Patient Preparation
- Fasting for 3-4 h previous to stress test it is recommended, to conduct the procedure at baseline condition. This direction is not necessary before the resting spect acquisition.
- Withdraw cardiovascular medications only if indicated by attending physician. In particular betablockers in case of exercise procedure. Allow 5 plasma half lives to pass on each of the pharmaceutical.
- When employing dipyridamole or adenosine (preferred if LBBB or use of betablockers is present) withdraw any food containing xanthines (tea, coffee, chocolate, beverages) for 12 h - 24 h.
- Adjust protocol for CAD diagnosis (stress-rest) or viability assessment (rest).
- To increase tracer myocardial uptake especially when looking for viability, the use of 5-10 mg isosorbide mononitrate sublingually is suggested 10 min before injecting the radiotracer for the resting phase. Alternatively 5 mg sublingual nitroglycerin can be employed. It must be used cautiously in patients on erectile dysfunction medication, those with severe anemia and in cases with aortic stenosis or other preload-dependant cardiac pathologies. Likewise, if the resting viability phase follows stress with dypiridamole. In all these cases, keep patient supine for 30 min after the final acquisition, check blood pressure and allow the patient to shift to the standing position gradually, in order to prevent fainting.
References:
Mut F. Diagnostico de la Enfermedad Coronaria and Gonzalez P et al. Viabilidad Miocardica, in Medicina Nuclear Aplicaciones Clínicas. Ignasi Carrio y Patricio González . Editorial Masson, Barcelona España, 2003, p 39-56 and 105-119, respectively.
Home Index Myocardial Perfusion Spect Mibi Myocardial Perfusion Spect Study Protocol