EXERCISE
- Install an iv line with saline infusion. Make sure the needle is in the vein lumen to avoid infiltration.
- Standard ECG stress monitoring by cardiologist.
- Employ Bruce or Naughton protocol, according to patient's clinical condition. See maximun age predicted heart rate.
- Administer the radiotracer at maximun stress, keep exercise level for 60-90 seconds after injection. In patients who do not experience angina nor ST depression and that do not reach 80% or more age predicted heart rate, it has been demonstrated better sensitivity, injecting 1 mg of atropine to induce tachycardia. Excercise level is kept for 2 min after atropine and the radiotracer is given 60-90 sec after atropine.
- Start spect acquisition 15 min after the 99mTc sestamibi injection. Food before acquisition is not necessary.
References:
de León, Gustavo et al. Submaximal Exercise Testing Plus Atropine in Myocardial Perfusion SPECT. Rev Esp Cardiol. 2010;63(10):1155-61
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