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Nuclear Stress Test

A nuclear stress test, also known as a myocardial perfusion imaging (MPI) test, is a medical test that evaluates blood flow to the heart using small amounts of radioactive material. The test involves two parts: the first part involves taking images of the heart at rest, and the second part involves taking images of the heart while it is under stress.

During the stress portion of the test, the patient can either walk on a treadmill or receive medication that simulates exercise to increase the heart rate. As the heart works harder, the radioactive material is taken up by the heart muscle, and special cameras capture images of the heart.

The length of time a nuclear stress test takes can vary, but typically it takes around 2-4 hours to complete, with the exercise portion lasting for around 10-20 minutes.

Most people do not experience pain during a nuclear stress test. However, some people may experience mild discomfort or side effects from the medication, such as headaches or nausea.

Rarely, the medication administered can cause chest pain and EKG changes.  If so, there is a reversal medication readily available to stop the drug.

Common diagnoses made by a nuclear stress test include:

  • Coronary artery disease, which can cause reduced blood flow to the heart muscle

  • Areas of the heart that are not receiving enough blood flow or oxygen

  • Heart muscle damage caused by a previous heart attack or other heart conditions

  • Abnormalities in heart function, such as abnormal heart rhythms or heart valve problems.

This test is NOT for you if: 

  • you have asthma and chronic airways limitation with a significant bronchospasm component;

  • 2nd and 3rd degree atrioventricular block and sick sinus syndrome without an artificial pacemaker.

  • unstable angina.

  • History of heart failure which is not well controlled, and there is a concern for deterioration.

  • Poorly controlled blood pressure with systolic blood pressure significantly higher (>200 mmHg at rest).

  • Myocardial infarction in the last week.

  • Acute pulmonary embolism

  • Acute inflammation of pericardium or myocardium

  • Severe pulmonary hypertension

  • Known hypersensitivity to adenosine

  • Caffeine intake in the previous 12 hours - See below to prepare properly for the test

Before the test:

  • No eating  in the hours leading up to the test. If you’re having a nuclear stress test, you might not be able to eat until after your test.

  • Avoid caffeine for 24 hours before testing. This includes coffee, tea, energy drinks and certain over-the-counter medications.

  • Not smoke or use tobacco products.

  • You MIGHT be advised to stop certain prescription medications the day of your test: beta-blockers (i.e. metoprolol, carvedilol) and asthma inhalers (Albuterol, Ventolin).

  • Wear lightweight, comfortable clothes and sturdy walking shoes.

What to Expect: Nuclear Medicine Stress Test | Cedars-Sinai

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