Name of the Procedure:

Cardiac Blood Pool Imaging, Gated Equilibrium (Planar, Single Study at Rest or Stress with Wall Motion Study and Ejection Fraction Analysis)

Summary

Cardiac blood pool imaging, also known as gated equilibrium radionuclide angiography, is a non-invasive imaging procedure. It uses a small amount of radioactive material to create detailed images of the heart's chambers. This helps in evaluating the heart's pumping function both at rest and during stress (either exercise or pharmacologically induced).

Purpose

The procedure is used to assess heart conditions related to the heart's pumping ability. It evaluates the heart's ejection fraction (the percentage of blood leaving the heart each time it contracts) and wall motion (how well the heart muscle moves). It helps diagnose or monitor conditions such as heart failure, cardiomyopathy, and coronary artery disease.

Indications

• Symptoms of heart failure (e.g., shortness of breath, fatigue)
• Monitoring heart function in patients with known heart disease
• Pre- and post-treatment evaluation in patients undergoing chemotherapy
• Assessing the effectiveness of medications used to treat heart conditions
• Patients with suspected or known coronary artery disease

Preparation

• Patients may need to fast for a few hours before the procedure.
• Certain medications, especially those affecting heart rate or function, may need to be adjusted or withheld.
• Pre-procedure diagnostic tests like blood work or an ECG may be required.

Procedure Description

1. A small amount of a radioactive tracer is injected into the patient's vein.
2. The patient lies on a table, and a gamma camera is positioned over their chest to capture images.
3. Initial images are taken at rest.
4. If stress imaging is needed, it is done either through physical exercise on a treadmill or stationary bike, or pharmacologically with medication to simulate stress.
5. Additional images are then taken under stress conditions.
6. The images are analyzed to assess the heart's ejection fraction and wall motion.

Duration

The procedure typically takes about 1-2 hours, including preparation and both rest and stress imaging phases.

Setting

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

Personnel

• Nuclear medicine technologist
• Cardiologist or nuclear medicine physician
• Radiologist (for interpretation of images)

Risks and Complications

• Minimal exposure to radiation, considered safe for most patients
• Rare risk of allergic reaction to the radioactive tracer
• Possible discomfort from the intravenous injection
• Rarely, side effects from stress-inducing medications, such as chest pain or palpitations

Benefits

• Non-invasive and relatively safe with minimal discomfort
• Provides valuable information about the heart's function and structure
• Helps guide treatment decisions and monitor the effectiveness of therapies
• Early detection of heart function abnormalities, potentially preventing further complications

Recovery

• No significant recovery time; patients can usually resume normal activities immediately after the procedure.
• Drinking plenty of fluids to help flush the radioactive tracer from the body might be advised.
• Follow-up appointments for discussing results and further action plans if necessary.

Alternatives

• Echocardiography (ultrasound of the heart): Non-radiative, but may not provide as detailed information on ejection fraction.
• Cardiac MRI: Provides detailed images but is more expensive and less widely available.
• Cardiac CT scan: Involves higher radiation exposure and provides more anatomical rather than functional information.

Patient Experience

• Patients might feel a brief sting from the injection of the radioactive tracer.
• Some experience minor discomfort from lying still on the table for an extended period.
• During stress testing, patients may feel typical exercise-related discomfort or mild side effects from the stress-inducing medication.
• Pain management is generally not required, and comfort measures, such as supportive pillows or warm blankets, are provided.