This test is most commonly used to assess for the presence of or extent of coronary artery disease (CAD). This test is usually more sensitive than a regular treadmill stress test. There are three parts to the test: acquisition of the rest images, the actual stress test, and acquisition of the stress images.
Part one: The nuclear technologist will start a small saline lock (“IV”) in your arm or hand. He will then inject a small amount of a radioactive substance known as Cardiolite. The Cardiolite circulates in your blood and is taken up by the heart muscle in proportion to the blood flow to your heart. After a short wait, you will then lie down on a table and a special camera will take a picture of your heart. This picture usually takes 20-25 minutes.
Part two: Most patients will then walk on the treadmill for the actual stress part of the test. You will be attached to an EKG machine and asked to walk on the treadmill—the treadmill starts off fairly slowly and has a modest incline. Every three minutes the treadmill speeds up and the incline increases a bit. Dr. Causey will be by your side to monitor how you feel and to monitor the EKG closely. Near the end of exercise, a second injection of Cardiolite is given in your IV.
For those patients who cannot walk very far on the treadmill, we often give an IV medication that either takes the place of exercise or is given to supplement very low-level exercise. There are four agents available that we can use for this so-called “pharmacologic stress”—the one that we now use the most is called Lexiscan. In most cases, we will have you walk very slowly on the treadmill during the infusion of the pharmacologic stress agent; however, if you cannot safely walk at all on the treadmill or if you have a certain pattern on your EKG, then we will have you lie down on a table during the infusion of the pharmacologic stress agent. During or just after infusion of the pharmacologic stress agent the second dose of IV Cardiolite is given.
Part three: The third part of the test will follow a short wait—if it looks like you will be waiting for more than a few minutes, we will often allow you to leave, get something to eat, and then return to our office. This third part is simple and involves lying down on the table and allowing the camera to again take a picture of your heart. This picture also takes 20-25 minutes.
Altogether, you may be with us for as long as 4-5 hours. You may want to bring something to read to help pass the time.
• Do not drink or eat anything with caffeine for 24 hours before the test—this includes coffee,
tea, certain soft drinks, chocolate and any caffeine containing medication (Excedrin or Anacin).
• You may eat a light breakfast before the test (but remember no caffeine)
• Do not take your beta-blocker for 24 hours before the test—this is a class of medication used
for hypertension and some heart problems. Metoprolol (Toprol or Lopressor), Carvedilol (Coreg), Atenolol (Tenormin), Nevibolol (Bystolic), Propranolol (Inderal), and Sotalol (Betapace) are commonly used beta-blockers. Other examples are Acebutolol, Betaxolol, Labetolol, Nadolol, Pindolol, and Timolol.
• Do not take the calcium channel blockers Diltiazem or Verapamil for 24 hours prior to the test.
• Otherwise, you may take your usual medications as you normally do. If you are not sure what
to take or not to take then please call us.
• You are welcome to bring a family member or friend but due to seating accommodations, you
may not be able to sit together. Your family member/friend may be asked to wait in the outer waiting room.
• Wear comfortable shoes and clothing. Please avoid jumpsuits, overalls, one-piece dresses, and
sandals. Short sleeves and tops that button in the front are preferable. You may want to bring a light jacket in case you feel cool in the waiting area.
• There are no restrictions after the test. You may resume your normal activities. Prolonged time
with children under the age of twelve should be avoided for 24 hours.
• If you are pregnant or think you may be pregnant, please let us know before we start the test.
• If you cannot make it to your scheduled stress test, please call the office at least 24 hours before
your test. Failure to cancel may result in a charge for any Cardiolite or other medications that have been ordered for you.
• Once the test is complete, our nuclear technologist will process the images. Dr. Causey will
then interpret the study and make any recommendations regarding follow-up/further testing/etc. We will then give you a call and send the report to your referring physician.
• Please call us if you have any questions.
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