Nuclear Exercise Stress Test

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A nuclear exercise stress test uses a radioactive imaging agent (not a dye) in conjunction with treadmill exercise to produce pictures of the heart muscle. The imaging agent gives off a small amount of radiation, which can be detected by a special nuclear camera. The amount of radiation exposure during the test is very small and poses no health risk. The test will help your doctor determine if there are areas of your heart, which do not receive enough blood supply due to coronary artery disease. Areas of your heart, which may have been damaged from a previous heart attack, may also be seen.

The test consists of a rest portion and a stress portion, which will take approximately 2½-3 hours to complete. The first part of the test is the rest portion, which is used to image the heart at rest. During this portion of the test, you will receive an injection of the imaging agent. There are no side effects associated with the imaging agent. You will then be required to wait 45-60 minutes in the waiting room to let the agent circulate. You may drink fluid of any kind while you wait. You will be able to use the restroom as often as you need. After the wait, you will be brought into the camera room for imaging. The pictures will take approximately 10 minutes to complete.

The second part of the test is the stress portion, where you will walk on a treadmill and be continuously monitored for blood pressure, heart rate, rhythm, and ECG changes. You will be given an injection of the same imaging agent used for the rest portion during your last two minutes of exercise. After your heart rate and blood pressure return to normal limits you will be brought to the camera room for another set of images. This set of images will take approximately three minutes.

Patient instructions for stress portion:

1. You will be sitting in a chair slightly angled back with your left arm above your head.
2. While being imaged you will not be permitted to move, talk or sleep.
3. Stop eating four (4) hours prior to the test.
   *you may have unlimited amounts of fluid prior to the test.
4. You may take your regular medications with water. However:
   *If you are taking any of the medications listed on the attached sheet, the medications must be held for 48-72 hours prior to the test (the procedure scheduler will notify you of the exact length of time).
   *Stop long acting nitrates eight (8) hours prior to the test (you MAY continue to use sublingual nitroglycerin).
5. If you are diabetic, please contact the physician who manages your diabetes for instruction on adjusting your medications while you are fasting.
6. Wear two piece clothing. No shirts with metal snaps or sequins. Wear comfortable walking shoes.
7. Your physician will notify you of your results approximately seven days from completion of the test.

Medication to be Held for Treadmill Nuclear Exercise Stress Test

Beta Blockers

1. Cartrol (carteolol)
2. Blocadren (timolol)
3. Coreg (carvedilol)
4. Corgard (nadolol)
5. Inderal (propranolol)
6. Kerlone (bextaolol)
7. Levatol (penbutolol)
8. Lopressor (metroprolol)
9. Sectral (acebutolol)
10. Tenorim (atenolol)
11. Toprol XL (metroprolol succinate)
12. Visken (pindolol)
13. Zebeta (bisoprolol)
14. Normodyne (labetolol)
15. Betapace (sotalol)
16. Bystolic (nebivolol)

Combination Beta Blockers with Diuretics

1. Corzide (nadolol and bendroflumethiazide)
2. Inderide (propranolol and hctz)
3. Timolide (timolol and hctz)
4. Ziac (bisproprolol and hctz)

Nitrates (Held 8 hours prior to test.)

1. Dilatrate-SR
2. Imdur
3. ISDN (isosorbide dinitrate)
4. ISMO (isosorbide mononitrate)
5. Isordil tembids
6. Isordril titradose
7. Monoket
8. Nitrocot
9. Nitroglyn E-R
10. Nitro-par
11. Nitro-time
12. Nitrong
13. Sorbitrate
14. Nitrogard
15. Nitropatch (patch)
16. Nitrobid (ointment)
17. Minitran (patch)

Ace Inhibitor and Calcium Channel Blocker

1. Tarke (trandolapril/verapamil)

Calcium Channel Blockers

1. Cardizem (diltiazem)
2. Cardizem CD (diltiazem)
3. Cartoa XT (diltiazem)
4. Covera HS (verapamil)
5. Isoptin SR (verapamil)
6. Tiazac (diltazem)
7. Verelan (verapamil)
8. Verapamil
9. Diltia XT
10. Taztia
11. Procardia (nifedipine)