Nuclear Cardiology
New Cardiac Nuclear Imaging System
Lancaster General Health is the first health system in Pennsylvania to offer the revolutionary technology of GE Healthcare's Discovery NM 530c cardiac nuclear imaging system—a high-speed, high-resolution CZT camera that greatly reduces imaging time and radiation exposure for patients compared to previous technologies. Read more...
What is a Nuclear Stress test?
The goal of a Nuclear Stress test is to diagnose coronary artery disease. This procedure utilizes an injection of a radioactive material in order to visualize the blood supply to the heart. The exam is separated into three parts: a resting image, a stress portion, and a stress image. The test takes approximately 3 hours to complete.
How should I prepare for the exam?
It is required that you do not eat or drink anything after midnight. If you need to take medications in the morning of the exam, you may take your medicine with a small amount of water. You should arrive for your exam about 15 minutes early to allow time for the secretary to register your information. It is advised that you wear comfortable clothing. Please refrain from wearing sandals, high-heels, or boots. It is a good idea to bring a book or magazine to read during the waiting periods.
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What does the equipment look like?
The camera closely resembles a CAT scan machine. The camera is not closed in like an MRI machine.
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How is the procedure performed?
When you arrive to the department you will be escorted to a changing room. You will change into a hospital shirt or gown. A staff member will then take you into a room where they will prep your skin for an EKG and place patches on your chest. A Nuclear Medicine Technologist will start an IV and inject the radioactive tracer through the IV line. The tracer is not a dye and there are no side effects. Once the injection is completed, you will relax in the waiting area for 30 minutes. During this period you will receive something to eat and drink. After 30 minutes, you will be taken back to a camera room to have your first set of pictures taken. The images take about 15 minutes to complete. During this time you must remain perfectly still.
Next, you will be taken into the stress room. There are 3 options available.
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If your doctor ordered an exercise/treadmill stress test, you will walk on the treadmill until your heart rate reaches the target rate (average time is about 6-9 minutes). You will receive another dose of radioactive material at this time.
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If your doctor ordered an Adenosine stress test, you will lie in a bed and receive a medication that will dilate all of your blood vessels, but not increase your heart rate (imitating exercise). This medication runs through your IV for 4 minutes. Midway through the test you will receive the second dose of radioactive tracer. Patients sometimes notice a flushing feeling, overall heaviness in the legs, and/or shortness of breath during the infusion of the medication. The side effects from the medicine go away quickly after the medicine is turned off. You may be asked to do some low level exercise during the infusion.
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If your doctor ordered a Dobutamine stress test, you will lie in a bed and receive a medication that will increase your heart rate. Once the target heart rate is achieved, you will receive the second injection of radioactive tracer through your IV line and the medication will be turned off.
There is another 30 minute wait after your stress test. Once the 30 minute wait is over, you will be taken back to the camera room for one last set of images. After the images are completed, the technologist will remove your IV and you will be allowed to change into your clothes. The test will be processed and evaluated before you leave.
A cardiologist will read your exam and send a report to your doctor. The results should be available to you within 2-3 days. If you do not hear from your doctor within that time frame, you should contact your doctor’s office.
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What are the risks and benefits of this procedure?
Benefits
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The information provided by this exam is unique and often unattainable using other imaging procedures.
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A Nuclear Stress test often produces the most useful information needed to make a diagnosis or to determine appropriate treatment.
Risks
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It is possible that you could experience chest pain during the stress test; however, your heart will be monitored and trained nurses and doctors are readily available.
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The dose of the radioactive tracer is a small quantity which limits the radiation exposure. The radiation risk is very low, especially compared with the potential benefits.
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Nuclear stress tests have been used for over 50 years and there are no known long-term adverse effects from the low-dose exposure.
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