Myocardial perfusion investigation

[Rosie0202]

Has anybody had one of these tests. This is to see how the blood is flowing through the heart by speeding up the heart rate. I am concerned as I have atrial fibrilation most of the time. The beta blocker slows down the heart rate yet they seem happy for me to take my usual dose on the day of the test.

[Happyrosie]

I can only say that whoever prescribed the test for you must be well used to people with existing cardiac problems.

My husband had one of these tests a few months ago. He doesn’t have af but is on betablockers.

[scentedgardener]

I had the stress, then a week later the rest test. Be assured that the staff will tell you what will happen, how long it will last, etc .The effects from the stress agent only lasts for 2 minutes and I would describe it more as discomfort. They do an ECG and have a BP cuff on your arm the whole time this is going on. I had AF the whole time and my BP was only just in range for them to do it.

For me, the worst thing was the scan because they "helpfully" propped my legs up on a pillow type thing. I thought they needed to do that to put me in the right position, or to make sure I didn't accidentally move, or something. Because I have a number of serious problems with my lumbar spine and the very worst thing I can do is to force it flat on a hard surface, I was in excruciating pain for the time it tooķ to do the scan, about 18 minutes. For the rest scan I took a flattish pillow to lue on and that was okay. There is very little padding on the scanner bed. Most people find it okay.

There is a lot of hanging about, so if there is someone who can go with you take them.

If you want any more information feel free to ask, but truly it's okay

[Smitty1956]

Hi, Rosie0202,

I had a 1-day rest/stress myocardial perfusion study completed in April 2022—-roughly 3 weeks following my HA in March 2022. The nuclear imaging isotope used was technetium tetrofasmin.

I was still feeling horrible after my HA. It wore me out to just comb my hair, and my heart would race whenever I tried to walk even just a few feet. I was scared to death to have this procedure done, and I honestly was afraid that I would die during the test. It sounds silly to me now, but I do have anxiety disorder; I was gobsmacked by having had a HA; and I still felt weak and ill.

Anyway, the test itself was not that bad. It was completed in one day, but it took several hours. I believe that I was also able to take my medication that morning including a low dosage of Xanax to help with my anxiety. Also, I did tell the nurses that I had taken the Xanax.

My protocol began with nursing staff asking routine questions, taking my blood pressure, weight, etc., and inserting an IV into my arm. I believe that I was given some medication/dye at that point (the rest phase), asked to drink some water, and asked to wait roughly 30-45 minutes.

I was then taken to a room with a chair and huge imaging device used to capture images of my heart in action while at rest (no prior exercise for 30-45 minutes). This part of the testing involved moving around in the chair in order to get better views of my heart and moving the camera around within a few inches of my body to also enhance imaging. This part probably took 30-45 minutes to complete. The images do show blood flow and how well the heart is functioning.

Next, I was taken to the waiting room area, given water to drink, and waited again (probably about 30 minutes). Eventually, I was taken to the room where the stress portion of the test was completed. The room had one doctor and 3/4 nurses along with me. The doctor explained what they would do to me and how I would likely feel. The doctor injected the technetium tetrofasmin (nuclear isotope) into my IV, and I felt a rapid skin flushing and increased heartbeat. This all lasted just a few minutes, and then it was over. My heart rate and blood pressure were continuously monitored by the doctor and nurses during the test.

I don’t know if this is true or not, but the doctor had a can of Coca-Cola in the room. She told me that if I felt like I needed to stop the testing to tell her, and she would have me drink some Coke, which would stop the drug. Again, I don’t know—but she appeared to be serious and the can was placed near me.

I then was taken to the waiting room area, given water to drink, and waited a few minutes. Finally, I was taken to the room with the chair and large imaging camera. Another set of pictures were taken to be compared with my heart functioning at rest.

It did take a few hours to do the rest/stress protocol, but it was not bad at all. Honestly, I had worried myself crazy beforehand for no reason. Plus, you will get tons of helpful information about your heart functioning.

Best wishes to you! ❤️

PS: I also take a beta blocker each day—75 mg Metropolol. I believe that I was told to take my medications that morning before the testing. If you are concerned, you might phone that department to doublecheck.

[Tabac in reply to Smitty1956]

I had a one day test done which they said to allow 4 to 5 hours for. I was in and out in 1.5 hours as I did the stress test test first which was OK so no need for the resting one. I was on a treadmill for the stress part. They only injected you with a stress agent if you were incapable of using the treadmill. Took a sandwich and drink with me to have after the stress test to help clear the radioactivity according to the leaflet I was sent.

The doctor I saw said they do the stress test first as there is no point in doing the resting part first and then find out you didn't need to do it as the stress part was OK. I was told my blood flow was perfect and it was queried that I'd actually had two previous NSTEMIs. I had another stent put in a year later so the scan wasn't much use for me in confirming potential future blood flow problems.

Nothing to worry about having the test done though.

[Smitty1956 in reply to Tabac]

I’m not sure why you replied to me instead of Rosie0202, but I agree that the test is useful. I found the information to be useful—one piece of data. I have since had an additional chest CT scan and an MRI.

It is true that this perfusion test can be completed via treadmill. I was not physically able to use the treadmill at that time. Thus, I had the injection of the nuclear isotope to simulate the effects of exercising.

The entire point of this test is to be able to compare the functioning of the heart while at rest and post exercise. That is why one set of photos is taken before you have had a period of exercise and/or nuclear isotope, and one set is taken post exercise or injection. This is needed in order to make comparisons of blood flow and EF.

Rosie0202, I would definitely plan on spending approximately four hours in order to complete this testing (if you are doing the 1-day protocol).

[Rosie0202 in reply to Smitty1956]

Hello Smitty 1956. Thanks for replying. Do you know if the treadmill test also requires an injection of nuclear isotope because if not, that might be a better option for me as I don't like the thought of 'glowing in the dark'.

[Tabac in reply to Smitty1956]

Sorry about the previous reply Smitty1956, it was meant for Rosie0202. Force of habit to reply to the last post as most boards I use you reply to the thread via the last post.

You still have a radioactive tracer injected when using a treadmill to create the stress.

[Smitty1956 in reply to Tabac]

No problem 😊. Have a good day!

[Rosie0202 in reply to Smitty1956]

Hello Smitty 1956

I've just been reading your response again. You mention sitting in a chair for the stress test with a circulating camera. I thought I was going to be lying on a scanner bed, which I don't like as I get claustraphobia. A chair would be great. You also mention in a later reply that you eventually also had a CT scan and MRI. Are you from the UK because they might have different approaches in other countries. Thanks .

[Smitty1956 in reply to Rosie0202]

I am in the US. It was a chair/lounge type seat. I’m sure that different places have slightly different set-ups. My point was simply to let you know that the test is really not anything to worry about.

And the point of the test is to allow the doctors to see the functioning of your heart—blood flow, EF, etc. in comparison of resting heart rate and active (post-exercise) heart rate.

I truly hope that all goes well for you!

I mentioned the other tests simply because I have ongoing heart issues like so many others. For months, I have been struggling with difficulty breathing. The other tests were completed later to try to figure out the cause of my breathing problems.

[Smitty1956]

lol! I don’t know about glowing in the dark. I don’t think that I do that yet. 🤪

If you can use the treadmill, then you would not need the nuclear isotope. Your doctor likely will determine which form of the test you need.

My ex-husband did not have a HA, but he needed to have 6 stents placed. He did fine with this—still going strong. But his cardiologist had him complete a nuclear stress test that also (I believe) involved using the treadmill. This was a follow up exam a few years following his stents.

Best wishes! ❤️