NUCLEAR EXERCISE STRESS TEST

Your physician has ordered a cardiac nuclear stress test. This test is performed for many reasons. It is done to identify the cause of chest pain or chest discomfort which can occur with blockages in blood flow to the heart, to monitor heart function in people with known heart disease, and to determine the response to medications or after angioplasty or bypass surgery. The nuclear stress test also involves taking pictures, also known as images, of your heart. A radioactive substance, known as a tracer, is injected into a vein in your hand or arm and travels in the bloodstream to the heart. Areas of the heart receiving adequate blood flow pick up the tracer more completely. When combined with exercise, the pictures can detect areas of the heart that are not receiving enough blood flow. This enables your physician to determine your heart’s response to exercise. The results assist the physician in managing your cardiac condition. 

A 24 hour notice of cancellation is required. The radioactive tracer material for your test is ordered in advance and is delivered daily. It is not reusable. You may be responsible for the cost of the material if you fail to cancel.

How do I prepare for the nuclear stress test?

• Do not eat anything 2 hours before the test.  Withhold caffeinated beverages, decaffeinated beverages and colas, and chocolate for a minimum of 12 hours prior to your test. You may have water or milk – these beverages are not restricted.
• Some “over the counter” medications such as Excedrin contain caffeine – please check the label for ingredients.
• Please inform us if you take any of the following medications or medications that contain: Theophylline, Persantine, Trental, Aggrenox, Tegretol or Permole. They may interfere with the test and may have to be held for 24-48 hours.
• You may take your medications other than those listed above on the day of the test unless otherwise instructed.
• Do not smoke or use any form of nicotine 12 hours prior to your test.
• Do not apply lotions or powders to the chest.
• Avoid heavy activity on the day of the test.
• Wear loose, comfortable clothing
• Ladies should not wear underwire bras, if possible. Underwire bras must be removed for the imaging portion of the test.
• Wear or bring suitable shoes for walking on a treadmill, i.e. gym/walking shoes.

What happens during the stress test?

Rest Portion

• You will be given an explanation of the test and asked to sign a consent form.
• A registered nuclear medicine technologist inserts an intravenous catheter into your hand or arm.
• A small amount of radioactive material, called a tracer, is injected through the intravenous catheter.
• You lie flat on a special table under a large scanning camera
• The camera takes pictures, called images, of your heart from many angles.

Stress Portion

• Electrodes are placed on your chest and connected to an electrocardiogram (ECG) machine, which permits continuous monitoring of your heart rhythm.
• A nurse or exercise physiologist supervised the stress portion of the test.
• Your will be given instruction on how to use the treadmill. And you will begin walking.
• Your blood pressure is checked frequently, and your ECG is continuously monitored.
• When you reach the point that you do not feel that you can exercise much longer, a second tracer is injected into the intravenous catheter.
• You will be asked to continue to exercise for one more minute.
• Report any symptoms, such as chest pain, shortness of breath, or dizziness.
• Exercise as long as you can since that increases the accuracy of the test.
• When the exercise portion is completed, your blood pressure and ECG will be monitored for several more minutes.
• Your lie under the camera for a second set of images.

Please allow 2 ½ – 3 ½ hours for the entire test to be completed.

When will I know the results of the stress test?

• Final interpretation of the test results is completed by a cardiologist with a specialty in nuclear cardiology.
• The physician ordering your test and/or your primary care physician receive a report within approximately 3-5 days.

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