Myocardial Perfusion Scan (NMMSG)

Introduction

You are receiving this information leaflet because you have been referred for a myocardial perfusion scan in the nuclear medicine department. Nuclear medicine involves the use of small amounts of radioactive tracers to help diagnose and sometimes treat medical conditions. These tests are valuable in identifying a wide range of health conditions. Your referring clinician will have already discussed with you why this test is necessary.

This leaflet aims to provide an overview of your test and answer general questions. A member of our team will explain the procedure in detail when you arrive. If you have any concerns beforehand, please feel free to contact us using the details at the back of the leaflet.

Myocardial perfusion scan

A myocardial perfusion scan is a two-day nuclear medicine test that assesses the blood supply to the heart muscle (myocardium). It compares the blood flow to your heart during stress, using a medication to mimic the effects of exercise, and at rest. By comparing these images, the scan can show areas of reduced blood flow or damage to the heart muscle.

Will it hurt?

There are no side effects from the radiopharmaceutical injection, and no restrictions following the test. During your stress test you will be given a drug (adenosine or dobutamine) that mimics the effects of exercise on the body, which may cause you some symptoms. Commonly, these might include dry mouth, headache, shortness of breath, chest tightness or chest pain. Effects brought on by the drug only last a few minutes and wear off very quickly. Staff will ensure you are back to normal before you leave the stress room.

How long will I be in the department?

Up to 3 hours on day 1.

Up to 2 hours on day 2.

What to do when you arrive

Upon arrival, please check in at the reception desk located on level 3. Once checked-in, kindly take a seat in the waiting area. This allows our team to confirm your attendance and prepare for your test. This process typically takes about 15 minutes.

Staff you are likely to meet

Your care will be provided by our specialist team, including nuclear medicine technologist/radiographer, cardiac technologist and nurses, who will guide you through each step of the procedure.

Preparation for examination

Please read the following information carefully, your test cannot proceed if these instructions are not followed. If you have any queries, please contact the Nuclear Medicine department on 01223 217145.

Day 1

For 24 hours before your appointment:

• If you are taking dipyridamole (Persantin) or any beta blocker medication, you must stop taking these 24 hours before your test.

For 8 hours before the test:

• Please avoid all caffeine-containing products before your appointment, including tea, coffee, chocolate, decaffeinated drinks, and vanilla products. If you drink tea or coffee on the day of your test, we will need to reschedule your appointment.

On the day of the test:

• Do not eat or drink anything except water for 4 hours before your test.
• Please bring a full list of your current medications, along with the medications themselves, to your appointment.
• Some patients may feel slightly unwell after the first part of the test. You may wish to arrange for someone to accompany you home after your appointment.

Day 2

On the day of the test:

• Do not eat or drink anything except water for 4 hours before your test.

Note: If required, patients with diabetes may have sugar water or glucose to help maintain their blood sugar levels.

Please wear clothing without metal fastenings. You may need to remove metal items (belts, jewellery, coins) during imaging.

If you require mobility assistance, please notify the department in advance so we can accommodate your needs.

Please contact us in advance of your procedure/examination on 01223 217145 if you:

• Have additional requirements that may require a longer appointment
• Are claustrophobic
• Are pregnant or breastfeeding
• Require hospital transport
• Have mobility issues
• Require clarification on your preparation

Benefits

Nuclear medicine investigations provide doctors with information to help them diagnose a variety of conditions. These investigations help to confirm or rule out a suspected diagnosis or occasionally identify a condition that was not suspected.

Risks

You have been referred for a nuclear medicine scan to help make a diagnosis or monitor your treatment. A specialist in radiology agrees that this is the best test to answer the clinical question that has been asked and that the benefit of the examination is greater than the risk. The scan involves a dose of ionising radiation equivalent to a few months or years of natural background radiation which we are all exposed to every day. Ionising radiation can cause cell damage that may turn cancerous however the risk of this happening from your examination is considered low. The dose delivered will be kept as low as is practicable

What will happen on the day of my scan?

This is a two-day protocol.

Day 1: Stress test

1. Arrival

A member of our team will explain the procedure and check that you have completed the required preparation for the test. You will then be asked to change into a hospital gown. A cannula will be inserted into a vein in your arm, and ECG electrodes will be attached to your chest.

2. Stress test

While lying on a bed a stressing agent will be infused through your cannula and will simulate exercise. The infusion will last only 5 minutes. Midway through the stress test a tracer will be administered through your cannula, which enables us to image your heart later. Throughout the procedure, our team will closely monitor your ECG and blood pressure to ensure your safety and that everything is progressing as expected.

Once the stress test is complete, we will continue to monitor you until your ECG, blood pressure, and symptoms have returned to their starting levels. This usually takes around 5 minutes.

3. Wait

You will then wait for approximately 30 minutes in which time you are required to drink around 200ml of water.

