Background Information:

What are the other Names for the Procedure?

• Cardiac Nuclear Medicine
• Heart (Cardiac) Nuclear Medicine
• Nuclear Cardiac Scan

What is Heart Nuclear Scan radiology procedure? (General Explanation)

• Nuclear medicine is a noninvasive procedure that uses very small amounts of radioactive material to diagnose and treat various kinds of diseases, such as heart disease, cancers, and endocrinal, gastrointestinal, and neurological problems
• It provides details about the molecular activity in the body and thus helps to detect diseases, during the early stages
• A Heart Nuclear Scan provides very accurate information about the function of the heart and the distribution of blood flow to the heart
• The procedure is used to diagnose coronary artery disease and damage to heart from a heart attack, chemotherapy or radiotherapy
• A radiotracer can be sent to the organ via different ways. It can be injected, swallowed, or inhaled as a gas, which eventually goes to the target organ; special imaging device then detects the emission and produce pictures
• In image fusion, images are taken from nuclear medicine and superimposed with a CT or MRI scan to produce special images, to get more information and accurate diagnosis

What part of the Body does the Procedure involve?

Physicians use nuclear medicine imaging to evaluate the heart.

Why is the Heart Nuclear Scan radiology procedure Performed?

A Heart Nuclear Scan procedure is performed for the following reasons:

• To diagnose disease related to heart in cases of angina (chest pain upon exercise) and unexplained chest pain
• To detect coronary artery disease (CAD)
• To see blood flow to the heart in healthy heart, after bypass surgery, or after revascularization procedures. A myocardial perfusion scan is used for these purposes
• To evaluate heart function and heart wall movement
• To evaluate heart injury due to heart attack (myocardial infarction)

What is the Equipment used? (Description of Equipment)

• The Heart Nuclear Scan procedure can use positron emission tomography (PET), single photon emission computed tomography (SPECT), or a gamma camera
• A gamma camera detects radiation and takes pictures of the target body part from different angles
• The gamma camera is used in SPECT as well, which rotates around the body to produce 3-D images of the body
• A computer uses the data from the cameras and produces images

What are the Recent Advances in the Procedure?

There have been no recent advances to replace the Heart Nuclear Scan (or Cardiac Nuclear) medical procedure.

What is the Cost of performing the Heart Nuclear Scan radiology procedure?

The cost of the Heart Nuclear Scan procedure depends on a variety of factors, such as the type of your health insurance, annual deductibles, co-pay requirements, out-of-network and in-network of your healthcare providers and healthcare facilities.

In many cases, an estimate may be provided before the procedure. The final amount depends upon the findings during the surgery/procedure and post-operative care that is necessary.

When do you need a Second Opinion prior to Procedure?

• It is normal for a patient to feel uncomfortable and confused with a sudden inflow of information regarding the Heart Nuclear Scan procedure and what needs to be done
• If the patient needs further reassurance or a second opinion, a physician will almost always assist in recommending another physician
• Also, if the procedure involves multiple steps or has many alternatives, the patient may take a second opinion to understand and choose the best one. They can also choose to approach another physician independently

What are some Helpful Resources?

http://www.radiologyinfo.org/en/info.cfm?pg=cardinuclear (accessed on 08/02/2014)

Prior to Heart Nuclear Scan radiology procedure:

How does the Heart Nuclear Scan radiology procedure work?

The Heart Nuclear Scan procedure works in the following manner:

• The patient is given radioactive material, which accumulated in the target organ
• After the radioactive material has accumulated, gamma camera, SPECT, or PET scans detect the radioactivity and takes the pictures
• During coronary arteries scan, images of blood flow to the heart at rest are taken. After the first scan at rest, patients are asked to do some exercise during stress test, or are given medications to increase blood flow to the heart
• During exercise, blood flow to the heart increases and thus blockages of coronary arteries are easy to detect. Another scan is performed and it is compared to the scan at rest, to find any blockages

How is the Heart Nuclear Scan radiology procedure Performed?

