Before the test is scheduled, let your doctor know if you have any medical conditions that may limit your ability to exercise. If you can’t exercise, your doctor may order a drug to mimic exercise. Let your doctor know if you have any of the following:
- Asthma
or chronic lung disease
- Arthritis
problems, especially with your hips or knees
For 24-48 hours before the test, do not eat or drink any foods or take any of the medications listed below:
- Beverages containing caffeine (such as coffee, tea, colas, or other soft drinks)
- Foods containing caffeine, such as chocolate (including candies, frosting, pies, cakes, cookies, cocoa, or chocolate milk)
- Over-the-counter pain relievers that contain caffeine, including Anacin and Excedrin
-
Products that contain
theophylline
such as Constant-T, Primatene, Quibron, Slo-Phylline, or Theo-Dur
- Dipyridamole (Persantine)
Read product labels and ask your doctor or pharmacist for more information about what products you should avoid before the test.
You may be asked to avoid eating or drinking for 4-8 hours before the test.
Wear loose clothing and low-heeled shoes with rubber soles or tennis shoes.
If you smoke, ideally you should avoid
smoking
for 1-2 days before the test, or at a minimum for at least four hours before the test.
Tell your doctor if you:
- Have a history of allergies
- Are taking any medications or herbal supplements
- Have diabetes
- Are pregnant or might be pregnant
- Are breastfeeding
- Have any prosthetic implants in your body
The test usually consists of two parts. One part of the test looks at the heart at rest.
The other part of the test, called “stress,” examines the heart after exercise, or after taking a drug that mimics the effect of exercise on the heart. The doctor interpreting the test will compare the exercise and resting images to evaluate the health of your heart. The order of the parts of the test will vary based on the protocol in your hospital. You will be informed if the exercise or the rest portion will be done first.
A blood pressure cuff is placed on one arm. An intravenous line (IV) is inserted into a vein on your other arm. Small round pads (ECG electrodes) are placed on your chest and attached to an electrocardiograph. This allows the doctor to monitor your heart rhythm. Your blood pressure and heart rate are monitored before, during, and after you have exercised.
The doctor or nurse will inject a small amount of radioactive material via the IV into your bloodstream. The amount of radioactivity in these materials is very small. The radioactive tracers concentrate in the parts of the heart that have the best blood flow, and emit signals that can be detected by a special camera. Images taken by the camera show any parts of the heart that are not getting enough blood. These images are taken while you are at rest and while you exercise.
The exercise or “stress” part of the test is usually done with a treadmill. You begin by slowly walking on the treadmill, and the pace increases gradually every three minutes. As you exercise, your heart rate and blood pressure will change. At your peak exercise, the tracer is injected into the IV and you will continue exercising for another one or two minutes.
15-30 minutes after exercising, you will lie down on a special table as images are taken of your heart.
If you are unable to exercise for any reason, the doctor may use a drug that mimics the effect of exercise on the heart. If you notice any changes in the way you feel, or experience any side effects, notify the doctor who is monitoring the test.
If you have
coronary artery disease, you may feel chest pain or
angina
during the stress portion of the test. A specialist will be nearby and may give you medication for the symptoms or stop the test early. Let the clinician know if you have any symptoms of jaw, neck, arm, or chest pain.
You will be able to leave after the test is done.
If you receive a medication that increases the work of your heart, you may experience symptoms of
anxiety, dizziness, nausea, shakiness, or shortness of breath. Let the doctor monitoring you know if you have any of these symptoms. There is a possibility that you may experience some effects from the medication for up to 24 hours after the test.
In general, this test should not be painful. If you were given a dilating medication, you may feel some discomfort such as flushing, chest pressure/pain, or shortness of breath.