Cardiac tests (2 day protocol for Myoview/Persantine stress test

All patients weighing 270 Pounds or more may be scheduled for testing over a two–day period (not necessarily two consecutive days) to insure quality heart scans and test results.

First Day: Resting Scan

• For the Myoview stress test, nothing to eat or drink four hours prior to test
• for the Persantine Stress Test, nothing to eat or drink six hours prior to test
• Consent form reviewed and signed
• Intravenous injection of radioisotope, Myoview
• Wait 30 minutes
• 15–Minute Heart Scan
• First Day Testing is completed

Second Day: Stress Test (Two-10 Days after Day One)

• For the Myoview Stress Test, nothing to eat or drink four hours prior to test
• For the Persantine Stress Test, nothing to eat or drink six hours prior to test, and no caffeine for 24 hours prior to test
• Intravenous started in arm by nuclear medicine tech for injection of radioisotope
• For Myoview Stress Test: exercise on treadmill
• For Persantine Stress Test: administration of medication Persantine (in place of walking on treadmill)
• Wait 30 minutes
• Heart scan performed
• Test is completed

The Myoview Stress Test (treadmill) is a diagnostic test to evaluate chest pain or shortness of breath, to detect the presence of early heart disease, to assess your functional capacity, or to update the status of your coronary circulation following a cardiac event.

You will receive an intravenous injection of Myoview, a radioactive tracer that identifies areas of decreased blood flow to the heart muscle caused by heart disease. There are no harmful effects from the radioactive substance.

Procedure:

• After the consent form has been signed, an intravenous is started in your arm for use throughout the entire test, approximately five hours. Please remain on the hospital campus throughout the entire test.
• After the IV has been started, you will receive the Myoview injection and then wait 30–60 minutes. The first set of heart scans will be taken. During this 15–minute scan, you will be asked to position your arms over your head. There is a two hour wait period after the first set of scans.
• After the first scan, ECG electrodes will be placed on your chest. You will be connected to the Stress Monitor and a series of ECGs will be taken before, during, and after exercise.
• You will be asked to walk on the treadmill until you reach your maximum heart rate or you need to stop exercise. During exercise, the treadmill will increase in speed and elevation every three minutes. The length of time for your exercise test will depend on your exercise tolerance.
• One minute prior to the completion of exercise, Myoview will be injected into the IV. You will then exercise for a full minute after the injection to circulate the Myoview.
• After exercise, you will have an additional scan for approximately 12 minutes.

Reminders and Preparation:

In order for you to be appropriately prepared for your test, please read all reminders prior to testing.

Very important: If you are unable to keep this appointment, please call (406) 457-4250 48 hours prior to testing.

• Please bring all medications you are currently taking on the day of your test.
• Nothing to eat or drink six hours prior to the test. Failure to follow this instruction will result in cancellation of the test. You may, however, take morning medications with a small amount of water.
• No caffeine or nicotine on the day of test.
• Please wear comfortable clothing and shoes—including a short sleeve shirt or blouse.
• Important: If you are Diabetic, please contact your physician for specific instructions for diet and/or Insulin and other Diabetic medications prior to testing.
• If you are pregnant or currently nursing, please inform your physician or technologist before this study is performed.
• If there is any possibility you may be pregnant, please notify the Cardiology Group Immediately. The test cannot be performed.

If you are of childbearing age you will be asked the time of your last menstrual period. If there is any question regarding irregular or late menstrual period, you may be required to have a pregnancy test (blood test) prior to testing to safely administer this test.

• Please bring a physician note/prescription or referral for this test on the day of the test. If your insurance coverage has changed and a referral is no longer required, a doctor's note/order for a specific test/appointment must be provided to office prior to testing).
• If you have any questions about this test, please call us at 406-457-4250.
• Important: Please remember to report for testing at the time provided to you. This test is timed for each patient. Reporting late—15 minutes or more—will result in rescheduling the test.
• *Please bring a snack with you on the day of your test (i.e., crackers, juice)

Persantine (Dipyridamole) or Adenosine Myoview Stress Test™
(Pharmacologic/Medication Stress Test)

This is a diagnostic test to evaluate chest pain, to detect the presence of heart disease, and to evaluate the degree of damage following a heart attack. This test does not require you to perform any physical exercise. The medication Adenosine or Persantine (Dipyridamole) will be used in place of exercising on the treadmill or bicycle.

By monitoring your EKG, heart rate, and blood pressure at one–two minute intervals and observing your symptoms, the cardiologist can determine your heart's tolerance to increased heart rates, as if you were exercising vigorously.

