What's a nuclear stress test like? Is it safe?

Posted by Gail, Alumni Mentor @baxtersmom, May 17, 2017

I had an EKG and my doctor dictated that it showed the following: Sinus Rhythm 79 PVC Inferior Lateral ST Depression. My doctor has ordered a nuclear medicine stress test because I have some back problems and I was concerned about doing the treadmill stress test. I guess I have two questions/concerns and wondered if anyone might shed some light on either of them. First, what does this dictation that my doctor put in my record mean about my EKG? I have had a benign PVC all of my life but don't know if this is the same thing. I had been feeling like my chest was heavy and very tired, a little breathless sometimes which is why I went in to the cardiologist. Second, has anyone had a nuclear medicine stress test? I am concerned about the side effects and not being able to control them. I read about some of them and saw that the FDA had issued a warning about risks with nuclear medicine stress tests. Then I saw on the Mayo Clinic site that the nuclear medicine test may be more accurate and if the regular treadmill one isn't conclusive, I might end up having to do the nuclear one anyway. It was an ECO stress test I had many years ago when the benign PVCs were discovered. I am really afraid of doing the nuclear test. Please guide me if you can.

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Hi. I can only respond regarding the nuclear stress test which I reluctantly submitted to while in hospital for A-fib. I don’t know what long term side effects are but the actual test did not present anything serious or terribly uncomfortable for me. I remember a headache for a few minutes and a weird feeling for 15 minutes after an injection and that is all. This test was required for me in order to start flecainide for a-fib. I too am wary of tests like these and long term effects and assume that a treadmill test is less risky. I generally do have side effects to most drugs, possibly because I am small, only 100 pounds right now. I hope this helps. Karen

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Hi Gail,
@grandmajan posed a similar question and concerns about the nuclear stress test a while back. See the responses she got from a number of Connect members here: http://mayocl.in/2r7tJu0

I’m also tagging @predictable and @cynaburst on this discussion to help you find answers to the information on your report. Gail, when are you scheduled for the stress test?

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Your doctor probably just wants to make sure that you don’t have any parts of your heart which are damaged and are causing arrhythmia. PVCs are usually benign but with the symptoms you describe your doc is probably just wanting to be cautious and to rule out anything more dangerous.
Nuclear stress tests identify damaged areas in the heart. I haven’t had one but they are used to identify areas of the heart that are damaged. These may cause arrhythmia.

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@colleenyoung

Hi Gail,
@grandmajan posed a similar question and concerns about the nuclear stress test a while back. See the responses she got from a number of Connect members here: http://mayocl.in/2r7tJu0

I’m also tagging @predictable and @cynaburst on this discussion to help you find answers to the information on your report. Gail, when are you scheduled for the stress test?

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Thanks Colleen for getting me all these responses. These largely comport with my experience.

I had the nuclear stress test on Monday last week (May 22nd I believe). It was really no problem at all. They had me walk on the treadmill for just a couple of minutes after injecting me with the medicine that speeds up your heart and simulates the exercise portion because they said it minimizes the effects of the medicine. My legs got a little heavy for about a minute and I felt a little dizzy but it went away really fast. I was not nauseated or ill in any way. Worst part is not being able to eat beforehand so I was ready for a snack right afterward. Got the results on Tuesday and essentially at rest all the blood flow is fine which indicates no heart damage as I understand it. Under stress there is one small area at the Apex of the Heart where there may be some decreased flow (doctor said it is either that or a shadow from the breast which sometimes causes an artifact in women). So on Tuesday May 30th I am scheduled for an angiogram (heart catheterization) to identify whether there is really a clogged artery and how much. If it is blocked 70% or more they will put in a stent and I will stay one night in the hospital. If no blockage, I will recover for a few hours and go home. I could have gotten on blood thinner but I prefer not to do that if we can figure this out another way. If I don’t have a blockage I don’t want to be on a med I don’t need, plus I would have to keep on getting tested to see if the med was working or not. So I chose the catheterization which my doctor said would be her choice if she were in my shoes. I always ask them this (If it were you……). I am a little apprehensive but I need to get this done because I have to have an Endoscopy to check a couple of things every two years and my gastroenterologist won’t do it without a clearance from the cardiologist. If there is not blockage, it is likely my hiatal hernia that is causing the pressure in my chest. Only the endoscopy can tell us if the hernia has changed since we last looked. If anyone has had angiogram, I would be curious to hear their experience as well.

