Mid-Cities Cardiac Care Center

Nuclear Stress testing

Cardiac Perfusion Scan (Exercise): About This Test

What is it?

A cardiac perfusion scan measures the amount of blood in your heart muscle at rest and after your heart has been made to work hard.

During the scan, a camera takes pictures of your heart after a radioactive tracer is injected into a vein in your arm. The tracer travels through the blood and into your heart. As the tracer moves through your heart, areas that have good blood flow absorb the tracer. Areas that do not absorb the tracer may not be getting enough blood or may have been damaged by a heart attack. The pictures show this difference.

Two sets of pictures may be made during the test. One set is taken while you are resting. Another set is taken after your heart has been made to work harder (called a stress test). The heart can be stressed by using medicine or exercise. This information is about using exercise to stress the heart.

This test is also known by other names, including myocardial perfusion scan, myocardial perfusion imaging, thallium scan, sestamibi cardiac scan, and nuclear stress test.

Why is this test done?

The test is often done to find out what may be causing chest pain. It may be done after a heart attack to see if areas of the heart are not getting enough blood or to find out how much your heart has been damaged from the heart attack.

How can you prepare for the test?

Do not smoke or eat a heavy meal before this test.
Wear flat, comfortable shoes (no bedroom slippers) and loose, lightweight shorts or sweatpants. Walking or running shoes are best.
Tell your doctor if:

You are taking any medicines.
You are taking medicines for an erection problem, such as sildenafil (Viagra), tadalafil (Cialis), or vardenafil (Levitra). You may need to take nitroglycerin during this test, which can cause a serious reaction if you have taken a medicine for an erection problem within the past 48 hours.
You have had bleeding problems or take blood-thinning medicine, such as aspirin or warfarin (Coumadin, for example).
You have joint problems in your hips or legs that may make it hard for you to exercise.
You have a heart valve problem, such as severe aortic stenosis.

You are or might be pregnant.
You are breast-feeding. Don't use your breast milk for 1 to 2 days after the scan. Use formula instead.

What happens during the test?

Resting or baseline scan

You will take your top off and be given a gown to wear.
Electrodes will be attached to your chest to keep track of your heartbeats.
Your arm will be cleaned. You will have a tube, called an IV, put into your arm. A small amount of the radioactive tracer will be put in the IV.
You will lie on your back or your stomach on a table with a large camera positioned above your chest. The camera records the tracer's signals as it moves through your blood. The camera does not produce any radiation, so you are not exposed to any additional radiation while the scan is being done.
You will be asked to remain very still during each scan, which takes about 5 to 10 minutes. The camera will move to take more pictures at different angles. Several scans will be taken.

This test takes about 30 to 40 minutes.

Stress scan using exercise

The stress scan is done in two parts. In many hospitals, you first have the resting scan. You then exercise to make your heart work harder and you have another scan. Sometimes the stress scan is done first.

You most likely will either walk on a treadmill or pedal a stationary bicycle. During this test:

Your heart rate and blood pressure are recorded.
You might be asked to use numbers to say how hard you are exercising. The higher the number, the harder you think you are exercising.
You will continue to exercise until you or your doctor feels you need to stop.

You will then have another resting scan. See the "Resting or baseline scan" section.

If a resting scan had not been done before the exercise scan, you may be asked to return to get this scan on another day or a few hours later.

What else should you know about the test?

No electricity passes through your body during the test. There is no danger of getting an electrical shock.
During the tests, tell your doctor if:

You have chest pain.
You are very short of breath.
You are lightheaded.
You have other symptoms.

What happens after the test?

You will be able to sit or lie down and rest.
Your heart rate and blood pressure will be checked for about 5 to 10 minutes.
You can go back to your usual activities right away.

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if:

You passed out (lost consciousness).
You have been diagnosed with angina, and you have chest pain that does not go away with rest or is not getting better within 5 minutes after you take a dose of nitroglycerin.
You have symptoms of a heart attack. These may include:

Chest pain or pressure, or a strange feeling in the chest.
Sweating.
Shortness of breath.
Nausea or vomiting.
Pain, pressure, or a strange feeling in the back, neck, jaw, or upper belly or in one or both shoulders or arms.
Lightheadedness or sudden weakness.
A fast or irregular heartbeat.

