Nuclear Stress Testing

Stress tests are ubiquitous, and virtually anyone who has been to a cardiologist has heard of one. However, nuclear stress testing takes it up a notch as an advanced diagnostic modality for new or worsened chest pain to understand how the heart is responding to specific treatments or to see how the patient is recovering from a procedure or prior heart attack.

How Does a Nuclear Stress Test Differ From a Standard Stress Test?

A typical non-nuclear stress test will measure heart rate and blood pressure while you are at rest and while exercising. On the other hand, the nuclear stress test gives Dr. Farrugia an idea of how blood is flowing to the heart, all the while still offering the baseline diagnostic information of a regular stress test.

How Does a Nuclear Stress Test Work?

To better visualize the blood flow to the heart muscle, we use what is known as a radioactive tracer, introduced into the body via IV. This tracer is then followed, and images of the blood flow are captured.  Nuclear stress testing is not as daunting as the name suggests. If Dr. Farrugia believes that it is the best next course of action, you can rest assured that any risks of the radioactive tracer are outweighed by the benefits of getting a proper and complete diagnosis. Further, it is important to distinguish between radioactive tracer and contrast dye, the latter of which can have some potential side effects.

Preparations for nuclear stress tests are relatively straightforward and will be outlined in a pre-procedure packet provided by our office. We do not want you to eat or drink any caffeinated or decaffeinated beverages for at least a day before the procedure. You are limiting your food intake before the procedure is also standard. However, there’s nothing wrong with having a light meal a couple of hours before the procedure. Unless we’ve told you otherwise, keep taking all your regular medications.

Once you’re ready for your nuclear stress test, the radioactive tracer will be injected and requires about half an hour to be absorbed into the heart. Once we have taken the appropriate imagery, we will ask you to walk on the treadmill if you are able. The treadmill will progressively get more challenging until you are suitably tired. At this point, you will receive a second injection of tracer so we can see the blood flow at peak stress. We will then take another set of images relatively soon after you recover from the treadmill exercise.

What if I Can’t Exercise?

If you cannot exercise, we will inject you with medication that mimics the physical changes your body would have experienced during exercise. During this time, you may feel many of the effects of strenuous activity without having done training at all. These effects will subside or be reversed with further medication. Once again, we will take measurements at various intervals to see how the heart functions during periods of stress and alternately in the absence thereof.

Nuclear stress tests are typically very helpful in making or confirming a diagnosis related to cardiovascular disease. If your stress test is uneventful, there are likely no significant issues to be addressed. Should the results appear abnormal, we may need to take the next diagnostic step, including interventional procedures such as cardiac catheterization.

If Dr. Farrugia mentions a nuclear stress test, we hope this article removes some of the fear and uncertainty about the procedure. Remember that it is a very safe, accurate, and effective diagnostic procedure that can help us get to the bottom of the cardiovascular ailments you may be experiencing.