Myocardial Perfusion Scan, Stress

What to Expect

During the Procedure

• Description of the room, monitoring devices, positions, and equipment that will be used - The equipment used during the procedure includes: an EKG machine and monitor, gamma camera for exercise or an IV pump for medication, a treadmill, and an IV line. You will be lying flat on a table while the images of your heart are obtained. Your arms will be positioned above your head. It will be necessary for you to lie very still while the images are being taken, as movement can adversely affect the quality of the images.

• Anesthesia - None required.
  
  
• Basic description of the procedure:
  
  
  1. An IV will be started in your hand or arm.
     
     
  2. You will be connected to an EKG machine with leads and a blood pressure cuff.
     
     
  3. For an exercise myocardial perfusion scan, you will exercise on a treadmill. The intensity of the exercise will be gradually increased by speeding up the treadmill.
     
     (For a pharmacologic myocardial perfusion scan, you will not exercise on a treadmill. Instead, you will lie on the table while a medication is injected into your IV to increase your heart rate.)
     
     
  4. Your heart rate and blood pressure will be monitored. Once you have reached your target heart rate (in the pharmacologic myocardial perfusion scan), or you reach your maximal exercise point (determined by the physician based on your heart rate and age), the radiopharmaceutical will be injected into your IV.
     
     
  5. If you experience any symptoms such as dizziness, chest pain, extreme shortness of breath, or severe fatigue at any point during the procedure, let the physician or technician know.
     
     
  6. After the radiopharmaceutical has been injected, you will continue to exercise for another minute or two.
     
     
  7. Next, you will lie flat on a table. Approximately 10 to 60 minutes after the radiopharmaceutical is injected, the gamma camera will begin to take pictures of your heart. In a special kind of test called SPECT (single photon emission computed tomography), the scanner will rotate around you as it takes pictures. This test portion will last about 30 to 40 minutes.
     
     
  8. After the scan is completed, you will be allowed to leave the area, but will need to return at the appropriate time for a second set of scans. The second set of scans is taken three to six hours after the first set. During this time, you will not be allowed to eat, unless specifically instructed to do so by the nuclear technologist, and will be allowed limited water or decaffeinated/non-caloric liquids. Your physician may decide to have you return on another day for the second set of scans.
     
     
  9. The second set of scans will be similar to the first set - you will lie on the table as before while the scanner takes pictures of your heart.
     
     
  10. Once the second set of scans has been completed, the IV will be discontinued, and you will be allowed to leave, unless your physician instructs you differently.
      
      
• Procedure time - The average procedure time is approximately four to six hours. However, events such as delays with procedures prior to yours and other factors may delay your procedure's start time. If any difficulties are encountered during the procedure, such as equipment problems or difficulty in obtaining an adequate scan, the procedure may take longer or may have to be delayed.

After the Procedure

• Recovery - In general, there is no recovery period required following the procedure. However, unforeseen circumstances might occur in rare instances where your physician will want to observe your condition for a time after the procedure.
  
  
• Length of stay - You should be able to leave after the procedure has been completed, unless you are scheduled for additional procedures, examinations, and/or appointments.
  
  
• Recuperation time - In general, there is no recuperation time after the procedure. However, you may feel tired or uncomfortable from lying still or from the exercise done during the procedure.
  
  
• Outcome - If the scan is normal, your physician may begin to look for other non-cardiac causes for any symptoms you may have had. If the scan is abnormal, indicating the existence of coronary artery disease, your physician may wish to do further testing, such as cardiac catheterization.
  

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