Preparation for your Procedure
Welcome and thank you for choosing Conemaugh Memorial Medical Center for your Cardiolite Persantine or Lexascan Stress Test. Our physicians and technologists are dedicated to providing highly skilled and compassionate care for you and your family. We understand that you may be apprehensive about your procedure. We hope the following information will be helpful to you as you prepare.
The Cardiac Diagnostics Lab is on the 3rd floor of Memorial’s Pavilion in the P3 Link.
We want to make your experience as comfortable as possible. If you have any questions or concerns that are not answered here, please do not hesitate to call your physician or the Cardiac Diagnostics lab at (814) 534-9659 between 7:00 a.m. and 3:00 p.m.
Your physician’s office will schedule the date and time of your appointment with Central Scheduling. You or your physician’s office will be provided any necessary instructions when the exam is scheduled.
If you develop a cough, cold, abnormal temperature, sore throat, flu-like symptoms; or come in contact with anyone suffering from measles, chickenpox or any other communicable diseases within 2 weeks prior to your procedure please call your physician. It may be necessary to reschedule your procedure for a time when you are feeling better.
You will not be permitted to smoke or consume caffeine for at least 24 hours before the scheduled time of the Stress Test. Avoid chocolate, coffee, tea, sodas or any other products containing caffeine. Consuming caffeine or smoking can cause a delay or cancellation of your procedure.
Your physician will tell you which medications, if any, you should stop prior to your procedure.
On the Morning of Your Procedure
You may have nothing to eat or drink for 4 hours before you are scheduled to arrive at the hospital. Please take all your regularly scheduled medications unless otherwise instructed by your physician. If diabetic, check with your physician for instructions on your diabetic medications.
Shower or bathe the morning of your procedure. Please do not use body powders, lotions or creams to your chest area. Please wear loose-fitting, clean, comfortable clothing.
Children under 18 years of age or incapacitated adults must be accompanied by a parent or legal guardian. You may be accompanied by one adult family member or friend. Children should not accompany adults having a procedure.
Please bring any order that your physician’s office provided for you. If you were not contacted by pre-certification please bring your identification and insurance cards. If you have questions about your insurance coverage or pre-certification, call your insurance company. If you are not covered by insurance, please make arrangements for payment by calling the business office at 814-410-8470.
Please bring a list of your current medications, including the dose and the frequency.
When you arrive at the hospital on the day of your procedure, check in at the Out patient registration desk to the left on the 1st floor lobby of Memorial’s main building. You will be registered and escorted to The Cardiac Diagnostic Center. Once there you will sign in at the desk. You will be taken to the waiting room.
Healthcare professionals will be available in this area to make you comfortable and to answer your questions. Your safety is our number one priority.
The staff may ask you the same questions several times; they will ask your name and birth date. By repeating our questions, we are verifying and re-verifying very important information to ensure that your time with us is as safe as possible.
During Your Procedure
You will be taken to the exam room and will need to put on a hospital gown. You will sit in a chair and be prepared for your stress test. The people around you in the room will be preparing for your procedure. The technician will stay by your side and will explain everything that is happening. They will do an assessment, ask you about symptoms you experience if any, and review your medications.
An intravenous catheter will be inserted into a vein in your arm. The Dual Isotope stress test exposes you to a small amount of radioactivity. Two isotopes - Cardiolite and Thallium are used. If you are pregnant or think you might be, or if you are breast-feeding, tell the doctor and technologist before your test. You may have the Nuclear Med Scan performed in the Cardiac Diagnostics Lab or be sent to the Nuclear Med Department.
This is a three part test. For the first part of the exam a resting scan in needed. A technologist will inject the radioactive Thallium isotope through your intravenous line. You should not feel any effects of the Thallium. The Thallium should reach the target area of the heart in approximately 10 – 20 minutes. You will be assisted to lie down on a special screening table under a rotating camera. The camera is located within a large, doughnut-shaped scanner similar in appearance to a (CT) scanner. Resting images will be obtained of all different angles of your heart. The technologist will help you get comfortable with a pillow for your head, and one under your knees. We try to make it as comfortable as possible for you so that you are able to lie still while we do the scan. A nearby computer aids in creating the images from the data obtained by the camera or scanner. This scanning process lasts approximately 20 minutes. You will not feel anything during this time. This will provide an image of your heart’s ability to utilize oxygen at rest.
For the second part you will be taken back to the procedure room for the stress test. The technician will have you sit in a chair while they hook you up to equipment. Twelve electrode patches will be placed on your chest and torso. If you have hair on your chest, small areas may need to be shaved for the electrodes to adhere properly. Wires will be attached to the electrodes in order to monitor your heart rate and EKG. They will be connected by these EKG leads to a Stress Test machine to record the electrical activity of your heart. A resting EKG and blood pressure are recorded. You will be monitored by the technician throughout the procedure.
You will be seen by the Cardiologist who will also do an assessment. Your physician will ask you to sign a consent form, which legally permits your physician to perform your procedure.
In patients who are unable to complete a high level of exercise because of physical limitations, stress to the heart is provided by pharmaceutical or chemical stimulation. A medication called Lexiscan or Persantine will be used. The decision to utilize the treadmill or medication is up to the physician. If a medication is used it will given to you intravenously. You may feel your heart pound for a few minutes.
Your blood pressure and heart rate will be monitored throughout the test. The Cardiologist will be monitoring your progress and the EKG for any changes. You will be asked if you have any discomfort. The test will stop when the doctor has enough information about your heart or when you experience any symptoms. 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. If you develop significant chest discomfort, shortness of breath, dizziness, an unsteady gait, or if the EKG shows alarming changes or serious abnormal heart rhythm; it may also be stopped if the blood pressure (BP) rises or falls beyond acceptable limits.
If any problems are encountered during the procedure the Cardiologist will speak to your physician and take appropriate steps to treat your symptoms.
For the third portion of the test, Cardiolite (a radioactive isotope) will be injected into your IV. Again you should not feel any differently but may experience a metallic taste. You will rest approximately 20-30 minutes for the isotope to reach the target area of the heart. After your wait, you will have your final set of exercise images taken on the same screening table as your resting images. This will take approximately 20 minutes. After this is done your study is complete.
The two sets of images are compared to look for changes in the way your heart gets blood supply during stress and at rest. Analysis of the images of the heart can help identify the location, severity and extent of reduced blood flow to the heart. These images are interpreted by a cardiologist and radiologist with special training in nuclear medicine.
Total time for this exam is approximately 2 to 3 hours.
There are several types of procedures that you may have. At times the physician may order just a Thallium stress or Cardiolite stress test.
After Your Procedure
Once your procedure is complete your vital signs will be monitored. Your intravenous line will be removed. You will be able to resume all your routine medications after the test. There are no restrictions.
You can resume your normal activities after your test. The results will be sent to your primary care doctor. He or she will review the results with you.
Your technologist is not permitted to discuss your results with you. They will be reviewed with you at your next physician’s office visit. If your test was ordered STAT by your physician, the technician will alert the doctor and clerical staff to see that your doctor receives your results as soon as possible.
Thank-you for allowing the Cardiac Diagnostic Lab to care for you during your procedure!