Myocardial Perfusion Imaging
- 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.
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.
I 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
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.
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.