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); multiple studies, at rest and/or
CPT4 code
Name of the Procedure:
Myocardial Perfusion Imaging, Tomographic (SPECT)
Common Name: SPECT scan for heart
Summary
Myocardial Perfusion Imaging (MPI) is a procedure using a special camera and a small amount of radioactive material to create images of the heart. This helps doctors see how well blood flows through the heart muscle, both at rest and during stress.
Purpose
This test helps diagnose coronary artery disease, assess damage from a heart attack, and evaluate treatment effectiveness. It determines areas with poor blood flow and identifies the health of heart muscle.
Indications
- Chest pain or discomfort indicative of coronary artery disease
- Shortness of breath with or without exertion
- Previous heart attack, to assess damage
- Monitoring the effectiveness of therapeutic interventions
- Suspected silent myocardial ischemia
Preparation
- Fasting for 4–6 hours before the procedure
- Possible adjustment of medications, as advised by a doctor
- Notify the healthcare provider of any allergies, pregnancy, or breastfeeding
- Diagnostic tests like an electrocardiogram (ECG) might be performed prior
Procedure Description
- Injection of a radioactive tracer into a vein.
- Initial images taken while the patient is at rest using a gamma camera.
- The patient undergoes a stress test or receives medication to simulate exercise.
- Second set of images captured after the stress test.
- Optional evaluation by SPECT to correct any image attenuation.
- Analysis includes qualitative/quantitative wall motion and ejection fraction measurements.
Duration
Approximately 3–4 hours, divided between resting, stress, and imaging phases.
Setting
Typically performed in a hospital nuclear medicine department or an outpatient imaging center.
Personnel
- Nuclear Medicine Specialist
- Radiology Technician
- Cardiologist
- Nursing Staff
Risks and Complications
- Rare allergic reactions to the radioactive tracer
- Minor bruising or infection at the injection site
- Rarely, stress testing may induce arrhythmias or chest pain
- Minimal exposure to radiation but lower than many other radiological studies
Benefits
- Provides detailed images of blood flow and heart muscle health
- Helps detect coronary artery disease early
- Guides treatment decisions, potentially preventing heart attacks
- Immediate results leading to quick adjustments in care
Recovery
- Most patients can resume normal activity immediately after
- Drink plenty of fluids to help flush out the tracer
- Follow-up appointment to discuss results with your doctor
- Avoid strenuous activity until the doctor advises otherwise
Alternatives
- Stress Echocardiography: Uses ultrasound waves and stress testing, but may not be as detailed.
- Coronary Angiography: Invasive procedure providing detailed images but requires catheter insertion.
- CT Angiography: Non-invasive, offers good information but involves higher radiation exposure.
Patient Experience
- Mild discomfort from the IV placement and the stress test
- Lying still for several periods during image acquisition
- Minimal to moderate radiation exposure
- Likely to feel tired after stress testing but generally safe and well-tolerated
Pain management and comfort are prioritized, and staff will provide necessary measures to ensure patient comfort throughout the procedure.