A Heart Nuclear Scan procedure is performed in the following manner:

• An intravenous (IV) line is inserted in the patient’s arm
• A radioactive tracer is injected through an IV, oral, inhaled, or injected via catheter depending on the nuclear medicine exam
• After 40 minutes of radiotracer injection, the patient will be asked to lie down on a movable imaging table with arms over head, for about 15-20 minutes
• After first scan at rest, patients are asked to do some exercises for stress test, or are given drugs to increase blood flow to the heart
• An ECG is connected to the patient, to monitor their heart activity. The blood pressure is also measured
• When blood flow reaches its peak level, the radiotracer is injected through the IV line
• 40 minutes after the radiotracer injection, images are taken
• The IV line is removed at the end of the procedure

Where is the Procedure Performed?

A Heart Nuclear Scan procedure is performed as an outpatient procedure, at a hospital.

Who Performs the Procedure?

The Heart Nuclear Scan procedure is usually done by a radiology technologist, under the supervision of a radiologist or a cardiologist.

How long will the Procedure take?

The entire Heart Nuclear Scan procedure takes about 2-4 hours.

Who interprets the Result?

The radiologist or a cardiologist interprets the results from the Heart Nuclear Scan procedure and informs the primary care physician, who then informs the patient; the complete set of results are usually available within 1-2 days.

What preparations are needed, prior to the Procedure?

The following preparations may be needed prior to a Heart Nuclear Scan procedure:

• The physician may evaluate the individual’s medical history to gain a comprehensive knowledge of the overall health status of the patient, including information related to the medications that are being currently taken
• The individual may generally continue their medications, but if they are taking beta-blocker medications; then, he or she should ask the physician about temporarily discontinuing them
• The patient should not take caffeine and avoid smoking for 48 hours before the procedure
• Do inform the medical professional if you have a history of any medical conditions, such as a heart disease, asthma, diabetes, or kidney disease
• Do inform the medical professional about any allergies, especially related to barium or iodinated contrast material, or to the anesthesia, which may be used in the procedure
• The patient will be asked to exercise during the exam; hence, patients are advised to inform the physician, if they have asthma, chronic lung conditions, or any other knee or hip problems
• It is advisable to wear comfortable and loose clothes. Avoid wearing any metal objects or jewelry, as it may interfere with the x-ray
• It is highly recommended to inform your healthcare professional, if you are pregnant or breastfeeding
• The patient may be asked to avoid eating or drinking, several hours before the test
• The patients may be required to be driven home, after the procedure

What is the Consent Process before the Procedure?

A physician will request your consent for a Cardiac Nuclear Medicine procedure using an Informed Consent Form.

Consent for the Procedure: A “consent” is your approval to undergo a procedure. A consent form is signed after the risks and benefits of the procedure, and alternative treatment options, are discussed. This process is called informed consent.

You must sign the forms only after you are totally satisfied with the answers to your questions. In case of minors and individuals unable to personally give their consent, the individual’s legal guardian or next of kin, shall give their consent for the procedure.

What are the Benefits versus Risks, for this Procedure?

Following are the benefits of Heart Nuclear Scan procedure:

• The cardiac nuclear medical procedure is a noninvasive and less expensive process and provides detailed information to the healthcare provider
• It provides details about both structure and function, which is usually unobtainable with other imaging techniques

Following are the risks of Heart Nuclear Scan procedure:

• Patients may develop an allergic reaction to radioactive material used in the procedure, but it is very rare
• The amount of radioactive material used in the procedure is very small, so the risk from radiation is very minimal compared to some other procedures
• Women should always inform the physician, if they are pregnant or breast feeding
• The patient may develop chest pain during the exercise or with the given drug, if they have coronary artery disease. But, this is usually preventable as the heart is constantly monitored with ECG, during the entire procedure 

What are the Limitations of the Heart Nuclear Scan radiology procedure?

Limitations of the Heart Nuclear Scan procedure include:

• Nuclear medicine scans do not provide resolution of structures as high as other imaging techniques
• The procedure takes a long time as radioactive material takes time to accumulate in the target organ or structure

What are some Questions for your Physician?

