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Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, at rest or stress (exercise or pharmacologic)

CPT4 code

Name of the Procedure:

Myocardial Perfusion Imaging, Planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); Single Study, at Rest or Stress (Exercise or Pharmacologic)

Summary

Myocardial perfusion imaging is a non-invasive test that uses a special camera and a small amount of radioactive material to capture images of the blood flow through the heart muscle. It can be performed while you are at rest or undergoing physical stress (exercise) or pharmacological stress (medication-induced stress).

Purpose

This procedure is used to evaluate blood flow to the heart muscle. It helps to identify areas with poor blood flow, heart muscle damage, and overall heart function.

Indications

  • Chest pain or discomfort
  • Shortness of breath
  • Previous heart attack
  • Known coronary artery disease
  • Irregular heart rhythms
  • Preoperative evaluation before cardiac surgery

Preparation

  • Fasting for at least 4-6 hours before the test.
  • Avoid caffeine and smoking 24 hours before the test.
  • Continue or temporarily stop certain medications as directed by your doctor.
  • Wear comfortable clothing and shoes if an exercise stress test is planned.

Procedure Description

  1. An intravenous (IV) line is inserted to administer the radioactive tracer.
  2. For a resting study, you will lie down while the camera takes images of your heart.
  3. For a stress study, you will either exercise on a treadmill or receive medication to simulate stress on the heart.
  4. Additional images are taken during the stress phase for comparison.
  5. The camera detects the radioactive tracer and produces detailed images.
  6. The technologist may perform quantitative analysis of wall motion and ejection fraction using specialized software.

Duration

The entire procedure typically takes 2-4 hours, with imaging sessions lasting about 15-30 minutes each.

Setting

This procedure is usually performed in a hospital's nuclear medicine department or an outpatient imaging center.

Personnel

  • Nuclear medicine technologist
  • Cardiologist or radiologist
  • Nurses

Risks and Complications

  • Exposure to a small amount of radiation
  • Allergic reaction to the radioactive tracer (rare)
  • Mild discomfort during IV insertion
  • Potential side effects from stress-inducing medication, such as flushing, headache, or shortness of breath

Benefits

  • Helps diagnose coronary artery disease and regions of the heart with poor blood flow.
  • Assists in determining the effectiveness of treatments and procedures.
  • Provides valuable information for planning further treatment or surgery.

Recovery

  • Most patients can resume normal activities immediately after the test.
  • Drink plenty of fluids to help flush the radioactive material from the body.
  • Follow any specific instructions provided by the healthcare team.

Alternatives

  • Echocardiography
  • Cardiac MRI
  • Cardiac CT angiography
  • Each alternative has its own benefits and limitations; discuss with your healthcare provider for the best option.

Patient Experience

During the procedure, you may experience mild discomfort from the IV insertion and a metallic taste from the tracer. If undergoing a stress test, you might feel tired or experience chest discomfort similar to physical exercise. Post-procedure, some patients may feel a bit flushed or experience mild nausea. Typically, these sensations are temporary and manageable. Pain management is usually not necessary.

Medical Policies and Guidelines for Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed); single study, at rest or stress (exercise or pharmacologic)

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