I thank everyone for their information and replies.

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@cynaburst

Your doctor probably just wants to make sure that you don’t have any parts of your heart which are damaged and are causing arrhythmia. PVCs are usually benign but with the symptoms you describe your doc is probably just wanting to be cautious and to rule out anything more dangerous.
Nuclear stress tests identify damaged areas in the heart. I haven’t had one but they are used to identify areas of the heart that are damaged. These may cause arrhythmia.

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@gailg, our friend @cynaburst is right on point, I think. Your initial diagnosis raised questions that are best answered by observing the heart doing its work. Some degree of coronary insufficiency may be suspected, and your follow up stress test and impending catheterization is providing important additional information. Stay at it! What did your doctor say about advantages and disadvantages of “blood thinners” in your situation? We’ll be interested in how things are going in the days ahead.

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VA scheduled me for a nuclear chemical stress test. Had been told not exercise or to lift over 20 lbs.
I asked about the "stress" part of the test but was only answered it dilates vessels and slows heart beat.
Is a stress test safe?

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@bummed

VA scheduled me for a nuclear chemical stress test. Had been told not exercise or to lift over 20 lbs.
I asked about the "stress" part of the test but was only answered it dilates vessels and slows heart beat.
Is a stress test safe?

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It is my understanding that the chemical stress test is given when a physical stress test might put the patient at risk. I don't know if it is "safe" but it was developed to be safer than the physical stress test. Good luck with your testing.

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@bummed

VA scheduled me for a nuclear chemical stress test. Had been told not exercise or to lift over 20 lbs.
I asked about the "stress" part of the test but was only answered it dilates vessels and slows heart beat.
Is a stress test safe?

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Hi, I had this particular test done 6 years ago and I'm here to tell the story. Don't worry, you're going to be ok!

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@bummed

VA scheduled me for a nuclear chemical stress test. Had been told not exercise or to lift over 20 lbs.
I asked about the "stress" part of the test but was only answered it dilates vessels and slows heart beat.
Is a stress test safe?

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Hi @bummed, welcome. According to this information, A nuclear stress test is generally safe, and complications are rare. As with any medical procedure, there is a risk of complications … Read more here under the heading "Risks": https://www.mayoclinic.org/tests-procedures/nuclear-stress-test/about/pac-20385231

@degarden_girl is right that it was developed to be less risk and @twojunes2 is hear to tell you that it's okay. @baxtersmom @predictable @tennisplayer @wisconsin2267 may also have more to share about what the test is like.

I think your concern is specific to the worry that you have a 4.8 cm aneurysm and feel that this may be too much. You may be interested in this Video Q&A with Mayo experts
– Video Q&A about Thoracic Aortic Aneurysms https://connect.mayoclinic.org/webinar/video-qa-about-thoracic-aortic-aneurysms/

Bummed, how long have you known that you have a aneurysm? What changes are you making to stay healthy?

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@bummed

VA scheduled me for a nuclear chemical stress test. Had been told not exercise or to lift over 20 lbs.
I asked about the "stress" part of the test but was only answered it dilates vessels and slows heart beat.
Is a stress test safe?

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had major motorcycle accident 8 13 2017, imaging at hospital then listed heart as normal. Va echo sept 13 2020 shows 4.8cm ATA, had a 2 minute discussion not to exercise or lift more than 25 lbs. I when to the VA for a NCST. I asked if I'm not supposed to exert and this stress test dilates and slows the heart and in constant Afib ( misses a beat every 4 to 5 beats ) they could would not say it's safe…
It appears to me the Nuclear doctor was not working with Cardiology. I understand the normal risks but don't want to add more thanks

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