Cardiac Centre Clinics
Myocardial Perfusion Scan (MYOVIEW)
Who
Patients for assessment of known or suspected coronary artery disease. The scan identifies areas of myocardium where ischaemia is inducible under stress. The technique is a powerful predictor of future cardiac events.
We use it mainly in the following situations:
- ECG uninterpretable for ischaemic changes. eg Bundle Branch, Block or paced rhythm, Left Ventricular Hypertrophy or Atrial Fibrillation on Digoxin
- Patient unable to walk on treadmill
- Previous treadmill test equivocal. eg Exercise test at variance with probability of coronary artery disease or inadequate exercise on previous treadmill test
- To assess haemodynamic significance of known coronary stenoses
Who not
Patients with uncorrected anaemia.
3 stress methods are used (see below) and each has its own contraindications. We need to know about:
- Asthma
- Limitations on exercise
- Heart block or tachycardia
- Stroke or peripheral vascular disease
- Weight and BMI
- Drugs
What
Patients are stressed in the presence of a Cardiologist, who chooses the most appropriate method.
We use either:
- Treadmill exercise
- Adenosine infusion with/without arm & leg exercise
- Dobutamine infusion with arm & leg exercise
Technetium-99m labelled Tetrofosmin is injected at peak stress and a gamma camera tomographic image is recorded 1 hour later.
1 week later, tetrofosmin injection and gamma camera imaging are repeated in a resting state. Often the "rest" scan is done before the "stress" one.
Rest and stress images are subsequently computer processed and compared. Scan reports are reviewed by a Consultant Cardiologist
When
Rest scan: Tuesday afternoon
Stress scan: Tuesday morning
How
Patients are often referred from a Chest Pain Clinic or as part of a hospital discharge plan. Others are identified by a Cardiologist.
Appointments are sent by post from the Nuclear Medicine Department, telephone 01225 824077
Where
Stress scan:
Rest scan:
Preparation
Non-diabetic patients are asked to take only water on each test morning, and diabetic patients take a light breakfast.
The appointment letter contains important information about tablets to be omitted on the "stress" test day.