Some of the basic questions that you might ask your healthcare provider or physician are as follows:

• What is the Heart Nuclear Scan procedure?
• Why is this procedure necessary? How will it help?
• How soon should I get it done? Is it an emergency?
• Who are the medical personnel involved in this procedure?
• Where is the procedure performed?
• What are the risks while performing the procedure?
• What are the complications that might take place, during recovery?
• What are the possible side effects from the procedure? How can I minimize these side effects?
• How long will it take to recover? When can I resume normal work?
• How many such procedures have you (the physician) performed?
• Are there any lifestyle restrictions or modifications required, after the procedure is performed?
• Are there any follow-up tests, periodic visits to the healthcare facility required, after the procedure?
• Is there any medication that needs to be taken for life, after the procedure?
• What are the costs involved?

During the Heart Nuclear Scan radiology procedure:

What is to be expected during the Heart Nuclear Scan radiology procedure?

The following may be expected during the Heart Nuclear Scan procedure:

• The entire procedure is mostly painless except for a slight pin prick associated with the IV insertion
• The patient may feel a cold sensation when radiotracer is injected through IV
• The patient may feel discomfort, as the patient is supposed to stay still during the imaging process, in order to avoid any blurriness in the images that are taken for analysis
• Patients are asked to do exercises, until they are short of breath or too tired or have chest or leg pain
• Patients, who are unable to do exercises, are given drugs to increase blood flow to the heart. Patients may feel short of breath, dizzy, nauseous, or anxious, due to injection of medication. But, these symptoms resolve once the infusion is complete 

What kind of Anesthesia is given, during the Procedure?

No anesthesia is given during the Heart Nuclear Scan procedure. 

How much Blood will you lose, during the Procedure?

There is no blood loss involved in the Heart Nuclear Scan procedure. 

What are the possible Risks and Complications during the Heart Nuclear Scan radiology procedure?

The risks of the Heart Nuclear Scan medical procedure include:

• Patients may develop an allergic reaction to radioactive material used in the procedure; though, it is very rare
• The amount of radioactive material used in the procedure is very small, so the risk from radiation is very minimal compared to other procedures
• Women should always inform the physician, if they are pregnant or breast feeding
• The patient may develop chest pain during the exercise or with the given drug, if they have coronary artery disease. But, this is usually preventable, as the heart is monitored constantly with ECG, during the scan

What Post-operative Care is needed at the Healthcare Facility after Heart Nuclear Scan radiology procedure?

There is no postoperative care necessary after a Heart Nuclear Scan procedure, at the healthcare facility.

After the Heart Nuclear Scan radiology procedure:

What is to be expected after the Heart Nuclear Scan radiology procedure?

The following may be expected after a Heart Nuclear Scan procedure:

• Patients may resume their normal activities after the procedure, unless otherwise suggested by the physician
• Patients are advised to drink plenty of water for the first few hours after the procedure, in order to get rid of small amounts of radioactive material left in the body

When do you need to call your Physician?

If the patient is experiencing an allergic reaction from the radiotracer, please do contact the physician.

What Post-operative Care is needed at Home after the Heart Nuclear Scan radiology procedure?

There is no postoperative care necessary after a Heart Nuclear Scan procedure.

How long does it normally take to fully recover, from the Procedure?

The patient needs no recovery time after the Heart Nuclear Scan medical procedure.

Additional Information:

What happens to tissue (if any), taken out during the Procedure?

No tissue sample is taken during the Heart Nuclear Scan procedure. 

When should you expect results from the pathologist regarding the tissue taken out, during the Procedure?

Since no tissue is removed during the procedure, a pathologist does not get involved in the care of the patient.

Who will you receive a Bill from after the Heart Nuclear Scan radiology procedure?

It is important to note that the number of bills that the patient may receive depends on the arrangement the healthcare facility has with the physician and other healthcare providers.

Sometimes, the patient may get a single bill that includes the healthcare facility and the consultant physician charges. Sometimes, the patient might get multiple bills depending on the healthcare provider involved. For instance, the patient may get a bill from:

• The hospital, where the procedure is performed
• Radiologist or cardiologist, performing the procedure
• Healthcare providers, physicians, who are involved in the process

The patient is advised to inquire and confirm the type of billing, before the Heart Nuclear Scan procedure is performed.