Our office was the first in the Lehigh Valley to use digital imaging.  This study is performed by injecting a small amount of radioactive tracer intravenously.  Patients walk on the treadmill during the second part of the test.  Patients unable to walk on the treadmill will receive a pharmacological drug to stress the heart while they are comfortable sitting in a chair.   This will enable us to take photos of the heart muscle to evaluate blood flow and function of the heart.  Patients need to be aware that this test requires 3-4 hours of their time at our office.


A Cardiolite stress test allows the doctor to look for blockages in the arteries of the heart that supply blood to the heart muscle. Cardiolite, is a low dose of radioactive tracer that goes to the heart muscle (myocardium) and allows pictures of your heart to be taken.


WHAT TO EXPECT IN THE MORNING

In the morning, a nuclear medicine technician will start an IV and inject the resting dose of Cardiolite You will then be asked to wait in the waiting area for a few minutes giving the Cardiolite time to circulate. Afterwards, you will have images taken on a SPECT camera.

During imaging, you will be asked to sit in a special chair with your left arm raised and placed on an arm rest. The chair will rotate every few minutes. You will need to sit still during the time the images are taken. This will take approximately 20 minutes.

After the resting images are finished, you might have time to leave the office and possibly have a bite to eat depending on your return time. The technologist will give you your return time and instructions after the first set of imaging is complete.

This first set of images are pictures of the blood flow through your heart while you are at rest.


WHAT TO EXPECT ON YOUR RETURN VISIT

When you return, you will be taken to a room where you will be prepped with ten stickers or electrodes that will be attached to your chest and connected to a belt worn around your waist. This is done so that the physician can monitor your ECG A baseline blood pressure and ECG will be taken.

For the second part of the test a variety of protocols may be utilized. The physician will determine which type of testing is the most appropriate. You might walk on the treadmill, be given Adenosine or a combination of both. For those that suffer from asthma, COPD, or emphysema, a drug called Dobutamine may be used. Below is a brief description of the four protocols.


Stress Protocol

Once the physician is present, you will be placed on the treadmill which starts slowly. Your ECG will be monitored continuously and your blood pressure will be taken at various stages throughout the test. The treadmill will go faster and a bit more uphill every few minutes until you have reached a predetermined heart rate. Once you have reached your target heart rate, you will be given another dose of Cardiolite through the IV.


Adenosine Sitting Protocol

Once the physician is present, you will be given Adenosine through your IV slowly approximately 4 and a half minutes while you remain sitting. Your ECG will be monitored continuously and your blood pressure will be taken at various stages throughout the test. Halfway through the test, the technician will re-inject Cardiolite into your IV.

As the Adenosine is infused, it is possible that you may feel warm, short of breath, cramping in your abdomen, or fullness in your chest. This is normal and will immediately resolve once the medication is stopped.


Adenosine Walking Protocol

Once the physician is present, you will be given Adenosine through your IV slowly over approximately 4 and a half minutes while you do a slow walk on the treadmill at a consistent speed and incline. Your ECG will be monitored continuously and your blood pressure will be taken at various stages throughout the test.

The results of the Adenosine walking protocol are no different than if you had simply been given the medicine while sitting. However, exercise has been shown to greatly reduce the side effects associated with the administration of Adenosine.


Dobutamine Protocol

Once the physician is present, a drug called Dobutamine will be infused through your IV while you remain sitting. This medication will increase your heart rate. During this infusion you may be asked to exercise by moving your legs. This will allow us to reach your target heart rate in a shorter amount of time and less medicine will given to you. Your ECG will be monitored continuously and your blood pressure will be taken at various stages throughout the test. Once you have reached your target heart rate, you will be given another dose of Cardiolite through the IV.

After the Stress, Adenosine, Adenosine walking or Dobutamine protocol is complete, you will be asked to sit in the waiting area and drink a couple of glasses of water if possible. The technologist will call you and another set of pictures will be taken on the camera.

The second set of pictures are pictures of the blood flow through your heart when your heart has had some form of exercise or stress. These pictures are compared to the first set of pictures in order to determine a result.

A report will be dictated, typed and placed in your chart. Your family physician will receive a report and you will be contacted by our office via telephone with your results.