Below are some common questions patients may have about myocardial perfusion imaging (MPI) and potential answers that you might consider when talking to your patients about cardiac stress testing.a Also, below are links to patient resources that you can download to help answer questions about MPI and inform patients about how to properly prepare for a stress test.
aSearch trends based on results from Google Monthly Search Volumes (02-16-14 to 12-16-18).
A cardiac stress test is often performed by having the patient exercise on a treadmill or exercise bicycle to increase their heart rate. Patients may want to be informed that they will receive an intravenous injection of a radiotracer during the procedure so they are not surprised on the day of the test.1
Patients can also visit Mind Your Heart Facts for more information about how a stress test is performed.
Patients may want to know that the test should take between 2 and 4 hours, depending on the protocol.1‑3 This will help them know how much time to allow so they can plan accordingly.
Going over the risks and benefits of the test helps to inform patients. For example, patients should be aware that they will be exposed to a low dose of radiation. According to the appropriate use criteria (AUC), an appropriate test is one in which the benefits typically outweigh the risks.4 Patients should also be informed about other possible side effects, including but not limited to arrhythmia, low blood pressure, and jitteriness.2
Although a heart attack is possible during a stress test, it is uncommon. In fact, the chance of a stress test causing a heart attack is about 1 in 5000.2
If a patient is pregnant, thinks she may be pregnant, or is nursing, it is important that she is aware of potential risks.2 It may be appropriate to inform these patients about other stress test options.
You might explain that the test results will show how well blood is flowing through the heart. A lack of blood flow could mean that arteries to the heart have narrowed or are blocked. Results could also show that there is scarring on the heart muscle that may have resulted from a previous heart attack. This information helps determine the best course of treatment.1
1. American Heart Association. Myocardial perfusion imaging (MPI) test (09-19-2016). http://www.heart.org/HEARTORG/Conditions/HeartAttack/SymptomsDi...k/Myocardial-Perfusion-Imaging-MPI-Test_UCM_446352_Article.jsp#. Accessed 03-06-2019. 2. National Heart, Lung, and Blood Institute. Stress testing. https://www.nhlbi.nih.gov/health-topics/stress-testing. Accessed 09-03-2019. 3. Dorbala S, Ananthasubramaniam K, Armstrong IS, et al. Single Photon Emission Computed Tomography (SPECT) myocardial perfusion imaging guidelines: instrumentation, acquisition, processing, and interpretation. J Nucl Cardiol 2018;25(5):1784-846. 4. Wolk MJ, Bailey SR, Doherty JU, et al. ACCF/AHA/ASE/ASNC/HFSA/HRS/SCAI/SCCT/SCMR/STS 2013 multimodality appropriate use criteria for the detection and risk assessment of stable ischemic heart disease. J Am Coll Cardiol 2014;63(4):380-406.