MYOCARDIAL PERFUSION SCAN

(Sestamibi Imaging Scan)

What is a Myocardial Perfusion scan?

A myocardial perfusion scan measures the blood flow to your heart muscle at rest and during exercise (either treadmill or pharmacologic).

What is involved?

A myocardial perfusion scan is done in the Nuclear Medicine Department at Port Perry Imaging. The test is done by a technologist specially trained in nuclear medicine and a stress technologist under supervision of the onsite cardiologist. The procedure is usually performed over two days and requires some preparation. The first day (rest imaging) will take approximately 1.5 hours and the second day (stress imaging) approximately 1 hour. A complete description of the myocardial perfusion scan follows

THE FIRST DAY:

When you arrive, the front desk staff will register you and the technologist will bring you to the Nuclear medicine room to explain the test and answer any questions you may have about the procedure.

The technologist will inject a small amount of radioactivity into a vein in your arm. There are no known side effects from this injection. You will then be asked to return to the waiting room for approximately 40 minutes while the radioactivity concentrates in the muscle of your heart.

After the waiting period is complete, the technologist will ask you to lie down on the imaging table in the Nuclear Medicine room. You will slowly slide into a special camera that will rotate very slowly for 11 minutes while images are taken of your heart. Note: Your head will not be under the camera. Following these images, you will be allowed to leave for the day, but are required to return another day for the second part of the test (usually the next day). The date and time of the second day will be confirmed to you by the technologist.

THE SECOND DAY:

When you arrive, you will be checked in by the front desk staff and the stress technologist will retrieve you from the waiting room. You may feel free to ask any other questions about the procedure at this time.

The stress technologist will place ecg electrodes on your chest and a blood pressure cuff on your arm.

The Nuclear Medicine technologist will place a small IV needle into a vein in your arm. This IV will be used for any injections you receive during the test.

If the test has been ordered as a treadmill test, you will be helped up to the treadmill. Your heart rate and blood pressure will be monitored as you are walking with standard electrocardiography. You will exercise for a period of time determined by your age and physical fitness and the radioactive tracer will be administered through the IV line at your peak heart rate.

In other cases the cardiologist will order a Persantine perfusion scan (pharmacologic stress test). Persantine is a special medication that will be infused through the IV to “exercise” your heart. With this medication you may experience flushing, headache, chest pain or nausea (rarely). This infusion only lasts for four minutes after which you will be injected with a small amount of radioactive tracer that will travel to your heart muscle. If you have any side effects from the Persantine, a medication called Aminophylline will be injected to reverse any of the side effects.

You will then lie on the imaging table for 11 minutes and images will be taken of your heart muscle like day 1.

Once all your images are completed and the technologist has verified them, you will be free to go home. You should not expect to experience any further side effects from this procedure.

Patient Preparation

Medications to stop prior to the test:

Only if you are scheduled for an Exercise Myocardial perfusion scan, please stop taking the medications listed below if permitted by your doctor:

24 HOURS PRIOR
Viagra, Aggrenox, Persantine
222, 282, 292, Anacin,
Asacol, Darvon, Distan,
Excedrine, Fiorinal
Lenoltec 1, 2, 3, Midol,
Sinutab with codeine

72 HOURS PRIOR
Cialis

Day 1- Rest Imaging:

You may have a caffeinated beverage before 8:00am on this day. You may have a light breakfast on the morning of the test. Diabetic patients may have a small breakfast with half dose of insulin.
Please bring a complete list of medications you are currently taking to this appointment.
Since you will have a 40 minute waiting period before images, it may be beneficial to bring some reading material.
Please refrain from wearing anything metal. Women should wear a sports bra or no bra if possible for the images.

Day 2- Stress Imaging:/strong>

No caffeinated beverages are allowed 24 hours prior to Day 2- stress day. This includes coffee/tea, decaffeinated coffee/ tea, carbonated colas, chocolate, and Lenoltec 3 (Tylenol #3).
You can continue to take all other medications for Persantine test.
You may have a light breakfast. Diabetic patients may have a small breakfast with half dose of insulin.

Do I need to do anything after the scan?

No special precautions are needed after the scan. If you are travelling across any borders within eight days of the scan, please inform the technologist, who will provide a letter.

What should I do if I cannot make my appointment?

If you cannot make your appointment, it is important that you notify Port Perry Imaging at 905-985-9727 as soon as possible. The technologist must order the radioactive tracer for you 24 hours prior to your Day 1 appointment. Failure to attend your appointment results in wasting of expensive radioactive tracer that is ordered specifically for you and also reduces appointment availability for other patients. Missed appointments may result in delays of your treatments.