Exercise Nuclear Stress Test

Basic Facts:

  • An exercise stress test that obtains images of the heart before and after exercise using a nuclear tracer and a special camera. 
  • Stress tests can be used for a variety of reasons such as:
    • Looking for blockages in the heart arteries
    • Understanding the prognosis of someone diagnosed with heart disease
    • Understanding the cardiac risk before a surgical procedure
    • Looking for heart rhythm abnormalities that might be related to exercise

Patient will be provided with specific pre-procedure instructions and a list of medications to hold. It is very important to follow the instructions because if they are not followed, the test may not work, and the patient may need to be rescheduled. This includes:

  • NO CAFFEINE 24 HOURS PRIOR. 

  • NO SMOKING OR NICOTINE PRODUCTS 12 HOURS PRIOR. 

  • NOTHING TO EAT 8 HOURS PRIOR. 

  • DRINK PLENTY OF WATER. 

  • Wear comfortable two-piece exercise clothing and rubber-soled shoes. The skin of the chest should otherwise be easily accessible and free of lotions or oils. Sports bras are fine, but NO underwire bras. 

  • Patient will be provided with a list of medications to hold. Common examples include carvedilol, metoprolol, atenolol, diltiazem, verapamil, and oral diabetic medications. 

  • The patient can drive themself to and from the office for the appointment.  

  1. This test is performed by a cardiac technician and nuclear technologist trained in stress testing. 

  1. The skin of the chest is cleaned and prepped and ECG leads are placed.  

  1. An IV is started and the nuclear medicine tracer is given through it. The patient waits 30-40 minutes while this tracer taken up by the muscle of the heart so that it “lights up” for the camera.  

  1. The patient will lie still with their arms overhead for 10-15 minutes while the camera moves around them. 

  1. Then the “stress” portion will occur on the treadmill. Starting at a walking pace and a slight incline, the treadmill will then increase its speed and incline until the patient becomes fatigued, a specific heart rate goal is achieved, or symptoms occur.  

  1. During this stress portion, the cardiac technician is monitoring the ECG, blood pressure, and for any symptoms. 

  1. Once the patient nears fatigue or target heart rate, the tracer is given again through the IV, and the patient exercises for one more minute. This creates a snapshot of the heart at peak exercise.  

  1. The patient then rests and is monitored for at least another 5 minutes or until the heart rate and blood pressure return to baseline. 

  1. After another 30-40 minute wait, the patient again lies under the camera for another 10-15 minutes for the second set of images. 

  1. The entire appointment lasts 3-4 hours.  

There are no post-test restrictions for this test. After the procedure, the patient can leave and go about their day. 

Virginia Heart Care Team will contact the patient with specifics regarding results.