Coronary heart disease is the leading cause of death in Australia and is caused by a slow build-up of fatty deposits on the inner walls of the coronary arteries, which supply blood to the heart muscles. Known as atherosclerosis, when these fatty plaques become significant enough to reduce blood flow to the heart muscles you could get angina (chest pain) or have a heart attack. Plaque build up in arteries begins when people are young and could be well advanced by middle age.
A Stress Myocardial Perfusion Scan examines the blood supply (perfusion) to the heart muscle using a gamma camera. The blood supply is made visible to the camera by the introduction of a small amount of radioactive tracer, (radiopharmaceutical or MIBI) injected into an arm vein. The injection is given during stress, then again while resting later on. The heart is subjected to a stress test using a pharmaceutical called persantin, as an alternative to exercising.
After each injection, a gamma camera placed over the chest images (maps) the pattern of tracer accumulated in the heart’s left ventricle, giving information useful in diagnosing and managing conditions such as coronary artery disease, infarcts and diseases of the heart muscle (cardiomyopathy).
What to bring
Preparation
A referral from your doctor or medical specialist, and an appointment is required for this examination.
Before you attend your appointment please read and follow exactly the printed instructions that will be given to you when making your appointment.
During the 24 hours before your appointment time:
Please call Apex Radiology immediately for clarification if you have any further questions.
If you are pregnant, breastfeeding, or caring for a small child on the appointment day, please notify us in advance to receive special instructions.
What to expect during my procedure?
When you attend your appointment at Apex Radiology you will be asked to answer a few safety questions, remove any jewellery, watches etc.
A nurse will explain and prepare you for the stress test, which includes introducing an intravenous cannula (a small tube for taking blood samples and administering medicines) and electrocardiogram (ECG) monitoring during the persantin (MIBI) infusion. A doctor will then speak to you, explain what you are likely to feel, and begin the stress test. Near the end of the stress test, the doctor will inject the MIBI through the intravenous cannula.
After 30 to 60 minutes resting, the technologist will position you in the gamma camera and begin imaging. The gamma camera is a large square radiation detector which rotates around the chest (SPECT). You will experience no unusual sensations or discomfort from the scan which takes around 15 minutes.
The images are usually combined with a low dose CT (Computed Tomography) scan performed at the same time on the same scanner. This combined SPECT/CT scan improves the accuracy of the information obtained, and adds only a few minutes to the duration of the procedure.
After the first scan is completed, the technologist will inject more MIBI, and ask you to wait, resting from 30 to 60 minutes before repeating the scan to show the heart perfusion at rest.
Please allow between two to four hours for the entire procedure.
Risks and side effects
Stress testing with persantin carries a very small risk of adverse cardiac events (eg cardiac arrest) in some patients. Other minor, transient side effects are more common, and include headache. These can be relieved with the injection of an antidote drug. These risks will be fully explained to you before the test begins.
Nuclear medicine examinations are considered very safe with almost no reported adverse reactions attributable to the radiopharmaceuticals used in these examinations.
Nuclear Medicine studies require very small doses of gamma radiation and are only performed where the benefits of the examination are deemed to outweigh any potential risks. At Apex Radiology you can be assured that using the latest technology and with staff trained in radiation reduction techniques, radiation doses are kept as low as reasonably possible.
If you are worried or concerned about having a Nuclear Medicine study you should discuss this with your referring doctor or medical specialist before coming for your examination.
If you think you may be pregnant, please inform our Nuclear Medicine team before your examination.
Who will perform and report my examination
At Apex Radiology your examination will be carried out by a Nuclear Medicine Technologist who has a degree in Medical Radiation Science and is accredited by the ANZSNM.
Your images will be reviewed along with your relevant medical history, and any other imaging, and be reported by our Nuclear Medicine credentialed radiologist or Nuclear Medicine Physician (a medical doctor specialising in the interpretation of Nuclear Medicine studies).
What to expect after my procedure?
Radiation from the injected isotope diminishes to a very low level by the end of the procedure, and you are free to resume normal activities. If you are caring for a small child, or breastfeeding, we may ask you to take some minor precautions.
How do I receive my results?
If your results are needed urgently, or you have an appointment straight after your scan with your referring doctor or health care provider, Apex Radiology will arrange to have your results available immediately. Otherwise your referring doctor or health care provider will receive your report within 72 hours of your examination.
Please ensure that you make a follow up appointment with your referring doctor or health care provider to discuss your results.
Apex Radiology
Head Office
U3, 290 Pinjarra Road
MANDURAH, WA 6210
