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Test Details
Test Code:NM0003
Test Name:Sestamibi/Tetrofosmin-Stress Myocardial Perfusion Scan
Test Details & Preparation
A myocardial perfusion scan is a type of nuclear medicine procedure. This means that a tiny amount of a radioactive substance, called a radionuclide (radiopharmaceutical or radioactive tracer), is used during the procedure to assist in the examination of the tissue under study. Specifically, the myocardial perfusion scan evaluates the heart’s function and blood flow.

A stress myocardial perfusion scan is used to assess the blood flow to the heart muscle (myocardium) when it is stressed by exercise or medication and to determine what areas of the myocardium have decreased blood flow. This is done by injecting a radionuclide (thallium or technetium) into a vein in the arm or hand.

There are different types of radionuclides. When one type of radionuclide is used, areas of the myocardium that have blocked or partially blocked arteries will be seen on the scan as "cold spots," or "defects," because these areas will be unable to take in the radionuclide into the myocardium. Another type of radionuclide binds to the calcium that is released when a heart attack occurs, so it will accumulate in area(s) of injured heart tissue as a "hot spot" on the scan.

There are two types of stress myocardial perfusion scans, one that is used in conjunction with exercise (myocardial perfusion scan with exercise) and one that is used in conjunction with medication (pharmacologic myocardial perfusion scan).

A myocardial perfusion scan with exercise is used to determine what areas of the heart muscle (myocardium) demonstrate decreased blood flow during exercise. This is done by injecting a radionuclide (thallium or technetium) into a vein in the arm or hand during exercise. After the radionuclide has been injected into a vein and has circulated through the blood stream, a special machine called a gamma camera takes pictures of the heart while the person lies still on a table. This scanning usually lasts about 30 minutes.

A pharmacologic myocardial perfusion scan is used when the physician has determined that exercise on a treadmill is not an appropriate choice due to the person’s medical condition. In this situation, a medication is given that causes the coronary arteries to dilate. This dilation of the coronary arteries increases the blood flow and is very similar to the response of the arteries during exercise. The medication is injected into a vein in the arm or hand.

After a given period of time, the radionuclide will be injected into a vein in the arm or hand. The gamma camera will take pictures of the heart while the person lies still on a table. A resting scan will be performed afterwards, just as with the actual exercise scan.
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