What Is Nuclear Stress Testing and How Can It Help You?

From MRIs to EKGs, there are a variety of ways to check your heart to detect heart disease and other conditions. One method is nuclear stress testing, which identifies any blockages or damage to your heart.

This test may be helpful for anyone suspected of having coronary artery disease (CAD) or at risk of a heart attack. Also, it can be conducted while the patient is at rest or exercising.

At Ivy Cardiovascular & Vein Center, we perform a nuclear stress test as part of our comprehensive cardiovascular care. Keep reading to learn more about how the test works and how it can help identify potential heart problems so you can get the treatment you need.  

What Is Nuclear Stress Testing?

One of several stress tests, the nuclear stress test reveals any area of your heart that is impaired or has inadequate blood flow. For this test to work, it requires:

• A scanner (positron emission technology (PET) or single photon emission computed tomography (SPECT)
• A tracer called a radionuclide (a small amount of a radioactive substance)

The scanner is for generating images of the blood flowing to the heart, while the tracer helps the cardiologist identify any risk of heart problems such as a heart attack. And even though the patient receives a small amount of radiation, the nuclear stress testing is deemed safe.

During your exam, you may hear this test referred to as a myocardial perfusion imaging (MPI) scan, cardiac PET scan, cardiac SPECT scan, or a radionuclide test. Generally, it takes about three to four hours and can either be performed while resting or after you've elevated your heart rate through exercise.

How to Prepare for the Test?

Preparing for a nuclear stress test involves detailed instructions provided by your healthcare provider. These pre-procedure instructions entail the following:

• No eating, drinking, or smoking for a specified amount of time before the test
• Avoid caffeine at least 24 hours prior
• People with diabetes are allowed a light meal
• Take prescribed medication as usual unless told otherwise by a doctor
• Wear loose-fitting clothes and comfortable sneakers
• Don't wear jewelry or any accessories containing metal
• Don't apply any lotion, oil, or powder to your skin
• Bring your inhaler if you are asthmatic or have breathing problems

This list of "do's and don'ts" ensures the test gets conducted correctly and yields accurate results. You can always discuss with your provider any particular circumstances during your pre-test exam, so they can inform you how best to prepare for this life-saving test.

What Can You Expect During the Test?

A nuclear stress test usually occurs in an outpatient medical facility. You may be expected to show up 30 minutes beforehand, and you should anticipate the examination lasting up to four hours.

Your provider will inform you of everything that will take place during the entire examination. If you're there for a one-day test, you will start with a scan at rest and end with the physical activity portion. And if you're doing two-day testing, you should expect to exercise on the first day and rest the following day.  

For the resting section of the test, you will be injected with the radionuclide or tracer and placed under a gamma camera to take images of your heart. Your provider will examine these scans for any blockages or anomalies.

The physical part of the test will first include adding electrodes to your chest and allowing an electrocardiogram (ECG) to record your heart activity while you exercise. Once hooked up to the machine, you'll start slowly walking on a treadmill or pedaling on a stationary bike. Gradually, your exercise will rise to the next level until you are either too tired to continue, have health issues, or are already at the desired target heart rate.

After reaching your highest exercise level, you'll receive an injection of the tracer, and that would conclude the exercise part of the test. You will then be scanned by the gamma camera to take images again.  

Some patients may not be able to perform the exercise test due to conditions such as severe arthritis. For those patients, the chemical nuclear stress test is conducted, where they receive medications to trigger the same response exercising would produce. The other aspects of the nuclear stress test remain the same.

How Can You Benefit From a Nuclear Stress Test?

As mentioned earlier, the nuclear stress test aims to help doctors identify signs of blockages causing low blood flow to the heart and other heart conditions such as CAD. They also use the test to determine:

• The heart chambers' dimensions
• How well the heart is functioning
• Any damage to the heart
• If the patient is at risk of experiencing a heart attack
• How effective are current treatments
• The best course of action for a specific heart condition
• Whether the patient is a candidate for a cardiac rehabilitation program

With the test's data, your doctor will have the necessary information to ensure you get the appropriate care for any heart conditions.  

Are There Any Risks?

Even though you are exposed to minimal radiation, nuclear stress testing is a relatively safe approach to detecting heart problems. However, if complications caused by the test were to arise, those may include:

• Chest pain
• Nausea or anxiety
• Headache or dizziness
• An allergic reaction to the tracer
• Decreased blood pressure
• Heart arrhythmia or heart attack

These complications rarely occur. However, you can consult your health care provider if you're concerned about these possible side effects.

How Can We Help?

Understanding how nuclear stress testing works may help put your mind at ease if your doctor recommends getting one. You may still be hesitant, but know that it's a standard medical test that could help save your life. Contact us to discuss how we conduct this stress test to promote heart health.