Test Preparation
Myocardial Perfusion Imaging

Myocardial Perfusion Imaging (MPI), also known as a Nuclear Medicine Stress Test, is done to determine how well the coronary arteries are delivering blood to your heart. We will be able to determine if a particular artery is blocked and therefore limiting the circulation to your heart. We will also assess heart wall motion and ejection fraction, and see if the heart muscle has been damaged from a previous heart attack. All of this information will assist your physician in making management and treatment decisions.

We image the blood flow using a radiopharmaceutical. This is a myocardial perfusion agent used for detection of coronary artery disease (CAD).

Before the Test:
1. Patient may have a light breakfast/lunch (e.g. toast, jam, fruit, juice, water) and then nothing to eat 1 hour prior to the test.
2. Discontinue all caffeine products 24 hours prior to the test. This includes all tea, coffee, decaffeinated tea/coffee, pop, chocolate, Tylenol 2 & 3 and/or medications containing caffeine.
3. Insulin-dependent diabetics should take their insulin and a light meal 1 hour prior to the test.
4. Wear loose fitting clothing (e.g. T-shirt, track pants, athletic shoes, etc.)
5. Bring a list of all current prescription medications and check with your physician regarding the discontinuation of any heart medications (e.g. Beta-Blockers like Metroprolol or Atenolol, as well as Calcium Channel Blockers like Diltiazem or Verapamil).
6. Do not take erectile dysfunction medications (e.g. Viagra, Cialis, Levitra, etc.) for 48 hours prior to the test.

*For female patients, if you are pregnant or there is a possibility of pregnancy, or are breastfeeding, Nuclear Medicine Stress Testing may not be appropriate for you at this time. Please consult with your physician.

During the Test:
The technologist will place an intravenous line into your arm or hand which is used to inject a small amount of Cardiolite, a radiopharmaceutical, which is carried by the blood stream to your heart. Approximately 1 hour after your injection, the technologist will take pictures of your heart for approximately 20 minutes with a special gamma camera that detects radiation. While the pictures are being taken, you will be lying on a bed and it is important to remain very still during this time to avoid blurring the images.

Once the first set of images has been taken, you will be prepared for a Stress Test.  ECG electrodes will be placed on your chest to monitor your heart rhythm throughout the test. You will begin to exercise on a treadmill during which your heart rate and blood pressure will rise. These are normal responses that are being closely monitored with your ECG.

If you are unable to exercise adequately on a treadmill, similar results can be achieved using a drug called Persantine. Persantine mimics the effects of exercise by dilating the blood vessels of the heart, allowing for increased blood flow.

Once you have reached your maximum level of exercise, a second dose of Cardiolite will be injected and you will continue exercising for an additional 1-2 minutes. If blood flow to the heart is limited due to CAD, then the amount of Cardiolite in your heart is reduced. Following the Stress Test, the IV will be removed.

A second set of pictures taken with the gamma camera is required to complete the test. The technologist will advise you when to return for this last portion (anywhere from 15 minutes to 2 hours after the Stress Test is completed). It is very important that the second set of pictures is taken in order to compare to the first set and assess the amount of blood supply to the heart at rest and during stress (exercise).

The test will last approximately 3 to 4 hours.

After the Test:
You will be able to return to your normal activities when the test is complete, unless your physician or technician tells you otherwise. You can drive after the test. If you are travelling by plane, train or crossing the border within one week after your test, please inform the technologist.

What to Bring:
To avoid delays on the day of your test, ensure that you bring your health card and your requisition.