After you call 911, the operator may tell you to chew 1 adult-strength or 2 to 4 low-dose aspirin. Wait for an ambulance. Do not try to drive yourself.

Call your doctor now or seek immediate medical care if:

You have had any chest pain, even if it has gone away.
You have new or increased shortness of breath.
You are dizzy or lightheaded, or you feel like you may faint.

Watch closely for changes in your health, and be sure to contact your doctor if you have any problems.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to keep a list of the medicines you take. Ask your doctor when you can expect to have your test results.

Cardiac Perfusion Scan (Medicine): About This Test

What is it?

A cardiac perfusion scan measures the amount of blood in your heart muscle at rest and after your heart has been made to work hard.

This test is also known by other names, including myocardial perfusion scan, myocardial perfusion imaging, thallium scan, sestamibi cardiac scan, and nuclear stress test.

Why is this test done?

How can you prepare for the test?

Tell your doctor if:

You are taking any medicines, including:

Medicine for an erection problem, such as sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra). You may need to take nitroglycerin during this test, which can cause a serious reaction if you have taken a medicine for an erection problem within the past 48 hours.
Blood-thinning medicine, such as aspirin or warfarin (Coumadin, for example).

You have had bleeding problems.
You are or might be pregnant.
You are breast-feeding. Don't use your breast milk for 1 to 2 days after the scan. Use formula instead.

What happens during the test?

Resting or baseline scan

You will take your top off and be given a gown to wear.
Electrodes will be attached to your chest to keep track of your heartbeats.
Your arm will be cleaned and an elastic band will be placed around your upper arm. A small amount of the radioactive tracer will be injected, usually into a vein on the inside of your elbow.
You will lie on your back or your stomach on a table with a large camera positioned above your chest. The camera records the tracer's signals as it moves through your blood. The camera does not produce any radiation, so you are not exposed to any additional radiation while the scan is being done.
You will be asked to remain very still during each scan, which takes about 5 to 10 minutes. The camera will move to take more pictures at different angles. Several scans will be taken.

This test takes about 30 to 40 minutes.

Stress scan using medicine

The stress scan is done in two parts. In many hospitals, you first have the resting scan. You are then given a medicine that makes your heart work harder and you have another scan. Sometimes the stress scan is done first.

You will have a test called an electrocardiogram (EKG or ECG), which takes about 5 to 10 minutes. You may have other EKGs during and after the stress test.
Medicine will be injected into your arm. It will make your heart worker harder. You may get a headache and feel dizzy, flushed, and nauseated from the medicine, but these symptoms usually do not last long.
Your heartbeat and blood pressure may be checked.
A few minutes after you get the medicine, another small amount of radioactive tracer is injected. You may be given something to reverse the medicine used to make your heart beat stronger.
You will wait for 30 to 40 minutes and then have another resting scan. See the "Resting or baseline scan" section.

This test takes about 30 to 40 minutes.

What else should you know about the test?

Sometimes more pictures are taken 2 to 4 hours after the stress scan.
No electricity passes through your body during the test. There is no danger of getting an electrical shock.

What happens after the test?

You can go back to your usual activities right away.
You will probably be able to go home right away.

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if:

You passed out (lost consciousness).
You have been diagnosed with angina, and you have chest pain that does not go away with rest or is not getting better within 5 minutes after you take a dose of nitroglycerin.
You have symptoms of a heart attack, such as:

Chest pain or pressure.
Sweating.
Shortness of breath.
Nausea or vomiting.
Pain that spreads from the chest to the neck, jaw, or one or both shoulders or arms.
Dizziness or lightheadedness.
A fast or uneven pulse.

After calling 911, chew 1 adult-strength aspirin. Wait for an ambulance. Do not try to drive yourself.

Call your doctor now or seek immediate medical care if:

You have had any chest pain, even if it has gone away.
You have new or increased shortness of breath.
You are dizzy or lightheaded, or you feel like you may faint.

Watch closely for changes in your health, and be sure to contact your doctor if you have any problems.