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At New York Cardiovascular Associates, we are a dedicated team of New York City’s top cardiology, pulmonary, and internal medicine specialists. A nuclear stress test measures blood flow to your heart, both at rest and when there is stress placed on the heart, like during exercise. New York Cardiovascular Associates’ leading heart doctors use stress testing as part of a complete diagnostics approach. Preparation: Your doctor may instruct you not to eat, drink, or smoke for two hours before your test. During: The first part of your nuclear stress test involves monitoring your heart’s activity while you are at rest, lying comfortably on a table. One to two hours later, you’ll have a second set of images taken of your heart, this time while your heart is under stress.
If you can’t exercise, you’ll receive a medication that safely simulates the effects of exercise on your heart. Our patient-focused care at New York Cardiovascular Associates enables you to have a safe, effective nuclear stress test, even if you limited mobility or a low tolerance for exertion. New York Cardiovascular Associates prides itself on providing exceptional care to our patients. NYCVA cardiologists and cardiac surgeons use noninvasive and minimally-invasive cardiac procedures to treat and diagnose heart conditions.
New York Cardiovascular Associates’ physicians include some of the best cardiologists, heart surgeons, pulmonologists, sleep specialists, and echocardiologists in NYC. The goal of our experienced, Manhattan-based team of cardiologists, sleep apnea specialists, pulmonary physicians, heart surgeons, and other staff is to provide the best, most up-to-date screening, diagnosis, and treatment for heart disease and vascular disease. New York Cardiovascular Associates has made a commitment to work with each patient to provide the best individual care — whether for heart disease, sleep disorders, or other pulmonary and vascular conditions.
Your on-line source for reliable and unbiased information about the evaluation & treatment of heart disease. Notice: Our website hosts Google sponsored ads and links that are displayed in the right hand column. A nuclear stress test combines imaging technology, small amounts of radioactive material, and an exercise stress test to diagnose and monitor heart problems.
The patient is brought to the stress laboratory where the heart rate and blood pressure are recorded at rest.
Disclaimer The content in this website is for educational purposes only, and therefore is not intended to be a substitute for professional medical advice, diagnosis or treatment. Nuclear imaging provides more information than stress exercise tests (sometimes called treadmill tests) or stress echocardiograms alone can provide. Certain imaging techniques such as a MUGA scan (see below) check for ventricular function (also called ejection fraction). It may also be used to monitor the success of treatments in patients already diagnosed and taking medications for heart disease, such as CHD and arrhythmia.
There are two main types of nuclear heart scans: Cardiac Single Photon Emission Computed Tomography (SPECT) and Cardiac Positron Emission Tomography (PET). Bring comfortable clothes and shoes with you if you are scheduled for the exercise stress test. If you have diabetes or lung disease you will be given special instructions by your doctor. Once the patient has reached their maximum exercise level or they have been injected with a chemical to stress the heart, the radioactive tracer is injected through the IV line. If blood flow (also called perfusion) looks normal while the patient was stressed and at rest, it is unlikely that they have CHD.
This means the heart is not receiving enough blood flow at all times and immediate treatment is usually necessary. On occasion however a cardiologist may discover that an area he had diagnosed as 'fixed' (or dead) may in fact not be scar tissue.
The radiotracers do expose the body to very small doses of radiation, although the radiation does disperse after 24 hours.
If a chemical stress test is used patients may feel the effects of a fast heart rate or flushing. Patients with severely diseased arteries can occasionally have a 'normal' test result, despite the extent of disease.
MUGA - or Multiunit Gated Blood Pool Scan is another type of nuclear scan which assesses how blood pools in the heart during exercise or at rest. Please Note: Information provided on this site is no substitute for professional medical help. We are devoted to providing you with the best medical care in New York City, starting the first time you walk through our doors.
The test therefore involves taking two sets of pictures of your heart – one while you are at rest and one while you are exercising or have taken medications to mimic the effects of exercise. Your cardiologist may order a nuclear stress test if a routine exercise stress test has been inconclusive.
