Exercise Stress Test / Nuclear Stress Test

Why is the test done?

The cardiac stress test is used to find out if there is significant blockage of the blood supply to
the heart (coronary artery disease). In a nuclear stress test, the doctor is looking at the heart
muscle itself and the amount of radioactive material picked up (perfused) by the heart. These
tests give doctors a good idea of what is going on in your heart.

What can you expect?

You will go to Fort HealthCare – Fort Memorial Hospital for the test. Use the main entrance on
Armenia Street by the revolving door. Ask for help in finding the Cardiac Eval (EKG) Department.
The nuclear stress test is a two day test done in two parts: a “rest” part and a “stress” part.
Please allow 1½ hours for these exams.

How should you prepare for the stress test?

• Do not eat or drink for four hours before the exam.
• If you take insulin, you should talk to your doctor or clinic to change your dose
• for the day. If you use a blood sugar meter, please bring it along to the test.
• Do not have any caffeine 24 hours before the test. This includes coffee, tea, chocolate,
• and sodas (diet, regular, or decaffeinated).
• Wear/bring pants or shorts that are easy to move in and soft-soled shoes.
• Contact your doctor with questions about any drugs you are on for your heart or blood
• pressure. Your doctor will have to decide whether to stop them before the test. If you
• were told not to take certain drugs, bring them with you and take them after the
• test.
• You will be asked to sign a consent form for the stress portion.

The “rest” portion of the test

The “rest” images for a nuclear stress test will be done on a separate day and will be compared with the stress images done after the “stress” portion of the test. On this day we ask that you do not eat any food for 3 hours prior to the test. You may drink water or juice and you can take your medications as usual. Enter through the main hospital entrance and go to radiology.

For the “rest” images, a radioactive material that helps take pictures of your heart will be injected through an IV line and pictures will be taken 30 minutes later. You will be asked to lie flat on a table and remain still while the pictures are being taken. The machine moves slowly around your chest while you lie still. Each picture takes between 20-25 seconds and the entire scan is done in approximately 15 minutes.

There are two ways the “stress” portion of the test can be done.

1. If you are able to walk about five blocks without pain, your heart can be stressed by walking on a treadmill. This workout will start out easy and slowly get harder. This is known as a treadmill stress test.
2. If you are unable to walk much, one of two drugs can be used to “stress” the heart. These will be given through an IV. This is known as a pharmacologic stress test.

For the stress test, small sticky pads will be placed on your chest. The contact of these pads to
the skin is important to get a good signal. Men may need to have hair shaved. These pads will
be hooked to an ECG monitor so that your heart rhythm can be watched closely throughout the
test.

Your heart rate and blood pressure will be monitored during the stress test. Tell the person
giving the test if you have any of these symptoms at any time:

• Chest or arm pain
• Shortness of breath

If you are having a nuclear stress test a radioactive material will be injected through an IV line
about 1½ minutes before the end of the stress test. It is carried to the heart by the blood where it is taken up by the heart muscle cells. The “stress” images will be taken 15-60 minutes after your stress test.

Any further questions?

 If you have any other questions or concerns, we will gladly help you with them. You can reach
 the Cardiac Eval Dept at (920) 568-5350. If you live out of the area, call 1-800-421-4677 and
 ask to be connected with Cardiac Evaluation.

Medications to HOLD for Stress Test
(Unless physician directs otherwise)

• Beta Blockers - Hold the evening before and the morning of the test.
• Blocadren (timolol) Normodyne (labetalol)
• Cartrol (carteolol) Sectral (acebutolol)
• Coreg (carvedilol) Tenoretic (atenolol/HCTZ)
• Corgard (nadolol) Tenormin (atenolol)
• Corzide (nadol/ bendroflunetazide) Timolide (timolol/HCTZ)
• Inderal (propranolol) Toprol (metoprolol)
• Inderide (propranolol/HCTZ) Trandate (labetalol)
• Kerlone (betaxolol) Visken (pindolol)
• Levatol (penbutolol) Zebeta (bisoprolol)
• Lopressor (metoprolol) Ziac (bisoprolol/HCTZ)
   

Calcium Channel Blockers – Hold the morning of the test. If long acting, hold the day before.

• Calan (verapamil)
• Covera-HS (verapamil)
• Dilacor (diltiazem)
• Isoptin (verapamil)
• Tiazac (diltiazem)
• Verelan (verapamil)
• Digoxin, Lanoxin – Hold the morning of the test
• Nitrates – Hold the morning of the test
• Imdur, Ismo, Monoket, - (isosorbide mononitrate)
• Isordil (isosorbide dinitrate)
• Nitro-Dur patch, Nitropaste, Nitro-Bid Nitrostat (nitroglycerin)
• Sorbitrate. Isobid isonate Trindil Minitran

Diabetic Medications: Cut insulin dose in half.
Hold oral diabetic medications until after the test.

You may take your next scheduled dose after the test is complete.

For Persantine Stress Tests also hold:

• Dypridamole, Persantine, Pletal, Aggrenox - for 24 hours prior to the test
• Theophylline products for 2 days prior to the test.
• Accurbron Slo-phyllin
• Aerolate Sustaire
• Aminophylline Theo 24
• Aquaphyllin Theolate
• Asmalix Theopid Duracaps
• Bronkodyl Theochron
• Contant T Theoclear
• Dilor Theodur and Sprinkle
• Dyphylline Theolair
• Elixophylline Theospan
• Elixophyllin Theophylline
• Lanophyllin Theo Time
• Marox Theovent
• Nuelin Trental
• Pentoxifylline T-PHYL
• Primatene Tedral SA
• Quadrinal Theo-Organidin, Theo-Sav, Theostat, TheoX
• Quibron Uniphyl
• Respbid UnidurLufyllin
• Slo bid