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Nuclear Cardiology (Nuclear Stress Test)

Nuclear cardiology examines blood flow to the heart through nuclear stress tests.

The experts at UPMC’s Advanced Cardiac Imaging Program at UPMC Presbyterian use state-of-the-art technology, including a D-SPECT® nuclear cardiology camera, to:

  • Get accurate results
  • Develop individual treatment plans
  • Provide ongoing care to patients with a range of heart conditions

Contact the UPMC Heart and Vascular Institute

To request an appointment, contact the UPMC Heart and Vascular Institute:

What Is a Nuclear Stress Test?

A nuclear stress test — also known as nuclear cardiac imaging — measures blood flow to the heart at rest and after activity.

It's one of the most common tests doctors at the UPMC Heart and Vascular Institute use to diagnose and treat many cardiovascular conditions.

How to Prepare for Your Nuclear Stress Test

There are several instructions that you will receive prior to your scheduled nuclear stress test. These include:

  • Tell your doctor about all of the medicines you take and ask if you should make any changes to your medicines, or to your diet, before the test.
  • You may be told not to eat anything for several hours before the test.
  • You may be told not to have any nicotine or caffeine products for 24 hours before the test.
  • Wear comfortable clothing and walking shoes.
  • Do not use powders or lotions on your chest area the day of your test.
  • Bring all of the medicines you take with you to the test.
  • Tell your doctor if there is a chance you could be pregnant.

What to Expect During Your Cardiac Nuclear Stress Test

There are three main steps to a nuclear stress test.

Step One:

  • A technician injects a tracer (a small amount of a FDA approved radioactive substance) into your bloodstream through a vein in your arm.
  • He or she scans then your heart while you're at rest to show how much of the tracer is taken up by the heart. This tells your doctor about the adequacy of the blood supply to the heart.

Step Two:

  • You walk on a treadmill to increase your heart rate.
  • If you aren't able to exercise, you will receive medicine. This will either dilate the arteries in your heart or make your heart beat faster and harder, like it would during exercise.

Step Three:

  • Your technician will give you another dose of the radioactive tracer and scan your heart a second time.

How Long Does a Nuclear Stress Test Take?

Typically, your appointment will take about 2-4 hours. Some of this time is spent in preparation for the test, and in waiting for the tracer in the bloodstream to be taken up by the heart.

The time required for performing the stress test and acquiring the images is about 60 min, but the actual exercise will take between 7 to 12 minutes.

In some cases, the testing may be broken up into two days. 

Nuclear stress test results

After the test, a doctor will read the scan. The types of information that may be obtained from your scan include:

  • Abnormalities in your scan that may indicate blockages in the heart arteries, which may be the cause of your symptoms.
  • The pumping function of your heart.

If you have had a prior scan that is available for comparison, your doctor may be able to get information about the effects of treatment on your heart.

Common results of a nuclear stress test include:

  • Normal blood flow at rest and during activity or stress. This means your heart is getting enough blood to work properly, and that major blockages in the heart arteries are unlikely.
  • Normal blood flow at rest, but not during activity or stress. This means that part of your heart is not getting enough blood when you exert yourself, and you may have blocked arteries, which might be the cause of your symptoms.
  • Abnormal blood flow at rest and during activity or stress. This means that you may have had a heart attack in the past from blocked arteries.

Common nuclear stress test side effects and risks

A nuclear stress test is generally safe, but like any medical procedure it can have risks. These may include:

  • Chest pain during the test
  • An abnormal heart rhythm, or arrhythmia, caused by exercise or the medicine given during the test that usually goes away when the test is over
  • In rare cases, a heart attack
  • In extremely rare cases, an allergic reaction to the radioactive tracer

Conventional Nuclear Stress Testing and New Technologies

During a conventional nuclear stress test, you must lie completely still with your arms above your head in a partially enclosed scanner for 15 to 20 minutes.

New technologies in nuclear stress testing, such as the D-SPECT® camera, allow doctors at UPMC to perform nuclear stress testing with increased efficiency and patient comfort.

Advantages of the D-SPECT® nuclear cardiology camera

The new D-SPECT® nuclear cardiology camera offers many advantages over conventional nuclear cardiac imaging.

Patient comfort

  • Allows you to sit upright in a chair with your arms down while the technician brings the imaging machine to your chest and scans your heart.
  • Lets you be more at ease during the test. Because you're more comfortable, you're less likely to move and disturb the images.

Faster, safer imaging

  • Reduces scanning time.
  • Uses less radiation.

Accurate results

  • Creates high-resolution 3D images that can rotate to show every angle of the heart chamber.

How Much Does a Nuclear Stress Test Cost?

The cost of a nuclear stress test varies depending on your insurance provider. Please call the physician's office to verify insurance coverage and cost.

Learn More About Stress Tests and Nuclear Medicine

UPMC Patient Education Materials:

Additional Resources

Dr. Soman was one of six Indian Americans honored by Kerala Center in New York.
Read the article by The American Bazaar.