The two sets of images taken during the test will allow your cardiologist to compare blood flow through your heart while you are at rest and exercising.
One of our leading cardiologists will oversee the process, make sure you understand your results, and discuss the next steps in your cardiac care. As a patient, you’ll benefit from the experience and skill of our physicians with a faster recovery and an improved quality of life. Our New York, NY team of heart specialists and cardiac surgeons provide comprehensive cardiovascular screenings and treatment for heart disease, stroke, cardiac arrest, high blood pressure, and vascular diseases.


We also have varicose vein specialists and other top doctors who are experts in the fields of vein and arterial disease.
It is our mission to provide this expertise to our New York City patients in a professional, compassionate and respectful manner.
Your doctor may use a nuclear stress test to diagnose coronary artery disease and assess damage from a heart attack or other heart problems. Sticky electrodes are attached to the chest and connected to the EKG portion of the stress test machine.
If part of the heart muscle is not receiving enough blood flow it may be a symptom of coronary heart disease.
This may be the result of previous heart attacks (including silent heart attacks), infections, medications or injury.
Either the doctor or a specially trained technician will insert an intravenous (IV) line into a vein in the arm. 30 minutes to an hour later they will be moved to a scanner machine which detects the flow of the tracer through the veins. A large scanner which contains a gamma camera will be moved over the body and will take internal pictures of the heart and veins. Depending on the extent of the damage (how many light spots appeared on the scan images), treatment can range from coronary angioplasty and stent placement to coronary artery bypass. Although it is important to pay attention to how much radiation you receive over a lifetime, the dosage associated with this test is considered safe. This can happen because the arteries are so blocked; there is little response difference between exercise and at rest. Do check with your health insurance before agreeing to the test because many will not cover it. Some patients may only have a resting scan MUGA, some may have an exercise scan MUGA, others may have both. The patches contain electrodes connected to an ECG machine, which will record your heart’s activity. This is a stress test used to determine the amount of stress your heart can handle before developing an abnormal rhythm or insufficient blood flow to the heart muscle. NYCVA’s sleep specialists treat a wide range of sleep disorders, including sleep apnea and insomnia. Our commitment to be the best NYC center for cardiac care, vein disease, and improved heart health is evidenced by our receipt of multiple national accreditations for our NYC cardiovascular center.
We do not control Google ads content and our editorial content is free of any commercial influence. A nuclear stress test can also show how well your heart pumps blood.A nuclear stress test, sometimes called a thallium stress test, is an important test because some heart problems can only be seen when the heart is under stress from exercising.
The physician pays particular attention to the heart rate, blood pressure, changes in the EKG pattern, irregular heart rhythm, and the patient’s appearance and symptoms.
Coronary heart disease (CHD) is the number one killer for both men and women in America (see heart disease statistics). It may also be used to determine treatment for newly diagnosed patients by determining how much exercise (stress) their heart can actually handle. Both tests can be used for the same diagnostic purposes and studies show no clear advantages in using one or the other in all circumstances.
They may be sent to the patient's personal physician or the cardiologist may discuss the results directly with them.
It is through this line that the radioactive tracers called radionuclides will be injected into the bloodstream.
The amount of tissue damaged, where blood flow is low, may also be graded as small, moderate or large in size. This is carried out the same way as the original nuclear heart scan but images are taken at a later point in time.
So when the radiotracers are injected there is little difference in blood flow movement in either situation.
They may only agree to cover the costs of an exercise stress test which is a more standard health screening tool. The procedure is carried out in much the same way as a regular nuclear scan, except that the radioactive material injected is first mixed with a sample of the patients blood before re injecting back in.
New York patients also receive the best care for pulmonary conditions including COPD and pulmonary hypertension. Our doctors have been recognized as among the top New York cardiovascular physicians, as well as top cardiac and vascular specialists in the US. The site receives no other outside funding and is personally supported by the Medical Editor, Dr. A nuclear stress test also provides important information about how the heart is functioning. Each lead of the EKG represents a different portion of the heart, with adjacent leads representing a single wall.
