Procedures

Stress Test With Imaging

An imaging stress test, also called a nuclear or Sestimibi stress test, is similar to the exercise stress test but provides more information by using images to show the blood flow to the heart muscle.

Nuclear cardiology and stress testing at the Massachusetts General Hospital Heart Center is a joint effort between the cardiology and radiology departments and provides various types of heart stress tests that help to identify and diagnose heart disease. Cardiologists use the cardiac stress test for different reasons depending on a patient’s condition. Our team may recommend a cardiac stress test to:

  • Evaluate the cause of chest pain
  • Measure the strength of your heart after a heart attack or surgery
  • Establish a baseline for patients who have cardiac risk factors such as high blood pressure, high cholesterol or a family history of coronary artery disease
  • Determine how well your heart tolerates exercise and activity

Nuclear cardiology nurses are carefully trained to conduct stress testing as well as respond to any issues surrounding the test. Cardiac nurses perform a focused interview with the patient as well as assess the appropriateness of the stress test. In addition, nurses provide a thorough explanation of the test to be performed and answer any patient questions.

During the study, nurses carefully monitor the patient’s responses to the test, including blood pressure, heart rate and the electrocardiogram. After the test, cardiac nurses document the study findings, and the study is finalized by a cardiologist who specializes in stress testing.

About the TestAn imaging stress test, also called a nuclear or Sestimibi stress test, is similar to the exercise stress test but provides more information by using images to show the blood flow to the heart muscle. The test uses a radioactive substance, which mixes with the blood and enters into the cells of the heart muscle. If the substance does not reach the heart, it means the arteries may be blocked or there may be damage to the heart.

The radioactive substance is injected two times - first at rest and a second time when you are at peak exercise. It is usually performed in conjunction with an exercise stress test, using either conventional exercise on a treadmill or using a medication, such as adenosine or dobutamine, which increases the heart rate like exercise.

Before the Test

When your physician schedules your test, it is important to ask your referring physician if you should take any of your medicines before the test. You should not eat, drink or smoke for 12 hours before your test. Because caffeine could interfere with the test we may give you, please not drink coffee, tea, soda or eat chocolate for 24 prior to the test. We recommend that you wear walking shoes and a comfortable two-piece outfit.

During the Test

After the first radiopharmaceutical injection, you will be brought into a room where you will lie on a table to have pictures taken of your heart using special cameras. This usually takes approximately 20 minutes. Similar to an exercise stress test, your heart rate will be monitored during exercise using an ECG. When you reach 80 percent of your predicted maximum heart rate, the second radiopharmaceutical is injected through an IV.

After you complete the exercise component of the test, you will again wait a minimum of 30 minutes while the injected substance localizes in the heart muscle. Your IV will be removed, and you will again be brought into a room where you will lie on a table to have pictures taken of your heart using special cameras. This usually takes approximately 20 minutes.

After the Test

As soon as the test is over, you may eat and return to your normal routine. Ask your doctor about taking any medicine that you were told to skip before the test.

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