Cardiac Stress Test
You have been referred by your physician for a stress test — an exam which shows how well your heart works during physical activity. The exam can be used to measure the blood flow to the heart as well as to see any areas where the heart has been damaged (such as by a heart attack). The test measures blood flow to the heart muscle both at rest and during stress on the heart. Images are usually taken when your heart is at rest and when it is under stress. Our team of subspecialty-trained physicians, nurses and technologists is led by Daniel S. Berman, MD, FACC, chief of Cardiac Imaging and Nuclear Cardiology.
This exam is also known by the names cardiac SPECT, myocardial perfusion SPECT, thallium stress test, nuclear stress test, treadmill test and stress perfusion test (vasodilator, pharmacologic).
An MRI cardiac imaging study with stress is similar, requires the same preparation, and takes about four hours.
Please follow this link to see a video about our nuclear medicine stress test. Some of the video is only for patients staying in the hospital. But much of it will be helpful to those who just come to our imaging center for this exam.
Preparations for the Test
- You can print and fill out the Cardiac Imaging Questionnaire, before arriving to speed the registration process.
- Do not eat or drink caffeine products (chocolate, soda, tea, coffee or Excedrin®) for 24 hours before exam. Note: Decaffeinated products contain caffeine.
- Consult your physician about going off beta blockers for 48 hours and calcium channel blockers 24 hours before your exam.
- Do not eat or drink for three hours before your appointment. Drinking water is OK.
- If you are unable to exercise on the treadmill, a medication will be administered to stress your heart. If you are undergoing this type of an exam, you may take all your heart and blood pressure medications as instructed by your physician.
- If you have diabetes, please speak to your physician prior to this exam to receive special instructions you may need regarding your medications.
- For SPECT exams, wear comfortable clothes and rubber-soled shoes or sneakers for the treadmill portion of this exam.
- Please bring all your medications or a list of them with doses to your appointment.
During the Test
- Approximate visit time for SPECT is three to four hours, and for PET it is two to three hours.
- You will receive two injections of a small amount of radioactive material. The level of radioactivity used is extremely low and has no side effects.
- To minimize the number of injections you receive, an intravenous line (IV) will be placed in your arm prior to your first injection (thallium) and will be re-used later for your second injection (Cardiolite).
- Following your first injection, you will be placed under a gamma camera and pictures of your heart will be recorded. This camera does not produce any radiation. It will be placed close to your chest and pictures will be taken for approximately 30 minutes. This portion of the test is called the rest study.
- Following your rest study, our trained staff will place EKG leads on your chest. The EKG will be used to constantly monitor your heart during your stress test.
- Your heart will be stressed, either through exercise or through the use of medication.
- During the test you will be constantly monitored by a Nurse Practitioner or a Physician.
- The actual stress portion of the test takes about 10 to 15 minutes, however the preparation takes longer (up to 30 minutes).
- Before the end of the stress test, a second injection (Cardiolite) will be administered. This radiopharmaceutical is taken up by your heart muscle and can be visualized by the gamma camera in the same manner as the rest study.
- The imaging portion of your stress study will take approximately 45 minutes.
What to Expect
- Normal responses during testing include feeling tired, shortness of breath and sweating.
- You should tell the nurse practitioner or physician if you feel any of these symptoms: chest, arm or jaw discomfort, severe shortness of breath, extreme tiredness, dizziness, lightheadedness, leg cramps or soreness.
- The test will be changed or stopped if it is unsafe for you to continue.
After the Test
- When the test is over, you may eat or drink and return to your normal routine.
- You may resume all your medications.
- Your films will be reviewed by our nuclear cardiologists, and results will be sent to your physician. Your physician will discuss these results with you and explain how the results relate to your health.
The S. Mark Taper Foundation Imaging Center provides a full range of advanced imaging, both radiology and cardiology, as well as interventional radiology and interventional tumor (oncology) treatments to the greater Los Angeles area, including Beverly Hills, Encino, Mid-Cities, Sherman Oaks, Silver Lake, Studio City, Toluca Lake and West Hollywood.