Myocardial perfusion imaging

Your doctor may order a stress myocardial perfusion scan for:

• Chest pain, either new onset or occurring over a period of days or longer. 
• To diagnose coronary artery disease (CAD), narrowing of the coronary arteries. 
• After a heart attack to assess heart muscle damage. 
• To assess blood flow to areas of the heart muscle after coronary artery bypass surgery, angioplasty, or stent placement. 
• There may be other reasons for your physician to recommend a stress myocardial perfusion scan.

• The exercise part of the test may lead to rare instances of abnormal heart rhythms, chest pain, or heart attack due to the stress on the heart caused by exercise. 
• The needle used to put in the IV for the injection of the radioactive tracer may cause slight discomfort. Allergic reactions to the tracer are rare. 
• At Spectrum Health we strive to keep the radiation exposure as low as possible.

• Certain factors may interfere or affect the results of the test. They include, but are not limited to medications containing theophylline, caffeine, nitrate medications, or medications that slow the heart rate. 
• If you are pregnant or think you may be pregnant or breastfeeding, please check with your doctor before scheduling the exam. 
• No food or drink for four hours prior to the test. You may have water. 
• If you are scheduled for a myocardial perfusion scan with medication (pharmacological), you will need to avoid taking any medications containing theophylline or caffeine. Coffee, even decaffeinated, is not allowed, as it contains some caffeine. Nothing with caffeine for 12 hours. Medications for asthma may contain theophylline. If you have asthma, inform your doctor. Theophylline should be stopped for 48 hours. 
• Please dress comfortably with comfortable shoes. Leave jewelry and valuables at home. 
• Based on your medical condition, your doctor may request other specific preparation.

• Insurance cards 
• A current list of medications (prescription and over the counter) you are taking. 
  • Please include how much you take (dose in milligrams) and how often you take them.

Generally, a stress myocardial perfusion scan follows this process: 

• An intravenous (IV) line will be started in your hand or arm. You will be injected with the radioactive tracer, wait approximately 30 minutes and then be placed under the camera for resting images. 
• You will be asked to remove any jewelry or other objects that may interfere with the procedure. 
• If you have any symptoms during the exam such as dizziness, chest pain, extreme shortness of breath or severe fatigue notify the healthcare provider or technologist.

• After resting images. You will exercise on the treadmill. The intensity of exercise is gradually increased. 
• Your heart rate and blood pressure will be monitored. Once you have reached your maximal exercise point the radioactive tracer will be injected into your IV line. 
• After the tracer has been injected, you will continue to exercise for several minutes. 
• After a short wait you will be placed under the camera for stress images.

• After resting images. If you are unable to exercise on the treadmill you will be given a medicine into your IV that will dilate your blood vessels similar to exercise. 
• Your heart rate and blood pressure will be monitored. 
• The tracer will be injected into your IV line. 
• After a 30 minute wait you will be placed under the camera for stress images.

• You will lie flat on a table while the images of your heart are taken. 
• Your arms will be on a pillow above your head. You will need to lie very still while the images are being taken, as movement can affect the quality of the images. 
• After both sets of images the IV line will be removed.

Three to four hours

Drink plenty of fluids and empty your bladder often for 24 to 48 hours after the test. This helps flush the remaining radioactive tracer from your body. When the test is complete, a cardiologist will review your results and enter them into your electronic medical record. Your primary physician will then be notified of the results. The testing staff will be unable to provide you with your results.