Stress Tests

Stress tests help us find out how well our heart handles its workload when presented with a challenge such as exercise. As your body works harder during the test, it requires more fuel and your heart has to pump more blood.

Nuclear Stress Test

A nuclear stress test measures blood flow to the heart muscle both at rest and when the heart is under stress, or while exercising. Though it is similar to a routine exercise stress test, it also provides images that can show areas of low blood flow through the heart and areas of damaged heart muscle.

If unable to exercise on a treadmill or if requested by your physician for specific circumstances, a nuclear stress test can also be provided using a pharmacological form of stress that does not require any physical exertion such as Lexiscan or Adenosine.

Preparing for the test:

• If you are diabetic, hold your medication
• Bring a snack and drink, if you desire
• Take all medications except for beta blockers and diabetic medications. Please let us know if you have any questions regarding your medication

• The stress portion will be performed next. We will place electrodes on your chest to record your blood pressure, heart rate, and ECG
• You will be asked to perform a “graded” exercise test on a treadmill. The first stage of the test will begin with the treadmill at a slow speed and a little uphill inclination. Every three minutes the treadmill increases in speed and elevation. The physician or technician may stop the test at any time for medical reasons, or you may stop the test because of significant fatigue or discomfort. In general, however, we encourage you to exercise as long as possible in order to maximally stress the blood flow to your heart

Treadmill Stress Test

The treadmill stress test records the heart’s electrical activity, including rate and rhythm, during exercise, most often for the diagnosis of coronary artery disease. Exercise places stress on the heart, and performing a treadmill stress test can bring out abnormalities caused by partial blockages in the coronary arteries – abnormalities that may not be apparent at rest.

Preparing for the test:

• You can drink water, but do not eat anything 4 hours prior to the test
• Please wear loose, comfortable clothing and comfortable walking shoes
• Do not put on any lotions on the day of the test
• Do not consume any caffeine or decaffeinated beverages for 24 hours before your stress test. Items with caffeine include sodas, “caffeine-free” sodas, coffee, decaf coffee, tea, decaf tea, chocolate, Excedrin, and certain cold or diet pills
• If you are diabetic, hold your medication
• Continue to take all medications except for beta blockers and diabetic medications
• Bring a snack and drink, if you desire
• Bring your inhaler(s), if you use them
• Bring a list of medications and dosages

During the test:

• We will place electrodes on your chest
• You will be asked to perform a “graded” exercise test on a treadmill. The exercise protocol that you will follow will be determined by the cardiologist supervising your test, but will begin at a relatively easy level and become progressively more difficult with each subsequent stage
• Your blood pressure, heart rate, and ECG will be recorded at frequent intervals at rest and during exercise and after exercise. The physician or technologist may stop the test at any time for medical reasons, and you may ask to stop the test at any time due to fatigue or discomfort. However, we encourage you to exercise as long as possible so that we may assess your heart under maximum stress.

Cardiac PET Scan

Cardiac Positron Emission Tomography (PET) exams help to evaluate heart health by measuring the blood flow brought by the coronary arteries to the heart muscle. A small amount of radiopharmaceutical will be given through an IV line. This lets the PET scanner capture pictures of your heart.

Preparing for the test:

• No caffeine for 24 hours prior to the test such as coffee, tea, soft drinks, and chocolate. Do not consume decaffeinated/caffeine-free beverages as they contain some residual caffeine.
• Nothing to eat or drink 4 hours prior to your test.
• Medications can be taken with a sip of water.
• If you have diabetes and take insulin, check with you your doctor.

• Do not take Excedrin or over-the-counter meds that contain caffeine or decongestants.
• Avoid tobacco use for 12 hours before the PET scan
• If you take herbal supplements or stimulants, stop taking them for 24 hours before the PET scan. These include Methylphenidate, Adderall, Vyvanse, and Dextroamphetamine,
• Wear comfortable, loose-fitting clothing.
• Do not wear jewelry or any metal objects

During the test:

• The test takes approximately 1 hour
• You’ll lie on a flat table that’s connected to the PET scanner (shaped like a giant doughnut) to take images of the heart. Two sets of images are taken.

Rest images:

• The technician will hook ECG electrodes to you to keep track of your heartbeat during the test and signal the computer when to take a scan.
• Radioactive tracer will be injected into an IV in your arm and images of the heart will be acquired.

Stress images:

• The stress medicine is Lexiscan or Adenosine. Side effects include headache, dizziness, and chest pain, shortness of breath, or nausea/abdominal discomfort, which are mild and are usually gone in less than 5 minutes.
• After the stress, we will inject a second dose of the tracer into your bloodstream through the IV, and another set of pictures of the blood flow to your heart is obtained.

*The amount of radiation you will receive is relatively low. None of these low-dose levels are associated with increased levels of cancer or other adverse effects.

*Cardiac PET is generally safe as the amount of radiation is small, and your body will get rid of it through your kidneys within about 24 hours. If you’re pregnant or think you might be pregnant, or if you’re a nursing mother, please let us know beforehand as the test could harm your baby.

After the scan:

• You can usually go back to your normal activities right away
• Make an appointment with your doctor to discuss the results of the test and next steps