As you might expect, stress testing is an important diagnostic tool for the detection of coronary blockages. However, there are important limitations to the test and cannot be applied to everyone. For that reason, we are happy to announce that this year, we acquired the very latest in nuclear diagnostic testing of the heart. This technique, called "Myocardial Perfusion Imaging", when combined with an exercise test, allows for very precise, non-invasive imaging of the heart. In this way, subtle problems of the cardiac circulation and muscle function can be detected. For those cases where exercise on a treadmill is not feasible, the test can also be done without exercise.

This test was previously performed with the isotope thallium, but at the present time, Myoview is used more often. The test is performed in conjunction with a treadmill exercise test and is referred to as a "Stress-thallium" test.

When the results of a routine treadmill study are inconclusive.

When there is known coronary artery occlusive disease and it is desirable to know the extent and severity of the disease (so-called risk stratification).

In some patients to determine the functional significance of coronary blockage observed on an angiogram

To determine if coronary disease is the cause of, or associated with, abnormalities on the resting electrocardiogram

To evaluate the results of coronary bypass surgery or coronary balloon angioplasty, stents or other intervention.

Myocardial perfusion imaging is a non-invasive test and carries no risk beyond that of the treadmill testing itself. The radioactive isotope injected for the study produces less radiation than x-ray procedures such as a CAT scan or kidney study and is non-allergenic.

The heart is imaged both at rest and during exercise. The isotope tracer is injected into an arm vein one to two minutes before you quit walking. After the termination of the treadmill test the isotope will be imaged in the heart area by a large camera. This imaging will take 20 to 25 minutes during which time you will be asked to lie on a bed with your arms over your head. You are asked not to move during the imaging.

Preparation For The Test

Do not eat or drink anything except water for three hours before the test. Please consult your doctor regarding whether you should take your medications. Please inform your doctor if there is a possibility that you are pregnant.

After The Test

The results of the test are not usually available immediately, and your doctor will go over the findings with you at a subsequent visit.

WHEN EXERCISE IS NOT FEASIBLE.

Myocardial perfusion imaging is indicated in some patients who are unable to perform treadmill exercise because of orthopedic or other problems. In such patients the cardiac effect of exercise stress can be simulated by the intravenous administration of a coronary vasodilator such as Dipyridamole (Persantine). The imaging of the heart proceeds as described in "Exercise Myocardial Perfusion Imaging", except an intravenous injection of Dipyridamole replaces the treadmill exercise portion of the test.

Since caffeine alters the efficacy of the test, it is essential that no coffee, tea or caffeine containing beverages or medications be consumed after midnight prior to the test.

OF TEANECK