Persantine Thallium Stress Test

What is it?

A persantine thallium stress test is a test where pictures are taken of your heart muscle. A "stress" test is usually done while a person exercises. While a person exercises, caregivers can see if areas of the heart muscle are getting enough blood. You will not need to exercise for this test. The medicine that you are given for this test will show caregivers if enough blood is getting to areas of your heart muscle. You will be given medicine called persantine. This medicine is also called diprydamole (deye-peye-RID-ah-mohl). You will also be given a medicine called thallium during this test.

Why do I need a persantine thallium stress test?

This test helps to diagnose a medical condition called coronary artery disease. This is when the blood vessels that give oxygen-rich blood to your heart muscles become narrow or blocked. This test helps caregivers see areas of the heart muscle that do not get enough blood supply. The test can also show areas that have been damaged after a heart attack.

Who should not have this test?

  • Tell your caregiver before the test if you might be or are pregnant. Caregivers may suggest waiting to have the test until after your baby is born. Tell caregivers if you are breast feeding. They may suggest waiting to have the test until after you have finished breast feeding your baby.

  • You also may not be able to have the test if you have:

    • An allergy to persantine.

    • Heart valve disease, a heart block, or recently had a heart attack.

    • Lung disease.

    • Low blood pressure.

What should I do to get ready for the persantine thallium stress test?

  • Do not eat or drink anything except water for six hours before the test. Do not eat or drink anything with caffeine for 24 hours (one day) before the test. Caffeine may be found in some types of coffee, tea, soda, chocolate, sports drinks and foods.

  • Do not use any medicines (over-the-counter or prescribed) that contain caffeine for six hours before the test. These include Anacin®, Excedrin®, Darvon®, or Fiorinal®.

  • Do not smoke or use chewing tobacco for six hours before the test.

  • Wear or bring comfortable, loose-fitting clothes.

  • Bring a list of all medicines you are taking, or bring the pill bottles. Ask caregivers if you need to stop taking any of your usual medicines for a time before the test.

  • If you have diabetes and are taking insulin, ask caregivers if you need to change the amount of insulin that you are taking.

  • Tell your caregiver if you take any medicine that has xanthine (ZAN-theen) in it. Some of these medicines include theophylline (Slo-bid™, Theo-dur®) and pentoxifylline (Trental®). You may need to stop taking the medicine for several days before the test.

  • Tell your caregiver if you have asthma or any other long-term lung disease.

How is a persantine thallium stress test performed?

  • When you arrive at the Nuclear (NU-klee-ar) Medicine department, you may need to change into comfortable clothing. A caregiver puts an IV (intravenous line) into a vein, usually in your hand or arm. Electrodes (patches) will be placed on your chest. The electrodes record your electrocardiogram (ee-lek-troh-KAHR-dee-oh-gram) or "EKG". This is a test that records the activity of your heart.

  • You will be given a medicine called persantine through your IV. This medicine opens the blood vessels in your heart (coronary arteries). This is the same effect that would be seen if you were to exercise. Several minutes later, another medicine called thallium will also be put into your IV. Thallium is a tracer. This means it moves through the blood and goes into heart muscle. Heart muscle that does not have enough blood supply takes in the thallium slowly or not at all.

  • You will need to rest for several minutes while caregivers watch your EKG and blood pressure. You are then taken to the radiology department where a scan is done. For the scan, you will need to lie down and rest for about 30 minutes. The scan shows areas of narrow or blocked vessels, or areas of damaged heart muscle.

  • You will need another scan three to four hours later to check your heart while at rest. You may be allowed to leave the hospital during this time. You will be able to eat, and drink fluids. Avoid food and fluids that contain caffeine. Caffeine may be found in some types of coffee, tea, sodas, chocolate, and sports foods and drinks. Do not smoke cigarettes or use chewing or pipe tobacco.

What will I feel during the test?

It is common to have minor side effects when receiving persantine and right afterward. The side effects include chest discomfort (not pain), dizziness, flushing of your face, headache, nausea (upset stomach), or shortness of breath. These side effects should only last a few minutes and usually caregivers can give medicine that stops them.

What should I do after the test?

You may continue activities, and eat, drink, and take your usual medicines just as you did before the test. Drink plenty of fluids, such as water and juices to help flush the tracer out of your body. The tracer leaves your body quickly through your urine. Your caregiver may tell you to flush the toilet three times each time after going to the bathroom. This makes sure that the small amount of tracer leaving your body does not stay in the toilet bowl.

What are the risks with having this test?

  • The place where your IV is could bleed, become red, swollen, painful, or infected. There is a very small chance that you could become very short of breath or have chest pain. You could also have low blood pressure, dizziness, leg pain, abnormal heartbeats, or a heart attack. Caregivers will watch for and treat these problems. The camera used for the scan takes pictures of the thallium and does not take x-rays. The amount of radiation that is in the thallium is small and safe.

  • If you do not have a persantine thallium stress test, caregivers may not be able to decide what would be the best care for your health problems. Your problem could get worse or you could die. Call your caregiver if you are worried or have questions about your medicine or care.

Care Agreement

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

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