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Myocardial Perfusion Stress Test

This test determines if your coronary arteries are supplying your heart with enough blood. Technetium, a radioactive tracer and picture-taking material, is injected through a vein in your arm. Your blood carries the tracer to your heart muscle and through the coronary arteries. A nuclear medicine camera is able to detect the radioactive tracer and see its distribution in your heart. This test can be done in one or two days.

There are two parts of the myocardial perfusion stress test:

  • Resting part

  • Stress part

Part 1: Resting

If you are having the entire test performed in one day:

  • An IV will be set in your arm and nuclear medicine technologist will give you an injection of technetium.

  • In about one hour you will lie down in the nuclear medicine camera for the first set of pictures. This takes about 15 minutes.

  • You will then be directed to the Cardiovascular Department for the stress part of the exam, which can be performed with exercise or pharmacological means.

  • After the stress portion of the test, you will return to nuclear medicine for a post-stress set of pictures. This takes about 15 minutes.

If you are having the test performed in two days:

  • The first day is usually the resting exam. A nuclear medicine technologist will give you an injection of technetium.

  • In about one hour, you will lie down in the nuclear medicine camera for the first set of pictures.

  • On the day you are having the stress part of the exam, you will return to the Radiology Department where an IV will be set in your arm. You will then be directed to the Cardiovascular Department.

  • In the Cardiovascular Department a cardiologist will supervise the stress test during which you will receive the second technetium injection through your IV.

  • After the stress test, you will return to Radiology for the second set of pictures. This will take about 15 minutes.

Part 2: Stress

A physician, cardiovascular disease technician and nuclear medicine technologist will be present for your stress test and will monitor your blood pressure, heart rate, and any signs of fatigue.

After your first set of images in nuclear medicine, you will come to the stress lab in the Cardiovascular Department. For this part of the test, electrodes with wires will be placed on your chest and attached to a belt you will wear during the test. A blood pressure cuff will be wrapped around your arm. Electrocardiogram (EKG) tracings and a blood pressure will be taken at rest.

Exercise myocardial perfusion stress test

As the test begins you will be asked to walk on the treadmill at a comfortable speed. The treadmill will gradually increase in speed and incline until the desired heart rate is obtained. EKG, blood pressure and signs of fatigue will be monitored throughout the test. When working on the treadmill becomes difficult, the nuclear medicine technologist will inject the radioactive tracer into your IV. The physician will stop the test when your heart rate has attained a predetermined level based on your age, or earlier if needed. EKGs and blood pressures will also be taken until the test is completed. you will then return to nuclear medicine for a second set of images.

Pharmacological myocardial perfusion stress test

If you are unable to walk on the treadmill, a pharmacological or medication-induced stress test may be administered. You will lie on a bed or walk slowly on a treadmill as the nuclear technician injects a medication followed by the radioactive trace. EKG, blood pressure and signs of fatigue will be monitored throughout the test.

A myocardial perfusion stress test can take four to five hours.