78451 Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, at rest or stress (

Name of the Procedure:

Myocardial Perfusion Imaging, Tomographic (SPECT)
Common names: SPECT MPI, Stress Test Imaging, Cardiac Nuclear Scan

Summary

Myocardial perfusion imaging using SPECT is a non-invasive test that evaluates blood flow to the heart muscle both at rest and during stress. It helps determine if the blood flow to the heart is adequate or if there are areas of reduced blood supply.

Purpose

This procedure is used to:

• Diagnose coronary artery disease (CAD)
• Assess the extent of damage after a heart attack
• Guide treatment plans for patients with heart conditions
• Evaluate the effectiveness of treatments such as angioplasty or coronary artery bypass surgery

Indications

• Chest pain or angina
• Shortness of breath
• Abnormal results from other cardiac tests
• Presence of risk factors for heart disease (e.g., high blood pressure, diabetes)
• Monitoring of known heart conditions

Preparation

• Avoid caffeine for at least 24 hours before the test.
• Fast for 4-6 hours prior to the procedure.
• Inform your doctor of any medications you're taking; some may need to be paused.
• Wear comfortable clothing and shoes suitable for exercise, if a stress test is part of the procedure.

Procedure Description

1. An IV line will be inserted into your arm to administer a radioactive tracer.
2. You will either rest or perform an exercise activity (e.g., treadmill or stationary bike) to increase heart stress.
3. Images of your heart are taken using a SPECT camera while lying still on a table. This captures how the tracer travels through blood vessels and into the heart muscle.
4. In the case of a rest study, images are taken while you are at rest without exercise.

Tools: SPECT camera, radioactive tracer, treadmill/stationary bike Anesthesia: None required

Duration

Typically takes 2-4 hours, including preparation and imaging.

Setting

The procedure is performed in a hospital or an outpatient imaging center.

Personnel

• Nuclear medicine technologist
• Cardiologist or radiologist
• Nurse or medical assistant

Risks and Complications

Common:

• Minor discomfort from IV insertion
• Mild allergic reaction to the tracer

Rare:

• Arrhythmia or heart attack, particularly if stress testing is involved
• Low risk of radiation exposure

Benefits

• Accurate evaluation of blood flow to the heart
• Helps in early diagnosis of heart conditions
• Guides treatment and management plans

Recovery

• Most patients can return to normal activities immediately after the procedure.
• Instructions on hydration to help flush out the tracer from the body.
• Follow-up with your doctor to discuss the results and any further steps.

Alternatives

• Echocardiography: Less detailed images but no radiation
• Cardiac MRI: Detailed images but more expensive and time-consuming
• Coronary Angiography: Invasive but provides direct visualization of coronary arteries

Patient Experience

• You may feel a slight pinch when the IV is inserted.
• Mild discomfort or fatigue from exercise if a stress test is part of the procedure.
• Generally, no pain during the imaging process.
• Pain management measures are usually not necessary, as the procedure is mostly comfortable.