REGADENOSON NUCLEAR 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, to determine the response to medications and/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

Your physician has determined that you would not be able to perform an exercise test, such as walking on a treadmill well enough to stress your heart adequately. As a result, a pharmacologic or medicated stress test must be performed. The drug, Regadenoson, is used to stress the heart without exercise. Regadenoson is a short acting medication that has the effect of dilating blood vessels to simulate exercise. Side effects may include shortness of breath, headache, flushing and chest discomfort all of which last only a few minutes. When combined with the administration of Regadenoson, 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 stress. 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 Regadenoson nuclear stress test

• Advise your physician and those conducting your test if you have active asthma or significant lung disease. Regadenoson can cause wheezing and may not be an appropriate drug for you.
• Please inform us if you take a theophylline containing medication used for lung conditions – these medications will interfere with the test and must not be taken for a minimum of 12 hours or up to 24 hours before the test.
• Please inform us if you take any of the following medications: Persantine, Trental, Aggrenox, or Tegretol – these medications will interfere with the test and must not be taken for at least 48 hours.
• Do not eat anything 2 hours before the test.
• Withhold caffeinated beverages, decaffeinated coffee, tea 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.
• Do not smoke or use any form of nicotine including nicotine patches for 12 hours
• Some “over the counter” medications such as Excedrin contain caffeine – please check the label for ingredients.
• Take your medications (other than those listed above) on the day of the test unless instructed otherwise
• Do not apply lotions or powders to the chest.
• Wear loose, comfortable clothing: ladies may want to wear a front-buttoning, short sleeve shirt. 
• Ladies should not wear underwire bras, if possible. Underwire bras must be removed for the imaging portion of the test.
• Failure to comply with the above directions will require your test to be rescheduled

What happens during the Regadenoson 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 supervised the stress portion of the test.
• Your blood pressure is checked frequently, and your ECG is continuously monitored.
• Regadenoson is administered through the intravenous catheter.
• After the Regadenoson injection, the second tracer dose is injected into the intravenous catheter.
•  You may feel a flushed feeling, which is a normal response to the Regadenoson.
• Report any symptoms, such as shortness of breath, headache, flushing or chest discomfort.
• Some people walk on a treadmill at a very slow speed during this portion of the test.
• When the stress portion is completed, your blood pressure and ECG will be monitored for several more minutes.
• You will 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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