If you are allergic to Persantine (Dipyridamole), please inform us immediately. If you are taking any medications for your lungs and/or have significant lung disease/asthma, please let us know. Side effects do exist for all medications, including Persantine or Adenosine, and will be completely explained to you.

You will also receive an intravenous injection of Myoview, a radioactive tracer that identifies areas of decreased blood flow to the heart muscle caused by heart disease. There are no harmful effects from the radioactive substance.

Procedure:

• Important: Please inform the Heart Center staff if you are allergic to Persantine.
• After the consent form has been signed, an intravenous is started in your arm for use throughout the entire test.
• You will receive the Myoview injection and then wait 30–60 minutes.
• The first set of scans will be taken and will take approximately 15 minutes. There is a 2–hour wait period after first set of scans.
• EKGs will be performed prior to testing, while sitting, standing, lying down, and after hyperventilation. (It may be necessary to shave small areas of your chest for placement of monitoring electrodes.)
• IV Adenosine or Persantine will be infused over four minutes. Inform the Cardiologist if you feel nauseous, lightheaded/dizzy, and/or if you develop a headache or chest discomfort Should you experience any symptoms/side effects, the antidote to Persantine, Aminophylline, will be given intravenously to reverse the effects.
• During the Adenosine infusion or after the Persantine infusion, Myoview will be injected. After 30–60 minutes, a second set of heart scans will be taken and will take approximately 12 minutes.
• The entire test will take approximately five hours. Please remain on the premises throughout entire test.

Reminders and Preparation:

In order for you to be appropriately prepared for your test, please read all reminders prior to testing.

Very important: If you are unable to keep this appointment, please call (406) 457-4250 48 hours prior to testing.

• Bring all medications you are currently taking on the day of your test.
• Nothing to eat or drink six hours prior to arrival time. No Nicotine on the day of testing.
• No caffeine products for 24 hours prior to the test, because caffeine interferes with the action of Persantine.

Caffeinated prodcts include coffee—with or without caffeine; all forms of tea—with or without caffeine; all chocolate beverages and food; all cola beverages—including sugar-free and decaffeinated) which include Dr. Pepper, Ginger Ale, Mountain Dew, Orange Crush, Root Beer and Tab, Jolt Cola, Mellow Yellow, and Mr. Pibb

Please note: Test will be cancelled if caffeine is consumed within 24 hours of test.

• Medications containing caffeine should be avoided 24 hours prior to the test. These include the prescriptions Cafergot (all forms); Synalogs-DC; Darvon Compound; Wigraine (all forms); Fiorinal and the non–prescriptions Non-Prescription: Anacin, Excedrin, NoDoz

Medications for asthma containing Theophylline should be avoided 36–48 hours prior to the test. These include Aerolate, Bronkodyl, Constant-T, Elixophylline, Quibron-T/SR, Respid, Slo-bid Gyrocaps, Slo-Phyllin Gyrocaps, Sustaire, Theo-24, Theobid Duracap, Theochron, Theoclear L.A., Theo-Dur, Theo-Dur Sprinkle, Theolair-SR, Theospan-SR, Theospan Jr., Duracap, Theophylline S.R., Theovent Long-Acting, Uniphyl

• Important: If you are Diabetic, contact your physician who manages your diabetes for specific instructions for diet and/or insulin and other diabetic medications prior to testing. Please bring a Snack on day of test.
• Specific medications must also be withheld prior to testing and will be reviewed with you by the Staff when your test is scheduled.
• If there is any possibility you may be pregnant, please notify the staff immediately. The test cannot be performed).
• If you are childbearing age, you will be asked your Last menstrual period. Iif there is any question regarding irregular or late menstrual period, you may be required to have a pregnancy test (blood test) prior to testing to safely administer this test.
• Please inform the staff if you have a history of any liver problems/disease—Hepatitis B or C.
• No alcohol, tranquilizers, or sedatives prior to testing.
• Allow at least two hours after your test before engaging in any physical exercise.
• Important: Please bring a physician note/prescription or referral for this test on the day of the test. If your Insurance coverage has changed and a referral is no longer required, a doctor's note/order for a specific test/appointment must be provided to the office prior to testing).
• Wear comfortable clothing, including short sleeve shirt/blouse (for IV access and blood pressures throughout test)
• If you have any questions about this test, please call us at 406-457-4250.
• Important: Please remember to report for testing at the time provided to you. This test is timed for each patient. Reporting late (15 minutes or more) will result in rescheduling test.
• Please bring a snack on day of test (i.e., crackers, juice).