Pharmacologic With Radiopharmacologic Stress Testing

WHAT YOU SHOULD KNOW:

• Pharmacologic with radiopharmacologic stress testing is also called a nuclear stress test. This test uses medicines to make the heart work just like it does when you exercise. A clear image of the heart before, during and after having the heart work under stress is seen. It is for people who have heart-related symptoms or other medical conditions and cannot do an exercise stress test. The medicines used will cause the heart to work harder and pump more oxygen-rich blood to the body. Any change in the heart activity including the rate and rhythm is seen and recorded. A blockage in the arteries or damage in the muscles or walls of the heart may be seen with nuclear stress testing.
  
  
• Medicine that works on the blood vessels or muscles of the heart is given during and after the test. This is done through an intravenous (IV) tubing inserted in a vein, usually in the arm. Images of the heart while you are resting and during and after giving the medicine are taken using a special camera. Your heart activity is recorded using an electrocardiogram (ECG), and watched on a screen. Having a nuclear stress test as soon as possible may diagnose your condition, and prevent other medical problems.

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.

RISKS:

Having a pharmacologic with radiopharmacologic stress testing has risks. You may be exposed to some radiation. You may have an allergy to the dye used and have trouble breathing. You may have nausea (upset stomach) or vomiting (throwing up). Your blood pressure may increase or decrease and you may feel dizzy, lightheaded, and weak. You may feel your heart throbbing or have extra heartbeats, chest pains or a heart attack. Caregivers are there before, during, and after the test to help you. Call your caregiver if you are worried or have questions about the test, your medicine, or care.

GETTING READY:

The week before your test:

• Ask a family member or friend to drive you home after this test. Do not drive yourself home.
  
  
• A safe amount of a radioactive dye will be given during the test through an IV. This dye helps the heart show up better in the images. Tell caregivers if you are allergic to shellfish (lobster, crab, or shrimp), as you may also be allergic to this dye.
  
  
• Ask your caregiver if you need to stop using aspirin or any other prescribed or over-the-counter medicine before your procedure or surgery.
  
  
• Tell your caregiver if you are taking blood pressure medicines or medicines for your blood vessels. He may ask you to stop taking these at least 48 hours before your test.
  
  
• If you have diabetes, ask your caregiver for special instructions about what you may eat and drink before your tests. If you use medicine to treat diabetes, your caregiver may have special instructions about using it before the tests. You may need to check your blood sugar more often before and after having your tests.
  
  
• If you are a female, tell your caregiver if you are or think that you might be pregnant.
  
  
• Talk to your caregiver if you are breast feeding. You may need to stop breast feeding for a time because of the dye used for this test.
  
  
• You may need to have some other tests done before the stress test. Ask your caregiver for more information about these and other tests that you may need. Write down the date, time, and location of each test.

The night before your test:

• Ask caregivers about directions for eating and drinking.
  
  

The day of your test:

• Write down the correct date, time, and location of your procedure.
  
  
• What to bring: You may want to bring items such as a toothbrush and bathrobe.
  
  
• Ask your caregiver before taking any medicine on the day of your procedure. These medicines include insulin, diabetic pills, high blood pressure pills, or heart pills. Bring all the medicines you are taking, including the pill bottles, with you to the hospital.
  
  
• Do not wear tight-fitting clothes on the day of your test. Wear walking shoes in case you need to exercise during the test.
  
  
• You or a close family member will be asked to sign a legal piece of paper (consent form). It gives your caregiver permission to do the procedure or surgery. It also explains the problems that may happen, and your choices. Be sure all your questions have been answered before you sign this form.

TREATMENT:

What will happen:

• You may be asked to change your clothes. Electrodes (sticky patches) will be put on your chest. If you have hair on parts of your chest or back, it may need to be shaved to help the patches stick to your skin. The electrodes will be attached to wires that send the electrical activity of your heart to the ECG monitor. A tracing of the heart while you are resting is recorded. The radioactive substance (dye) will be given through your IV.
  
  
• It may take some time before the heart muscles absorb the dye. Pictures of the heart at rest will be taken using a special camera, and then medicine used to place the heart under stress will be given. ECG tracings, and the rate and rhythm of your heart will be checked. You will receive a second dose of the dye, and pictures will be taken during and after it has been given. Images taken of your heart at rest and while under stress will be compared. Your caregiver may also use computerized tomography (CT) scans or magnetic resonance imaging (MRI) during this test.

After your test: Before you leave, the IV and electrodes are removed. You can then get dressed. Ask for help if you need it. If you are staying in the hospital after the test, caregivers will take you to your room. If you plan to go home after the test, but need to wait for test results, bring a friend or family member to wait with you. They can support you during and after the test.

CONTACT A CAREGIVER IF:

• You cannot make it to your test.
  
  
• You have a fever (increased body temperature).
  
  
• You have questions or concerns about your test or medicines.

SEEK CARE IMMEDIATELY IF:

• You have nausea (upset stomach).
  
  
• You have chest pain or discomfort that spreads to your arms, jaw, or back.
  
  
• You are sweating more than the usual or have trouble breathing all of a sudden.

Copyright © 2008 Thomson Healthcare Inc. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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