The treadmill is stopped when the patient achieves a target heart rate (this is 85% of the maximal heart rate predicted for the patient’s age). During the test, a doctor will inject a radioactive material or dye called a tracer through the vein into the bloodstream. It is caused by the buildup of fatty deposits in the arteries and can lead to angina attacks and severe chest pain (noted particularly after exercise). It allows the cardiologist to check for signs of heart enlargement, one of the symptoms of heart failure.


However, a PET scan may provide clearer internal images of a woman with thick layers of breast or abdominal tissue. The most commonly used radionuclides are called technetium (Tc) which include rubidium, thallium and nitrogen. An exercise test is more common - but if the person is physically unable or too elderly for this, a chemical stress test will be used instead. A fixed defect refers to an area of the heart that does not get enough blood at rest or under stress. If the radiotracers are taken up late it suggests that the area of heart in question may still actually be viable or alive. This is usually the only occasion when a stress test can come back negative, even though there is severe CHD.
The test is normally carried out to test how well the heart pumps blood and whether or not it has to compensate for any blocked arteries. The dye will travel through your bloodstream to your heart, while a monitor takes images of your heart. The speed and incline of the treadmill will increase as the test continues – either until you reach a target heart rate, become unable to continue, or are instructed to stop because of warning signs like abnormal heart rhythm. In addition, our nuclear and ultrasound technicians are certified and recognized as top specialists in their fields. Other imaging methods, such as X-rays and CTs, do not show how the heart responds to stress. However, if the patient is doing extremely well at peak exercise, the treadmill test may be continued further.
The tracer travels along the veins towards the heart and special cameras outside the body can trace its journey. These radionuclides attach to other molecules creating long names such as 99m-Tc-tetrofosmin (brand name Myoview) and 99m-Tc-sestamibi (MIBI, brand name Cardiolite). More radioactive tracers will need to be injected through the IV line when the person is at rest.
It is called 'fixed' because the defect remains fixed on both scans, whether exercise has taken place or not. Looking at these images, your cardiologist will be able to examine the flow of blood through your heart, and detect any areas of inadequate blood flow. When you reach your peak level of exercise, you’ll again receive a radioactive dye through an IV, while the monitor takes images of your heart. The test may be stopped prior to achievement of the target heart rate if the patient develops significant chest discomfort, shortness of breath, dizziness, unsteady gait, etc., or for EKG changes. A cardiologist who specializes in nuclear imaging will select the best test for the individual patient. They will be asked to continue walking or pedaling until they feel too tired to continue or chest or leg pain begins. Very often a fixed defect is scar tissue and the artery supplying the area has been completely blocked off as a result of a previous heart attack. Discuss all of your testing options with your doctor to understand which options are right for you. First, the patient will undergo an exercise stress test or chemical stress test so that their blood flow can be monitored while a€?stresseda€™. At the same time electrocardiogram (ECG) patches will be attached to various parts of the body to monitor the heart rate during the test. A 'reversible' defect refers to an area of the heart that still has good blood flow at rest. A radiopharmaceutical agent was given and pictures of its distribution in the heart were taken by a special camera.
The second set of images will be taken several hours or a few days later when the patient is at rest.
The information will help the doctor determine whether a blockage is present in vesels of the heart. The two sets of images will be compared for signs of any blockages and areas of damaged heart muscle. Patients who are unable for this test will be injected with a chemical which will force their heart to artificially beat faster, mimicking the effects of exercise.
Generally there is no point in opening the heart to operate on a fixed defect because even if the artery is opened up, the muscle tissue it would supply is dead. Needless to say, I was able to grade lots of papers and plan my lessons during the down time while the drugs were dispersed through the body. A reversible defect however means that the heart muscle is still salvageable and the procedure may prevent a future heart attack or relieve symptoms of angina. J will be with me throughout the entire procedure and to drive me home.I again thank all of you for your thoughts and prayers as well as patience as I go through all of these procedures. I am only hoping that my heart will get back into its normal rhythm and that the muscle continues to get healthier.In the near future, I do have a sleep consultation and testing appointment.



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