A Patient Guide to Myocardial Perfusion Imaging

What is Coronary Artery Disease?

Coronary Artery Disease (CAD) is caused by inadequate blood supply to the heart, usually caused by blocked arteries.

What is a Myocardial Perfusion Imaging stress test?

Myocardial Perfusion Imaging stress test is usually done in Nuclear Medicine Departments or Cardiac Clinics. They may perform the test on an outpatient or inpatient basis. The test involves an injection of a small amount of radioactive material which circulates in the bloodstream and shows if your heart muscle is receiving adequate blood supply under stress and/or rest conditions. The radioactive injection is a clear liquid called MYOVIEW (Tc99m Tetrofosmin for injection). Another material which could also be used is called Thallium. (See product package inserts)

How safe is a Myocardial Perfusion Stress Test?

Any stress procedure may have some risks and you should consult with your physician regarding the risks and benefits of this procedure. The radioactive materials, MYOVIEW and Thallium, have been shown to be safe with low incidence of

adverse reactions. This test and materials are used routinely worldwide, under physician supervision, for myocardial perfusion imaging.

Neither MYOVIEW nor Thallium are "dyes," and there should be no serious side effects from their injection.

Why would my doctor order a Myocardial Perfusion Imaging stress test instead of a regular stress test?

Under certain circumstances, a regular stress test may yield indeterminate results. To improve the diagnostic accuracy, your physician may request a myocardial perfusion stress test.

How is the test performed?

The test usually consists of two parts, after exercising and under resting conditions. There are many variations for performing the test, which depend on the department's routine procedure. The entire test may be completed in one day or in two separate days. You will be informed if the exercise or rest portion will be done first. MYOVIEW will be administered by injection during peak exercise and once again while you are at rest.

As in a regular stress test, ECG electrodes will be attached to your chest. This will allow your physician to monitor your heart rate before, during, and after you have exercised. A blood pressure cuff will be placed on your arm to monitor your blood pressure before, during and after exercise. Additionally, an intravenous (I.V.) line will be placed in your hand or arm vein to allow for ease of the MYOVIEW injection. The IV will be removed when the exam is completed.

The exercise part of the exam is usually done with a treadmill, very similar to a treadmill used at a healthclub. Exercising will begin slowly, and approximately every three minutes, the pace will gradually increase. As you exercise, your heart rate and blood pressure will change. This is normal and remember you are being closely monitored throughout the exam. At your peak exercise, MYOVIEW will be injected into the I.V., and you will be asked to continue exercising for an additional one or two minutes.

Approximately fifteen minutes after the exercise is complete, pictures will be taken of your heart using a special camera able to trace either MYOVIEW or Thallium that has localized in your heart. You will be asked to lie down on a special table. The camera will rotate above and around your chest while special pictures are being taken, which will take approximately 20 to 30 minutes to complete. You may breathe normally while the pictures are being taken. It is very important that you hold very still while the camera takes the pictures of your heart. You will not receive any radiation from the camera.

After one-half hour or so, a second injection of MYOVIEW will be given. The resting pictures are taken in the same manner as the exercise pictures. Remember the order in which pictures are taken depends on the department's routine imaging procedure. The total time needed for the test also varies and may take from two to five hours.

What happens if I am unable to exercise?

Some people, due to a variety of disabilities, are unable to exercise adequately enough on a treadmill machine to achieve a diagnostic test result. In these cases, your physician will decide a course of action for your testing.

Are there any special preparations/instructions for the Myocardial Perfusion Imaging study?

You should wear comfortable, loose-fitting clothing for exercise and comfortable shoes appropriate for walking.

Your physician may instruct you to have a light breakfast and avoid certain foods such as milk products or
caffeine-containing beverages. If you are diabetic or insulin-dependent, consult with him/ her on such dietary restrictions and insulin use.

Consult with your physician regarding whether certain medications should be taken before, or held until after, the test. Certain medications may interfere with the effectiveness of the exam.

Depending on the department procedure, time permitting, you may have time to go back to work between the two parts of the exam. The physician will inform you if this is possible.

Important Points to Remember

  • There may be two parts of the exam.
    Return for the second part.

  • You may receive an injection for both parts of the exam.

  • The radioactive material is ordered especially for you. If you are unable to keep your appointment for any reason, notify the department before the exam.

  • A written report of the test will be sent to your physician once it is interpreted.

  • If you are pregnant or suspect you may be, notify your doctor before taking the test.

Please note that this information is provided for educational purposes only. It is not intended to substitute for informed medical advice. The user of this site should not use this information to diagnose or treat a health problem or disease without consulting with a qualified health care provider.

A Patient Guide to Myocardial Perfusion Imaging Video

This eight and a half minute video provides an easy to follow, step by step overivew of Myocardial Perfusion Imaging Scan for patients about to undergo a heart scan. Requires high speed internet connection and Internet Explorer to play.

Patient Guides