Skip to main content
Cardiolucent

Procedure

Nuclear Stress Test (Myocardial Perfusion Imaging)

Detecting reduced blood flow to the heart muscle

A nuclear stress test (also called myocardial perfusion imaging) combines a stress challenge — either treadmill exercise or a vasodilator medication — with a small dose of intravenous radiotracer to image blood flow to the heart muscle at rest and at stress. Areas with reduced flow at stress reveal narrowed coronary arteries, while areas with fixed defects suggest prior heart damage. The test is highly sensitive for detecting clinically meaningful coronary disease and is one of the most commonly performed non-invasive cardiac tests in the world.

What's Included

  • Resting and stress perfusion imaging
  • Treadmill or pharmacologic stress (typically regadenoson)
  • Continuous EKG and blood-pressure monitoring
  • Same-day or two-day imaging protocol
  • Quantitative analysis of perfusion defects
  • Assessment of left ventricular function from gated imaging
  • Personal review of findings with Dr. Kedan

How It's Performed

The test is performed at a partner imaging center. An IV is placed and a baseline radiotracer dose is given, followed by resting images on a SPECT or PET camera. You then undergo stress — typically treadmill exercise; if you cannot exercise, an IV vasodilator is used instead — and a second radiotracer dose is given at peak stress. Repeat imaging captures perfusion at stress. Total time at the facility is typically 2 to 4 hours.

How to Prepare

  • Avoid caffeine (coffee, tea, chocolate, soda) for 24 hours before the test.
  • Fast for 4 hours; clear liquids and routine medications are usually fine.
  • Hold beta-blockers and certain other medications only if specifically instructed.
  • Wear comfortable clothing and walking shoes in case of treadmill stress.
  • Plan for a 2- to 4-hour appointment.

What to Expect After

There is no significant recovery — you resume normal activity immediately. Drink extra water for the rest of the day to help clear the radiotracer. Dr. Kedan reviews the perfusion images, gated function, and stress EKG personally and walks you through the findings at a follow-up. Results directly determine whether medical therapy, additional imaging, or catheterization is the right next step.

Indications

  • Chest pain with intermediate risk of coronary disease
  • Known coronary disease being reassessed for new symptoms
  • Abnormal or equivocal exercise EKG
  • Pre-operative risk stratification before major non-cardiac surgery
  • Post-revascularization functional assessment
  • Risk stratification after a heart attack
  • Assessment of viability in chronic ischemic cardiomyopathy

Common Questions

Frequently Asked Questions

What is a nuclear stress test?
It is a two-part imaging study that combines stress — treadmill exercise or vasodilator medication — with a small dose of IV radiotracer to image blood flow to your heart muscle at rest and at peak stress. Differences between rest and stress reveal narrowed coronary arteries that limit flow only when the heart works hard.
How is it different from a regular treadmill test?
A standard treadmill test records the EKG and blood pressure during exercise. A nuclear stress test adds imaging of blood flow, which dramatically improves accuracy in detecting coronary disease and provides a map of which arteries are affected.
How long does it take?
Plan on 2 to 4 hours at the imaging center. Some protocols split rest and stress imaging across two days.
How do I prepare?
Avoid caffeine for 24 hours, fast for 4 hours, and continue routine medications unless told otherwise. Wear comfortable clothing and walking shoes in case of treadmill stress.
Is it painful?
No. The IV placement is a brief pinch, the radiotracer is painless, and the imaging itself is silent and motionless. Vasodilator medication can cause a brief flushing, headache, or shortness of breath that resolves within minutes.
What are the risks?
Risks are very low. They include the small radiation dose of nuclear imaging, possible side effects from the pharmacologic stress agent (transient flushing, headache, breathlessness), and the same low cardiac risks of any stress test. The procedural team monitors you continuously.
What does the result show?
Rest and stress perfusion images that highlight any regional reduction in flow, the size and location of any defect, whether it represents ischemia or scar, and quantitative measurements including ejection fraction and wall motion.
Who interprets the study?
A nuclear cardiologist generates the report, and Dr. Kedan reviews the images personally and integrates the findings into your overall plan.
When will I get the results?
Typically within 24 to 48 hours of the test. Dr. Kedan reviews them with you at a dedicated follow-up — often the same week.
How do I schedule one?
Call Cardiolucent at (310) 304-5555. The test is ordered after a clinical evaluation and coordinated at a partner nuclear imaging facility.

Explore

Related Procedures

Find out if reduced coronary blood flow is causing your symptoms.

Schedule with Dr. Kedan in Beverly Hills.
Schedule an Appointment

Medical Disclaimer

The information on this site is for general educational purposes only and is not medical advice, diagnosis, or treatment. Reading this site does not create a doctor–patient relationship. Always consult a qualified healthcare professional for personal guidance. If this is an emergency, call 911. Mentions of medications, devices, or procedures are informational and not endorsements. Full medical disclaimer.

†Some listed indications involve investigational/off-label use. Learn more.