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ICANL-LOGOMyocardial Perfusion Imaging

Preparation

  • No caffeine for 24 hours prior to the exam (including coffee, tea, “decaf” coffee/tea, chocolate, most sodas, all energy drinks, and some pain relievers).  Please read the labels.

  • No food for four hours prior to the exam. Drinking plain water is encouraged, especially if have difficult veins as we will need to start an IV through which the imaging agent is given.

  • No powders or lotions on the chest, and no perfume or cologne please.

  • Please call at least 48 hours in advance if you need to cancel your test.  The drugs for your scan are expensive, ordered in advance, and expire within a few hours of your scheduled exam time.

  • You should not undergo this test if you have taken theophylline, dipyridamole, Persantine, Aggrenox, Tegretol, carbamazepine, Viagra, Levitra, or Cialis in the preceding 48 hours.

If you are scheduled for the treadmill exercise stress test and are taking a beta blocker, such as metoprolol, Toprol, atenolol, Tenormin, Tenoretic, propranolol, Inderal, Bystolic, carvedilol, Coreg, labetalol, nadolol, bisoprolol, nabivolol, or Ziac, and do not have atrial fibrillation, please discuss with your doctor if you should hold your beta blocker for 12-36 hours prior to your scheduled appointment as this may affect the test. If you have not been given instructions regarding your beta blocker, please
feel free to call prior to your appointment. Please take all of your other medications as prescribed unless you are instructed otherwise by your doctor or are diabetic. If you are diabetic and your appointment is before 11:30am, hold oral diabetic medication and, if approved by your doctor, take half of your usual insulin dose. If your appointment is after 11:30am, you may eat 4 hours before your study and take your usual diabetic medications.

Please wear comfortable clothes and shoes for the treadmill. It is helpful to wear a two-piece outfit (i.e. shirt and pants), as we will be placing EKG electrodes on your chest to monitor your heart. The procedure is easy, but typically takes 2-3 hours. At least 30 minutes of this time is spent waiting for the imaging compound to circulate in the body so you may want to bring something to read.

We do not use any x-ray contrast dyes. Our imaging agents release a small amount of radioactivity that is detected by our very sensitive camera. Most people experience nothing following the injection, though some people notice a slight metallic taste in their mouth. Two separate images will be taken of
your heart while in a seated or lying down position. Imaging times typically range from 4 to 15 minutes. Before the second set of images you will either walk on a treadmill, or be given a drug that directly dilates your coronary arteries.

If you are able to walk on a treadmill, we will target a level of exercise that gets your heart rate up to a diagnostic range, which is based on your age.  The older you are, the less work you need to do on the treadmill.  When we reach your target, we will inject the imaging agent through the IV and have you walk or jog for two more minutes.  After you are done on the treadmill, we will take the second set of pictures.

If you are unable to get your heart rate up on a treadmill, we will substitute a drug; such as regadenoson or adenosine for the treadmill. This drug is given through the IV while you either sit in a recliner or walk on the treadmill. This drug will try to relax your coronary arteries. We will inject the imaging agent while this drug is having its effect on your circulation. The drug’s effect is short in duration, but we do have a reversing agent available if needed. We will then take a second set of pictures of your heart, typically after a 30 minutes wait. During this time we would like you to have a small meal or snack, so please bring something with you to eat. You may have caffeine at that time as well.


Myocardial Perfusion Imaging

Frequently asked questions:

Is the radioactivity hazardous to children, pets, or others around me?

No. You will be given a diagnostic dose of a medically approved imaging agent, and the radiation exposure to you is similar to having a CT scan. No precautions are needed for people or animals around you. However, you should not undergo this test if you are pregnant.

Will I have a problem with airport security?

For a period of time, you might set off radiation detectors in security zones. Most security personnel are familiar with nuclear medicine testing, but please be sure to notify your technologist if you will be traveling by airplane or ferry, or crossing an international border (including Canada) within 60 hours (2.5 days) following your test. The technologist will provide you with a travel safety slip for TSA or any other security agencies who may request it.

How long do I have to walk on the treadmill?

It depends on your level of fitness; the less fit you are, the shorter the time. We are looking to reach a particular age-based heart rate , rather have you go a specific distance.

Myocardial Perfusion ImagingI am claustrophobic. Am I going to be enclosed in a tunnel?

No.  You will be either sitting or lying down and the camera will be brought into position close to your chest.

Can my spouse or a relative come with me?

Yes, but he or she will need to wait for you in our waiting room. They cannot come with you into the nuclear exam area unless they are an interpreter or you have special needs.

Why do you need two sets of pictures?

The first set shows us the health of your heart muscle. If you have any heart muscle damage we will see that on the first set. The second set will show if you have coronary artery blockages that are affecting blood flow.

May I use my cell phone in the lab?

No.  Cell phones must be turned off.

Can I listen to music while on the camera?

Yes! Please bring your music and headphones.

Do I need someone to drive me home?

No.  There will be no lingering effects that will prevent you from your normal activities.

When do I get the results?

You should allow a few days for your health care provider to receive and review your report. Please bring with you the names of all providers who should receive a copy of your report.

Marko Yakovlevitch, MD, FACP, FACC and Thomas J. Sawyer, MD & Chetan Pungoti, MD

Chetan Pungoti, MD
Thomas J. Sawyer, MD, FACC
Marko Yakovlevitch, MD, FACP, FACC

Please note: Above content has been prepared to help you understand the test you are about to undergo. In order to be broadly understandable, the concepts have been simplified and generalized. Please consult your provider for specific and authoritative information.

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