4. Imagine Procedure

We will then perform a 20-minute scan of your heart. During the scan, you will be asked to lie on your back with your arms raised above your head. Occasionally, we may need to repeat some images to ensure we have all the information required. If this is necessary, we will ask you to wait for a short period before repeating the scan. Once the scan is complete, you will be free to leave and return on the day of your rest test.

Day 2: Rest test

1. Arrival

A member of our team will check that you have correctly preparation for the test. You will then be injected with the tracer. This will not make you feel any different.

2. Wait

You will then wait for approximately 30 minutes in which time you are required to drink around 200ml of water.

3. Imagine Procedure

We will once again perform a 20-minute scan of your heart. This scan will be carried out in the same way as the scan you had on Day 1. Again, we may need to repeat the scan if it is required. Once the scan is complete, you will be free to leave the department.

Accessibility requirements

If you require support for your appointment, e.g. if you find it hard to hear, see or be understood by others, please let the receptionist or healthcare professional know on arrival or contact us by email (opens in a new tab) or by phone 01223 256998

Pregnancy status

As a standard precaution, it is normally recommended to avoid radioactive tests during pregnancy. Please note that certain radioactive substances may pass into breast milk in small quantities. If you are currently breastfeeding, or if you know or suspect you may be pregnant, please contact our department in advance to discussion your situation. We also ask that you inform our staff upon arrival so we can ensure your safety and provide appropriate guidance.

We have a legal responsibility to enquire if you are pregnant. Women aged between 12-55 years will be asked if there is a possibility they could be pregnant. This is important for us to know before you have your examination involving ionising radiation. You can discuss this with a healthcare professional in private if you wish.

Can I bring someone with me?

To ensure the safety and comfort of all patients, we kindly request that you limit your companions to one adult during your visit. Please note that children and pregnant women are unable to accompany you in the department due to safety precautions. Your companion may be asked to wait outside during your procedure. We appreciate your cooperation and understanding. Should you require any special assistance, please contact us in advance.

Childcare whilst in department

Staff are unable to look after or supervise children whilst your procedure/examination is taking place. Please make alternative arrangements for the care of your children whilst you attend for your examination. If you attend an appointment with children with no one to look after them whilst you have your examination, then your appointment will unfortunately have to be cancelled and rescheduled.

Personal belongings

Please keep all your personal belongings with you at all times during your visit as we cannot accept responsibility for any lost, stolen or damaged items. Rest assure that you will be able to take these items with you into the scanning rooms.

Travelling abroad?

Please be aware that most airports have sensitive radiation monitors which detect very small amounts of radiation and may detect a residual trace from your test.

We advise you keep and travel with your appointment letter if you are travelling within 4 days after your scheduled scan. If you inform us of your travel, we can provide you with a signed travel letter at your appointment. If residual trace is detected, the airport may have to contact our department as a precaution.

What happens after my procedure/examination?

Once we have verified the quality of your scan and have confirmed we have all the necessary information, you will be able to leave the department. You may resume all normal activities as there no restrictions following this test.

Possible side effects and additional aftercare

This test has no significantly known side effects, and you can resume normal activities right way. However, if you provide the majority of close care to any babies, please contact us to speak with our Physics team before your appointment.

Please avoid having blood tests within 24 hours of your test.

How, when and by whom will my results be communicated?

Imaging examinations are reported in order of clinical priority to ensure those with the highest urgency are reported first. Your referring team or clinician will be responsible for communicating reports back to you.

While results are available through MyChart, please note there is a standard 3 week delay between when the examination is reported to when it appears on your portal. This allows your clinical team adequate time to review and act on your results before they are released to you.

Are there any alternative tests?

If this test isn’t suitable for you, please contact your referring clinician to discuss alternatives. They can recommend the best options based on your individual needs.

Contacts/Further information

If you have any queries or cannot make your appointment, please contact the department as soon as possible on 01223 217145.

Opening times: Monday-Friday 8am-5pm.

Facilities available

Our clinic provides a toilet with disability access for your convenience, as well as a dedicated baby changing room and an alternative waiting area for returning patients. Please note that the waiting area and toilet facilities are reserved for radioactive patients only, as part of our safety protocols. If you are not a radioactive patient alternative restroom facilities can be found around the corner in the outpatient department.

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Directions to the department

The nuclear medicine department is located on level 3, at the outpatient end of the hospital.

Question, concern or complaint?

Firstly, speak to your nurse, doctor or other staff member as soon as you can so they can do their best to put things right straightaway.

If you don’t feel able to speak directly to the people caring for you, contact the patient advice and liaison service (PALS). Please call 01223 216756 9am to 4pm Monday to Friday, via email (opens in a new tab), or via a form available on the CUH PALS webpage.

PALS is open every weekday, and you can leave a message in the evenings and weekends.

MyChart

We would encourage you to sign up for MyChart. This is the electronic patient portal at Cambridge University Hospitals that enables patients to securely access parts of their health record held within the hospital’s electronic patient record system (Epic). It is available via your home computer or mobile device

More information is available on our website.