Thallium exercise stress test

Thallium exercise stress test (stress thallium test, perfusion scan): A thallium stress test combines nuclear scanning with exercise on a treadmill or stationary bicycle to assess heart function.

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Your doctor uses a thallium stress test to:

• Determine if there is adequate blood flow to your heart during increasing levels of activity
• Evaluate the effectiveness of your cardiac treatment plan
• Determine the likelihood of having coronary artery disease and the need for future testing

What to expect:

Ten small areas of your chest are cleaned, and small sticky electrode patches are attached to these areas. Men may have their chest partially shaved to help the electrodes stick. The electrodes are attached to an electrocardiograph (EKG) monitor, which charts your heart's electrical activity during the test.

Your blood pressure and EKG recording will be taken before, during, and after exercise. You will walk on a treadmill or pedal a stationary cycle. The degree of difficulty will gradually increase. You will be asked to exercise very hard, until you are exhausted. At regular intervals, the lab personnel will ask how you are feeling. Tell them if you feel chest, arm, or jaw pain or discomfort; shortness of breath; dizziness; lightheadedness; or any other unusual symptoms. It is normal for your heart rate, blood pressure, breathing rate, and perspiration to increase during the test. The lab personnel will watch for any symptoms or changes on the EKG monitor that suggest the test should be stopped.

At your maximum level of exercise, a small amount of thallium is injected into a vein. The thallium travels through the bloodstream, reaching the coronary arteries and then the cells of the heart muscle. A camera detects the distribution of thallium in the myocardium. Because the thallium works as a tracer to indicate the areas of the myocardium that blood is reaching, regions that show less thallium have a loss of perfusion, or blood flow.

After the test you will walk or pedal slowly for a couple of minutes to cool down. Your heart rate, blood pressure, and EKG will continue to be monitored until the levels begin returning to normal. The appointment lasts about 60 minutes, with the actual exercise time usually taking between seven and 12 minutes.