How do you prepare for the procedure?

Please arrive at least fifteen (1 5) minutes prior to your appointment so that we can obtain the maximum benefit from the radiotracer prepared. If you are unable to come for the procedure, please inform us in advance.

Do not eat at least three (3) hours before the procedure as we do not want you to exercise
with a full stomach. However, you are encouraged to drink water to keep yourself
well hydrated.
24 hours before the procedure, please AVOID the following:
    Coffee or tea that is brewed, instant, iced or decaffeinated
    Colas or other soft drinks that contain caffeine, including those labeled "caffeine-free"
    Chocolates, including candies, frosting, cookies, pies, cocoa and chocolate milk
    Aspirin / paracetamol products
48 hours before the procedure you should NOT take the following, as you may require
pharmacological stress test Please check with your physician before stopping.
    Persantin
    Theophylline or theophylline-containing medicines
Please check with your physician whether you need to stop any beta-blocker that you have
been prescribed.
Please bring along a list of all medications you are on .
If you are taking insulin for diabetic condition, please consult your physician about any
adjustments in dosage you may need.
ASTHMA - CAUTION. The use of stress agent (dipyridamole) is generally avoided in patients
with asthma. Please be sure and inform your physician and the staff if you have a history of
asthma, bronchitis or emphysema.
Please dress in comfortable clothing and shoes suitable for walking and jogging.

What are the benefits and risks?

Benefits

An isotope cardiac stress test is capable of diagnosing significant disease in approximately
85%-93%of patients with coronary artery disease. It also provides incremental prognostic
information to your physician regarding further management decisions. The procedure may be
done before or after treatment for heart ailments.
During an exercise stress test, the doctor will evaluate the patient's general state of health
and the heart's reaction to exercise. As the intensity of the workout increases, the patient's
heart rate and rhythm, blood pressure and general condition are continuously monitored on
the ECG and by the doctor. The higher the level of exercise, the harder the heart has to work
and the more blood flow is needed. This test therefore allows the doctor to assess whether
the blood supply to the heart is sufficient during different levels of exercise intensity.

Risks

Radiation
    Do not worry about the amount of radiation you receive during the test. It is no more than
what you would receive from similar x-ray procedures.
    This test should not be done on pregnant women. Please inform the nurse of doctor is you
think you are pregnant or are a nursing mother.
Radio-tracer
    Adverse side effects of the radiotracer injection is rare, but do alert the staff if you feel dizzy
or nauseous during the exam.
Stress agent
    Dobutamine. This medicine will cause your heart to beat stronger and faster, similar to
exercise. This medicine is very short acting, and will be out of your system within twenty
minutes. In case of any complications the effects of Dobutamine can be immediately
stopped.
    Adenosine and Persantin. These agents dilate blood vessels not only in the heart but also
in rest of the body. Therefore, it is common to feel hot, flushing and warm. Many people may
have headache or abdominal pain, while few may feel nausea, particularly with persantin.
The effect of persantin may last up to 30 minutes , while of adenosine subsides immediately
due to short half life of 10 seconds only. The side-effects of adenosine (dipyridamole) can be
reversed by aminophylline (an anti-asthma medication).
The risk of an adverse event such as a heart attack is approximately 1 in 10,000, but certain
contraindications exist and this test should not be ordered for patients who have:
    suffered a heart attack in the previous two days
    unstable angina
    uncontrolled arrhythmias, or abnormal heart rhythms
    severe symptomatic aortic heart valve disease
    uncontrolled heart failure
    infection or inflammation of the heart
    acute aortic dissection
    acute pulmonary embolism

What happens after the procedure?

Drink plenty of water to assist in the elimination of the radiotracer from your body.
You should resume your regular daily activities after the procedure. If you were asked to
temporarily stop taking any medication prior to the procedure be sure to ask when you should
resume taking your medications.
Your results will be given to your personal doctor after the nuclear medicine physician has
reviewed your images and prepared a written report.