37420 Health Library | Health and Wellness | Wellmont Health System
  • Nuclear Stress Test

    (Myocardial Perfusion Imaging)


    Myocardial perfusion imaging is a test that uses a low dose of a radioactive agent to evaluate the blood flow and function of the heart. Since blood flow to the heart is best tested when you increase the work of the heart, this test is usually done with exercise. If you cannot exercise, your doctor may use a drug that increases the work of your heart to mimic exercise.
    Blood Flow Through the Heart
    Blood Flow Through the Heart
    Copyright © Nucleus Medical Media, Inc.

    Reasons for Test

    Myocardial perfusion imaging is used to look for previous damage to your heart and your risk of future heart damage.
    Some specific reasons to do the test include:  

    Possible Complications

    Complications can include:
    • Chest pain
    • Irregular heart rhythm
    • Heart attack (rare)
    • Radiation exposure
    During the test, technicians will be alert for any signs of heart or lung problems. They will be ready to take action if complications develop. Your doctor will be available during the test, as well.

    What to Expect

    Prior to Test

    Before the test is scheduled, let your doctor know if you have any medical conditions that may limit your ability to exercise. If you cannot exercise, your doctor may order a drug to mimic exercise. Let your doctor know if you have any of the following:
    • Asthma or chronic lung disease
    • Arthritis problems, especially with your hips or knees
    For 24-48 hours before the test, do not eat or drink any foods or take any of the medicines listed below:
    • Beverages containing caffeine (eg, coffee, tea, colas, or other soft drinks)
    • Foods containing caffeine, such as chocolate (including candies, frosting, pies, cakes, cookies, cocoa, or chocolate milk)
    • Over-the-counter pain relievers that contain caffeine, including Anacin and Excedrin
    • Products that contain theophylline , such as Constant-T, Primatene, Quibron, Slo-Phylline, or Theo-Dur
    • Dipyridamole (Persantine)
    Read product labels and ask your doctor or pharmacist for more information about products you should avoid before the test.
    You may be asked to avoid eating or drinking for 4-8 hours before the test.
    Wear loose clothing and low-heeled shoes with rubber soles or tennis shoes.
    If you smoke, you should avoid smoking for 1-2 days before the test, or at a minimum, for at least four hours before the test.
    Tell your doctor if you:
    • Have a history of allergies
    • Are taking any medicines or herbal supplements
    • Have diabetes
    • Are pregnant or might be pregnant
    • Are breastfeeding
    • Have any prosthetic implants in your body

    Description of Test

    The test usually consists of two parts. One part of the test looks at the heart at rest.
    The other part of the test, called “stress,” examines the heart after exercise, or after taking a drug that mimics the effect of exercise on the heart. The doctor interpreting the test will compare the exercise and resting images to evaluate the health of your heart. The order of the parts of the test will vary based on the protocol in your hospital. You will be informed if the exercise or the rest portion will be done first.
    A blood pressure cuff is placed on one arm. An intravenous line (IV) is inserted into a vein on your other arm. Small, round pads (ECG electrodes) are placed on your chest and attached to an electrocardiograph. This allows the doctor to monitor your heart rhythm. Your blood pressure and heart rate are monitored before, during, and after you have exercised.
    The doctor or nurse will inject a small amount of radioactive material via the IV into your bloodstream. The amount of radioactivity in these materials is very small. The radioactive tracers concentrate in the parts of the heart that have the best blood flow, and emit signals that can be detected by a special camera. Images taken by the camera show any parts of the heart that are not getting enough blood. These images are taken while you are at rest and while you exercise.
    The exercise or “stress” part of the test is usually done with a treadmill. You begin by slowly walking on the treadmill, and the pace increases gradually every three minutes. As you exercise, your heart rate and blood pressure will change. At your peak exercise, the tracer is injected into the IV and you will continue exercising for another one or two minutes.
    15-30 minutes after exercising, you will lie down on a special table as images are taken of your heart.
    If you are unable to exercise for any reason, the doctor may use a drug that mimics the effect of exercise on the heart. If you notice any changes in the way you feel, or experience any side effects, notify the doctor who is monitoring the test.
    If you have coronary artery disease , you may feel chest pain or angina during the stress portion of the test. A specialist will be nearby and may give you medicine for the symptoms or stop the test early. Let the clinician know if you have any symptoms of jaw, neck, arm, or chest pain.

    After Test

    You will be able to leave after the test is done.
    If you receive a medicine that increases the work of your heart, you may experience symptoms of anxiety , dizziness, nausea, shakiness, or shortness of breath. Let the doctor monitoring you know if you have any of these symptoms. There is a possibility that you may experience some effects from the medicine for up to 24 hours after the test.

    How Long Will It Take?

    The entire test takes 3-5 hours. You may receive the entire test in one day, or you may have each part of the test on separate days.

    Will It Hurt?

    In general, this test should not be painful. If you were given a dilating medicine, you may feel some discomfort such as flushing, chest pressure/pain, or shortness of breath.


    The doctor will compare the images taken of your heart during rest with the images of your heart during stress. If your heart is relatively healthy, there should be little or no difference between the images taken during stress and those taken at rest. If your heart has partially blocked arteries, images taken during stress will be different from those taken at rest.

    Call Your Doctor

    After the test, call your doctor if any of the following occurs:
    • Your symptoms continue or worsen
    • You develop any new symptoms
    • You continue to experience side effects from the medicines used
    In case of an emergency, call for medical help right away.


    American College of Cardiology http://www.acc.org/

    American Heart Association http://www.americanheart.org/



    Heart and Stroke Foundation of Canada http://www.heartandstroke.ca/

    Health Canada http://www.hc-sc.gc.ca/index%5Fe.html/


    HeartCenter Online website. Available at: http://www.heartcenteronline.com . Accessed on May 2, 2003.

    RadiologyInfo: the radiology information resource for patients website. Available at: http://www.radiologyinfo.org . Accessed on May 10, 2003.

    University of Texas website. Myocardial perfusion imaging. Available at: http://www.utmb.edu . Accessed on May 2, 2003.

    11/30/2010 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Einstein AJ, Weiner SD, Bernheim A, et al. Multiple testing, cumulative radiation dose, and clinical indications in patients undergoing myocardial perfusion imaging. JAMA. 2010;304(19):2137-2144.

    Revision Information

  • Join WellZones today.

    Make a Change For LifeLearn more

    Wellmont LiveWell is creating a new tradition of wellness in the mountains by providing individuals with tools and encouragement to live healthier lifestyles.

  • HeartSHAPE Spotlight

    At risk for a heart attack? Learn more

    Fight heart disease early and prevent heart attacks with HeartSHAPE® - a painless, non-invasive test that takes pictures of your heart to scan for early-stage coronary disease.

  • Calories and Energy Needs

    Calorie NeedsLearn more

    How many calories do you need to eat each day to maintain your weight and fuel your physical activity? Enter a few of your stats into this calculator to find out.

  • Ideal Body Weight

    Ideal Body WeightLearn more

    Using body mass index as a reference, this calculator determines your ideal body weight range. All you need to do is enter your height.

  • Body Mass Index

    Body Mass IndexLearn more

    This tool considers your height and weight to assess your weight status.

  • Can we help answer your questions?

    Wellmont Nurse Connection is your resource for valuable health information any time, 24 hours a day, seven days a week. Speak to a Nurse any time, day or night, at (423) 723-6877 or toll-free at 1-877-230-NURSE.