Myocardial Perfusion Scan (NMMSG)

What is ‘nuclear medicine'?

Nuclear medicine refers to the medical use of radioactive tracers for the diagnosis and sometimes treatment, of medical conditions.

Nuclear medicine tests are helpful to diagnose a wide variety of illnesses. The clinician that referred you to nuclear medicine will have already explained to you the reasons for having this test.

This leaflet is to explain your scan and provide you with some general information. The procedure will be fully explained to you when you attend. We are happy to provide additional information beforehand and our contact details are on the back of this leaflet.

Benefits of nuclear medicine tests and are they dangerous?

Nuclear medicine procedures are commonly used diagnostic tools that utilise ionising radiation to obtain important clinical information.

There are small risks associated with the use of ionising radiation. Ionising radiation can cause cell damage that can, after many years or decades, contribute to the development of cancerous cells. This procedure carries only a very small chance of this happening to you. Our tests have been optimised by a team of clinical scientists and technologists to ensure that the dose you receive is appropriate for your test.

Your doctor will have considered the risk and benefits of having the test before referring you to us. The benefits of the test outweigh the potential risk.

What is a Myocardial Perfusion scan?

This test looks at the perfusion of your heart muscle during stress (drug induced exercise) and then at rest. Comparing your stress and rest tests allow us to identify whether there is damage to your heart muscle. This might have been caused by a myocardial infarction or ischemia (reduced flow of blood through your heart vessels during exercise).

Will it hurt?

There are no side effects from the radiopharmaceutical tracer 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.

Important patient preparation guidelines for Myocardial Perfusion Scan

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.

How is the test carried out?

Day 1

For 24 hours before you appointment:

• If you are taking dipyridamol (Persantin) or any beta blocker tablets you must stop these 24 hours before the test.

For 8 hours before the test:

• Do not eat or drink any chocolate, caffeine, decaff and vanilla products.
• If necessary, diabetics may have sugar water or glucose.
• Please note: If you drink tea or coffee we will not be able to proceed with the test.

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 and any tablet you will need during the day.
• You are required to bring a fatty meal with you e.g. a sausage roll, cheese sandwich, cream cake etc.
• Some patients may feel a little unwell after the first visit, so you may choose to arrange for someone to take you home after the test.

Day 2

On the day of the test:

• Do not eat or drink anything except water for 4 hours before your test.
• You are required to bring a fatty meal with you e.g. a sausage roll, cheese sandwich, cream cake etc.

If you are diabetic please bring your medication with you.

If you are the main carer for any babies, please contact us to speak with our Physics team before your appointment.

How is the test carried out?

This is a two day protocol.

Day 1: Stress Test

On arrival: We will check that you have prepared correctly for this test. A cannula will then be inserted into a vein in your arm and ECG electrodes will be attached to your chest.

Stressing: 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 stressing a radioactive tracer will be injected through your cannula, which enables us to image your heart later.

Wait: You will then wait for approximately one hour in which time you are required to eat the fatty meal and drink plenty of fluids.

Scan: You will have a scan of your heart which takes about 20 minutes. For the scan you will need to lie on your back with your arms above your head. Occasionally we need to repeat images. If this happens we will ask you to wait a little longer and then repeat the scan. Once the scan is finished you will be free to leave and return on the day of your rest test.

Day 2: Rest Test

On arrival: We will check that you have prepared correctly. You will then be injected with another radioactive tracer injection.

Wait: You will then wait for approximately one hour in which time you are required to eat the fatty meal you brought with you. If you had to repeat the scan on day 1 you may be asked to wait for longer than one hour.

Scan: You will have a scan of your heart which takes about 20 minutes. For the scan you will need to lie on your back with your arms above your head. Occasionally we need to repeat images. Once the scan is finished you will be free to go.

How long will the test take?

Up to 3 hours on day 1.

Up to 2 hours on day 2.

What if I am pregnant or breastfeeding?

It is usual to avoid radioactive tests during pregnancy. Small amounts of some radioactive substances may appear in breast milk. Patients who are breast feeding and those that know, or suspect that they are pregnant must contact the department before attending to discuss this further and should also inform the department upon arrival.

What happens after the test?

When we have checked the technical quality of your scan and are happy we have all the information we need, you will be able to leave the department. You are free to go home or return to your ward. There are no restrictions following this test.

Your results will be reported and available from your referring clinician/ team or GP within 3 weeks after your appointment. If you have MyChart, your results will become available once released by your referring consultant.

Family/friends

Due to the small size of the waiting area in Nuclear Medicine we ask that you please limit the number of people accompanying you for your visit. Children and pregnant women should not accompany you to the Nuclear Medicine department.

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.

How to find/contact the department

The Nuclear Medicine department is located on level 3, in the outpatient end of the hospital. 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.

Medication

Bring all of your medicines (including inhalers, injections, creams, eye drops or patches) and a current repeat prescription from your GP

Please tell the ward staff about all of the medicines you use. During your stay If you wish to take your medication yourself (self-medicate) please speak with your nurse. Pharmacists visit the wards regularly and can help with any medicine queries.

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: MyChart

Contacts/further information

Nuclear Medicine department: 01223 217145