What to Expect: Nuclear Stress Testing

A nuclear stress test is an advanced diagnostic tool for finding the cause of new or worsening chest pain, stratifying risk for heart disease, deciding how well treatment is progressing, and/or evaluating recovery after a heart attack. Most of the stress tests performed by Heart House physicians are done in the office. A regular stress test shows the EKG, heartrate and blood pressure while you are walking on a treadmill. A nuclear stress test shows your physician pictures of the blood flow to the heart muscle, in addition to the EKG, heartrate and blood pressure.

In order to take the pictures of your heart, you will receive an injection of a radioactive tracer through an IV. The tracer allows the Nuclear camera to take pictures of the blood flow to the heart muscle. There are no side effects from the radioactive tracer. It is not a contrast dye. It does not contain iodine and will not harm your kidneys. Nuclear stress testing, is very safe and can help your cardiologist accurately diagnosis heart disease.

Preparing for Your Nuclear Stress Test

When preparing for the nuclear stress test, you will receive pre-procedure instructions. Do not eat or drink anything that is caffeinated or decaffeinated for at least 24 hours before the procedure. You may have a light meal 2 hours before your appointment. All medication should be taken as you would normally, unless otherwise directed by our office or your physician.

During the Procedure

We ask that you arrive for your stress test approximately 15 minutes before your appointment time to register. Testing begins by placing an IV in your arm and injecting the radioactive tracer. You will then sit in the waiting area for about 20 and 45 minutes to allow the tracer to be absorbed by the heart muscle. After the waiting period, we will take pictures of the blood flow to your heart muscle with the nuclear camera.

Following your pictures, we will perform your stress test. We can do your stress test by having you walk on the treadmill or by giving you a medication which makes your body think it is exercising. We will monitor you before, during, and after your stress test to make sure you are safe and comfortable.

For people that are able to exercise, we will monitor your heartrate, blood pressure and EKG while you are walking on the treadmill. The treadmill will go higher and faster until you become tired. Once you have exercised as much as you can, we will give you a second injection of the tracer so we can see the stress blood flow to your heart muscle. It is normal to feel tired, short of breath, heaviness of the legs while exercising.

If you are unable exercise, we will monitor you as we give you an injection of a medication which makes your body think its exercising by opening your blood vessels. It is normal to feel short of breath, pressure in head chest or belly. The side effects go away within a couple of minutes. We can also give you a reversal medication, if needed, to take away the side effects. You will receive a second injection of the tracer so we can see the stress blood flow to your heart muscle.

After your stress test you will sit in the waiting area again and then we will take a second set of pictures. Once your pictures are finished you are free to leave the office. We will process the images and the physician will read the EKGs and the pictures. Someone from the office will call you with results within 24 hours.

Results and Next Steps

Normal results from a nuclear stress test are typically a good indicator that there is no significant cardiovascular problem that needs immediate attention. Abnormal results will require further diagnosis and/or treatment that will be discussed with your cardiologist. Some patients may be referred for a cardiac catheterization, which is a procedure to see if there are any blockages in the arteries that supply the heart muscle with blood. Depending on the results of the catheterization, you may need stents to open up the blocked arteries.  Significant blockage in the arteries may require a bypass procedure. Milder problems may only require watchful waiting or medication.

Nuclear stress testing is a very safe and easy diagnostic procedure that allows your physician to diagnose coronary artery disease. Please call the office if you have any questions or concerns about your nuclear stress test.