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Information on Nuclear Testing
There are two types of nuclear stress test, pharmaceutical and non-pharmaceutical. The type scheduled is determined on your ability to exercise. If you are able to work out on a treadmill to increase your heart rate you will be given a Treadmill or Exercise Nuclear Stress test. If you are unable to exercise on the treadmill for a duration of time that allows the test to be diagnostic, then you will be given a medication to simulate the same effect on your heart. These nuclear stress test are referred to as Adenosine, Dobutamine, or Lexiscan (Regadenoson) Nuclear Stress tests.
Treadmill: You will be exercising on an electric powered treadmill. As you walk, the speed and incline will increase at select intervals during the test, until you reach your target or peak level. The length of the exercise test depends on you and how you are feeling.
Adenosine or Lexiscan (Regadenoson): These medications increase the blood flow to your heart. Adenosine is given through your IV over 4-6 minutes, If you are given Lexiscan (Regadenoson) it will only take 10 second for the infusion. With either medication you may be asked to do simple exercises to help circulate the isotope. You may also be given medication to reverse any effects of the medication. Your physician will choose the most appropriate medication for you.
nucear imaging equipment
Dobutamine: The dobutamine is given through your IV in gradual increments to obtain your peak heart rate. You may be asked to do simple exercises, or additional medication may be given, to help reach the level.
- At the appropriate time, during the stress, Sestamibi (the second isotope) will be injected into the IV. At the conclusion of the stress portion of the test, a waiting time of 20-90 minutes is required before the stress images can begin.
- The stress images are identical to the resting images; however a heart monitor will be connected during the 15-20 minute scan.
- At the conclusion of the test, the IV will be removed and you will be able to get dressed. You may then proceed to other testing or office visits that may be scheduled for you at our office OR leave the testing facility and return home to your normal activities and medication routine.
How to prepare for these tests?
- You will be asked not to eat or drink for 4 hours prior to the test, with the exception of a small amount of water to take your medications. Caffeine products (see attached list) and smoking should be avoided for 24 hours. If you are taking any medications, bring them with you or a list of the medications and prescribed doses. If you are taking a cardiac medication that is listed on the attached sheet and have not been previously instructed whether to continue or stop the medication, please call your physician to find out if you should taper or stop taking any of these medications prior to the test.
- If you have diabetes: please do NOT take any oral medications or regular insulin the morning of the test. Take 1/2 of your long acting insulin dose the morning of the test.
- Please do not take long-acting nitrates or vasodilators such as Imdur, Isosorbide, Dipyridamole or Trental for 24 hrs prior to the test.
- You should plan to wear comfortable clothing and shoes if you are scheduled for a Treadmill Stress test. A Lexiscan, Adenosine or Dobutamine Stress test does not require walking.
- The total time of your visit including the testing and the two sets of images is 2-4 hours.
- It will be necessary to raise both of your arms above your head during the two imaging sequences of the test (15 minutes per image).
Question: What will the test be like?
- When you arrive for your test, you will be asked to remove your clothing above the waist and put on a hospital gown.
- The exam will be explained to you and you will be required to sign a consent form. Please do not hesitate to ask any questions.
- An IV will be placed in a vein in your hand or arm. The IV will be used to inject the two isotopes used for the procedure as well as the Lexiscan, Adenosine or Dobutamine, if ordered for your type of test.
- Thallium or Tetrofosmin is the first isotope to be injected through the IV. It will be necessary to wait 15-20 minutes before the resting images can begin. You will then lie down on an imaging table with both of your arms above your head. The imaging camera will move slowly around your chest for approximately 15 minutes, you will not be in an enclosed tube.
- Once the resting images are completed, EKG electrode pads will be place on your chest to monitor your heart during the stress portion of your test.
- Blood pressure and EKG tracings will be monitored throughout the stress testing.
- The type of stress testing depends on what your doctor has ordered. You will either walk on the treadmill, or lie on a bed and be given a medication, Adenosine, Dobutamine, or Lexiscan (Regadenoson), to simulate stress.
MUGA stands for Multi Gated Acquisition. This type of nuclear imaging is performed in order to quantify the pumping function of the ventricles. It is typically ordered for patients who have been exposed to cardiotoxic drug agents such as in chemotherapy e.g., with doxorubicin or immunotherapy (herceptin) or who have had a cardiac transplant. Please allow 2 hours for this test; no fasting is required.