.
The arteries that supply blood to the heart muscle can become clogged or narrowed from plaque buildup (called atherosclerosis or coronary artery disease). To examine your heart’s blood circulation, we use safe, radioactive tracers. The images of the tracers allow us to see the heart muscle that is receiving the blood supply more clearly.
The nuclear pharmacological stress test has three parts: imaging while you are at rest, putting your heart under stress using medication and imaging after being under stress.
To begin, our nuclear medicine technologist will take you to an exam room to explain the procedure. We will put an intravenous (IV) line through a vein in your arm to give you the radioactive tracers and the stress injections.
For the first part of the test, which measures your heart function at rest, our technologist will inject radioactive tracer into the IV line. The radioactive tracer will need to circulate through your blood before scanning can begin.
During the imaging session, you will lie flat on your back on a table with your left arm resting above your head. Nuclear cameras will slowly move around your chest for about 20 minutes. It is very important for you to lie as still as possible during the imaging session. Normal breathing is fine.
For the second part of the test, which measures your heart function during stress, a technician will take you to the exam room. Here, you will prepare for the pharmacological (medication) stress portion of the test. We will gather your medical history, explain the test and answer any questions. At this time, you will need to sign a consent form.
The technician will use gel to place small plastic pads on your chest that connect to the electrocardiogram (EKG) monitor to measure the electrical signals from your heart. For men, we may need to shave small areas to remove chest hair to ensure the pads stick. We also will take a baseline blood pressure reading.
When the nurse arrives, you will receive medication slowly through the IV line to simulate stress. During this time, if you develop any discomfort, please tell the nurse immediately. You may have to walk on the treadmill slowly for a few minutes after getting the medicine for it to flow through your body. This will be followed by a second radioactive tracer injection.
After the pharmacological stress portion of the test, we will remove the EKG pads and your IV line. You will have a break before the second set of pictures. During this waiting period, you may have a small low-fat meal, regular coffee (no creamer) and any other liquids.
After the break, you will have a second imaging session of 20 minutes, following the same steps as the first. After testing, you may resume your regular diet and routine. We will send a copy of the report to your referring doctor.
The complete process of the nuclear pharmacological stress test will take about four hours. You will have short breaks between imaging sessions.
- Ask your doctor if you need to stop taking your medications, such as beta-blockers, before the test.
- Avoid food and drink four hours before your appointment. If you eat or drink, you will need to reschedule your test.
- Avoid caffeine, decaffeinated beverages or chocolate for 24 hours before your appointment. This includes coffee, tea, cocoa, soda pop and other caffeinated drinks.
- Bring or wear loose, comfortable clothing and shoes suitable for walking. Avoid heels or sandals. Avoid wearing a dress, full slip or tight jeans. Wear pants or shorts and a loose-fitting top.
- Bring a list of your current medications or bring your medications in their bottles.
- Take any medications with sips of water unless otherwise instructed by your doctor.
- Talk to your doctor and reschedule your test if you are pregnant, may be pregnant or are a nursing mother.
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