Non-invasive cardiac imaging of function and anatomy is now central to the diagnosis and treatment of those with known or suspected coronary artery disease (CAD). These include nuclear cardiology, echocardiography, cardiac CT and cardiac magnetic resonance imaging. As the methods and techniques are refined, it is likely that a combination of both anatomic and functional imaging will become increasingly common. Selective use of various modalities, alone or in combination is currently used until a “one stop shop” emerge.
Overall, there has been an increase in incidence of CAD going along with the increase in obesity, type II diabetes, metabolic syndrome, aging population and stress. We have also seen striking changes in our ability to identify and characterize patients at risk with nuclear cardiology at the forefront. Nevertheless, a significant number of patients still have a sudden catastrophic event as their first manifestation of disease. How do we identify the patients at risk in the pre-symptomatic phase of CAD? How can we characterize risk in symptomatic patients? So that only those who are likely to benefit from invasive therapies are subjected to the risks remains the guiding principle.
What is Nuclear Cardiology?
Nuclear cardiology is performed to diagnose coronary artery disease (blockage in the blood vessels feeding the heart), assess damage to the heart muscle from previous heart attacks, and to evaluate areas of the heart which have decreased blood flow.
What happens during the exam?
This procedure is done in two parts (rest and stress) and evaluates the blood flow pattern of the heart during rest and again during exercise. This “stress” test can either be walking on a treadmill or receiving a medicine which simulates the effect of exercise.
A small IV will be placed in a vein in your arm (this will be left in for the entire procedure) and is used for the injection of the heart imaging agents. There are no side effects to the imaging agents that are used. The imaging agent has a small amount of radioactive isotope which the camera detects and then produces images of your heart according to its own blood flow pattern. This procedure does not carry any greater risk than the radiation exposure you would receive if undergoing an x-ray CAT (CT) scan. The radioactive material is cleared from your body through urine.
EKG patches will be put on your chest (men may need to have their chest shaved in areas where the patches will be placed) and then you will be connected to an electrocardiography (EKG machine) so your heart rate and rhythm can be monitored.
The test will take approximately 4 hours to complete. You will be at the clinic the entire time during the test which includes “rest” and “stress” pictures. Should you be a two day study, you will be at the clinic 2 hours each day, one day for your “rest” portion and one day for your “stress” portion of the exam. The longest time you will be asked to lie on the imaging table will be approximately 20 minutes.
How Do I Prepare?
Be sure to wear comfortable clothing and shoes. Women should avoid wearing dresses or one-piece outfits. Do not wear a blouse/shirt with metal buttons or undergarments with metal wires (a bra with hooks in the back is fine). Metal will block the camera from detecting the imaging agent therefore, if you wear any of the items above containing metal, you will have to change into a hospital gown.
For all nuclear medicine tests
NO FOOD OR DRINK 4 HOURS PRIOR TO YOUR EXAM
NO CAFFIENE, INCLUDING DECAFFEINATED PRODUCTS, 12 HOURS PRIOR TO YOUR EXAM. This includes regular, decaffeinated and “caffeine-free” coffee, tea, chocolate, and colas. Medications that contain caffeine include:
- Fioricet
- Fiorinal
- Norgesic
- Norgesic Forte
- Anacin
- Excedrin
- No-Doz
For diabetic patients
NO FOOD OR DRINK 2 HOURS PRIOR TO YOUR EXAM. Please bring a light snack with you. There will be an opportunity to eat during the test. If you are insulin dependent, please take your insulin as is normal for you with a small meal such as a piece of toast or a bowl of cereal. Caffeine instructions remain the same as above.
If you use an inhaler(s), bring it with you on the day of the test.
Patients requiring an interpreter
Please bring an interpreter the day of the test. If you are unable to arrange your own interpreter, please contact us prior to the day of your exam.
Please notify the nuclear imaging department if you are scheduled for an Adenosine nulcear exam and currently taking one of the following medications –
- Xanthine
- Theophylline
- Quibron
- Slo-Phyllin
- Theo-Dur
- Aminophylline
- Persantine
- Dipyridamile
- Aggrenox
Please contact our office 24 hours in advance if you must cancel. We have to special order the medicine for this procedure a day prior to the exam and we cannot return the medicine for credit. If advance notice has not been given – we may need to charge a cancellation fee!
If you have any questions regarding your exam please call (253) 572-7320 for exams scheduled in our Tacoma office and (253) 841-4347 for exams scheduled in our Puyallup office.
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