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Nuclear Stress Test

South Charleston Cardiology Associates performs Nuclear stress tests, also known as Cardiolite stress test, which is a diagnostic test used to check the blood flow to the heart. During the test, a small amount of a radioactive material, which is not a dye, is injected into the vein to be able to obtain the images of your heart. A Nuclear camera, also known as a gamma camera , detects the radioactive injection to produce computer images of the heart.

In association with exercise, the test will help determine if the heart is getting enough blood flow during activity versus resting.

Stress testing is performed by Board Certified Nuclear Medicine Technologist’s and a Cardiologist in our fully Accredited Nuclear Lab.

What to expect during the Nuclear stress test

A nuclear medicine technologist will prep you for the test by placing 10 electrodes on your chest for EKG purposes and then, place an IV into a vein in either your hand or arm and inject a small amount of a radioactive material. The radioactive material is not a dye or contrast, it is mainly saline based. Tc-99m Sestamibi is extremely safe and there are no known adverse or allergic reactions. After the injection, you will have a short wait prior to the resting images. The radioactive injection allows the images of the heart to be taken by the nuclear camera. The patient sits still in a reclined chair for approximately 7 1/2 minutes while the camera rotates around the chest area taking images of the heart.

Once resting images are obtained, you will then be taken to do the stress test. To exercise the heart, patients walk on a treadmill.  If you are unable to exercise, a small dose of a medication is given to mimic exercise, this is called a chemical stress test (see below). At this time one of our Cardiologists, along with one of our Nuclear Medicine Technologists monitors the patient’s blood pressure and EKG during exercise and makes sure that the patient reaches his/her maximum level of exercise. The stress test is done using Bruce Protocol, which is where the treadmill will speed up and elevate every 3 minutes. Once you have reached peak exercise (which is determined by the Cardiologist) you will get a second injection of the radioactive material which allows the second set of images to be obtained, called stress images. While waiting on the stress images, the patient will then be able to get a drink , which is provided while they wait for the last set of images. After a short wait period, the patient again lies down under the camera while Images of the heart are then taken after exercise .

What does a Nuclear stress test show?

  • If blood flow to the heart is not blocked after exercise and rest, then the coronary arteries do not have a significant stenosis, blockage or narrowing.
  • If the test shows that blood flow is normal during rest, but abnormal during exercise, then the heart is not receiving enough blood when it is working harder than normal.  This may be due to a blockage in one or more of the coronary arteries.
  • If the test is abnormal during both exercise and rest, there is limited blood flow to the patient’s heart at all times.  This could suggest a prior heart attack.
  • Your cardiologist will review the results of your stress test and you will receive the results within 2-3 business days. At that time, you will be advised of treatment options.

How to prepare for a Nuclear stress test?

  • It may be a good idea to bring something to read to occupy your time in between the multiple parts of the test.  You will be at our office for about 2-3 hours.
  • Please arrive at least 15 minutes early to fill out  paper work if you are a new patient or if your insurance information has changed.
  • If your stress test is scheduled between 7:00AM and 10:45AM, do not eat or drink anything after midnight prior to the test. No caffeine or nicotine after midnight prior to the test. DIABETICS may have juice and toast with their pills and/or 1/2 insulin dose , 2 hours prior to test. DO NOT put any lotions, powders or oils on your chest area.
  • If your stress test is scheduled after 11:45AM, do not eat or drink anything after 7:00AM prior to the test (Please try to avoid anything with milk). No caffeine or nicotine after midnight prior to the test. DIABETICS may have juice and toast with their pills and/or 1/2 insulin dose , 2 hours prior to test. DO NOT put any lotions, powders or oils on your chest area.

For 24 hours before the test, do not take the following medications:

  • Beta Blockers such as: Atenolol, Betapace, Bystolic, Carvedilol, Coreg, Inderal, Lopressor, Metoprolol, Propanolol, Sotalol, Tenormin, Toprol, etc.

For 48 hours before the test, do not take the following medication:

  • Theophylline

*Note: Consult your doctor as some other medications may not be listed

  • If you are taking other medications for your heart that you are unsure about, please check with your doctor before taking medications on the day of the test.
  • Wear loose comfortable clothing and tennis shoes. No flip flops or high heels. Do not wear shirts or blouses with metal buttons or zippers.
  • Please notify our office if you have any questions that were not answered.
  • Since there are no adverse side effects from a Nuclear Stress Test, you will be able to drive immediately following.

Chemical Stress Test

At South Charleston Cardiology Associates, we take every patient’s needs into consideration. If a patient is unable to walk on the treadmill for their nuclear stress test, then our doctors will perform a chemical stress test. Each patient that needs a chemical stress test will be given one of these three drugs; Persantine, Dobutamine, Lexiscan, in order to get your stress levels up. This will help look for any blockages in the coronary arteries. Conveniently, a chemical stress test provides the patient with the same results, preparation, and instructions as a nuclear stress test.

*Feel free to call our office with any questions or concerns.

Exercise Stress Test

South Charleston Cardiology Associates performs an exercise stress test which is used as a screening tool to test the effect of exercise on your heart.

What to expect during the stress test

A Technician will prep you for the test by placing 10 electrodes on your chest for EKG purposes. To exercise the heart, patients walk on a treadmill.  At this time one of our Cardiologists, along with one of our Technician monitors the patient’s blood pressure and EKG during exercise and makes sure that the patient reaches his/her maximum level of exercise. The stress test is done using Bruce Protocol, which is where the treadmill will speed up and elevate every 3 minutes

The test continues until:

  • You reach a target heart rate
  • You develop chest pain or a change in your blood pressure that is concerning
  • ECG changes show that your heart muscle is not getting enough oxygen
  • You are too tired or have other symptoms, such as leg pain, that keep you from continuing

You will be monitored until your heart rate returns to baseline. The total time of the test is around 60 minutes

How to Prepare for the test?

  • Wear loose comfortable clothing and tennis shoes. No flip flops or high heels.

For 24 hours before the test, do not take the following medications:

  • Beta Blockers such as: Atenolol, Betapace, Bystolic, Carvedilol, Coreg, Inderal, Lopressor, Metoprolol, Propanolol, Sotalol, Tenormin, Toprol,

*Note: Consult your doctor as some other medications may not be listed

  • If you are taking other medications for your heart that you are unsure about, please check with your doctor before taking medications on the day of the test.
  • Please notify our office if you have any questions that were not answered.