Nuclear Stress Testing at MCB

If you have recently been diagnosed with coronary heart disease, are looking into starting a new physical fitness program, or are preparing to undergo surgery, your primary care physician is probably looking into scheduling a nuclear stress test for you very soon. Here are Medical Center Barbour, we perform nuclear stress tests Monday through Friday and work with every practicing physician in Eufaula and beyond to ensure that you don’t have to go out of town for your nuclear stress test. Medical Center Barbour knows that getting any kind of medical testing done can come with a tinge of anxiety, but you can rest assured that our excellent medical personnel are here for you to provide outstanding care and put you at ease. So, to ensure you are completely comfortable with the entire process that takes place during a nuclear stress test, MCB has put together this article so that you can go into your appointment with confidence!

What is a Nuclear Stress Test?

A nuclear stress test uses radioactive dye and an imaging machine to create pictures showing the blood flow to your heart. The test measures blood flow while you are at rest and are exerting yourself, showing areas with poor blood flow or damage in your heart.

The test usually involves injecting radioactive dye, then taking two sets of images of your heart — one while you’re at rest and another after exertion.

A nuclear stress test is one of several types of stress tests that may be performed alone or in combination. Compared with an exercise stress test, a nuclear stress test can help better determine your risk of a heart attack or other cardiac event if your doctor knows or suspects that you have coronary artery disease.

Why is the Test Performed

The test is done to see if your heart muscle is getting enough blood flow and oxygen when it is working hard (under stress).

Your provider may order this test to find out:

How well a treatment (medicines, angioplasty, or heart surgery) is working.
If you are at high risk for heart disease or complications.
If you are planning to start an exercise program or have surgery.
The cause of new chest pain or worsening angina.
What you can expect after you have had a heart attack.

The results of a nuclear stress test can help:

Determine how well your heart is pumping
Determine the proper treatment for coronary heart disease
Diagnose coronary artery disease
See whether your heart is too large

How to Prepare

Your physician will give you specific instructions on how to prepare for your nuclear stress test.

You may be asked not to eat, drink or smoke for a period of time before a nuclear stress test. You may need to avoid caffeine the day before and the day of the test.

Ask your physician if it’s safe for you to continue taking all of your prescription and over-the-counter medications before the test, because they might interfere with certain stress tests.

If you use an inhaler for asthma or other breathing problems, bring it to the test. Make sure the physician and the health care team member monitoring your stress test know that you use an inhaler.

Wear or bring comfortable clothes and walking shoes. Don’t apply oil, lotion or cream to your skin on the day of your nuclear stress test.

What to Expect

A nuclear stress test may be performed in combination with an exercise stress test, in which you walk on a treadmill. If you aren’t able to exercise, you’ll receive a drug through an IV that mimics exercise by increasing blood flow to your heart. A nuclear stress test can take two or more hours, depending on the radioactive material and imaging tests used.

First, the physician will ask you some questions about your medical history and how often and strenuously you exercise. This helps determine the amount of exercise that’s appropriate for you during the test. Your physician will also listen to your heart and lungs for any abnormalities that might affect your test results.

Before you start the test, a technician inserts an intravenous (IV) line into your arm and injects a radioactive dye (radiopharmaceutical or radiotracer).

The radiotracer may feel cold when it’s first injected into your arm. It takes about 20 to 40 minutes for your heart cells to absorb the radiotracer. Then, you’ll lie still on a table and have your first set of images taken while your heart is at rest.

A nurse or technician will place sticky patches (electrodes) on your chest, legs and arms. Some areas may need to be shaved to help them stick. The electrodes have wires connected to an electrocardiogram machine, which records the electrical signals that trigger your heartbeats. A cuff on your arm checks your blood pressure during the test. You may be asked to breathe into a tube during the test to show how well you’re able to breathe during exercise.

If you can’t exercise, the physician will inject the drug into your IV line that mimics exercise by increasing blood flow to your heart. Possible side effects may be similar to those caused by exercise, such as flushing or shortness of breath. You might get a headache.

For an exercise stress test, you’ll probably walk on a treadmill or ride a stationary bike. You’ll start slowly, and the exercise gets more difficult as the test progresses. You can use the railing on the treadmill for balance. Don’t hang on tightly, as this may skew the results.

You’ll continue exercising until either your heart rate has reached a set target, you develop symptoms that don’t allow you to continue or you develop:

Moderate to severe chest pain
Severe shortness of breath
Abnormally high or low blood pressure
An abnormal heart rhythm
Dizziness
Certain changes in your electrocardiogram

You and your physician will discuss your safe limits for exercise. You can stop the test anytime you’re too uncomfortable to continue.

You’ll have another injection of radiotracer when your heart rate peaks. About 20 to 40 minutes later, you’ll lie still on a table and have a second set of images made of your heart muscle. The dye shows any areas of your heart receiving inadequate blood flow.

The physician will use the two sets of images to compare the blood flow through your heart while you’re at rest and under stress.

After you stop exercising, you might be asked to stand still for several seconds and then lie down for a period of time with the monitors in place. The physician can watch for any abnormalities as your heart rate and breathing return to normal.

When the test is complete, you may return to normal activities unless the physician tells you otherwise. The radioactive material will naturally leave your body in your urine or stool. Drink plenty of water to help flush the dye out of your system.

Understanding the Results

There are a few different results you might get from a Nuclear Stress Test, and your physician will explain it all to you thoroughly.

Normal blood flow during exercise and rest. You may not need further tests.
Normal blood flow during rest, but not during exercise. Part of your heart isn’t receiving enough blood when you’re exerting yourself. This might mean that you have one or more blocked arteries (coronary artery disease).
Low blood flow during rest and exercise. Part of your heart isn’t getting enough blood at all times, which could be due to severe coronary artery disease or a previous heart attack.
Lack of radioactive dye in parts of your heart. Areas of your heart that don’t show the radioactive dye have tissue damage from a heart attack.

If you don’t have enough blood flow through your heart, you may need to undergo coronary angiography. This test looks directly at the blood vessels supplying your heart. If you have severe blockages, you may need a coronary intervention (angioplasty and stent placement) or open-heart surgery (coronary artery bypass).

As always, we are here for you for whatever medical testing you may need! Remember, you always have the option to get quality care, close to home with Medical Center Barbour! Simply ask your primary care physician to refer you to MCB!

Nuclear Stress Testing at MCB