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Pharmacologic Myocardial Perfusion Stress TestThis test is often requested for patients who are unable to exercise. The medication adenosine (or persantine) acts to dilate blood vessels. There are differences between the responses of normal and abnormal blood vessels to adenosine (or persantine) which may be reflected by differences in blood flow to the heart muscle.For the test a small intravenous tube (IV) is inserted into a vein. The patient then receives an injection of a tracer which travels in the blood and is taken up by the heart muscle. Images of the heart muscle are taken at rest to obtain pictures which represent blood flow to the heart muscle at rest. In order to obtain the images the patient lies under a gamma camera for 20 minutes. A dose of adenosine (or persantine) is then infused over 4 minutes. Some minutes later, a second injection of the tracer is given through the IV. A second set of images are obtained which represent blood flow to the heart muscle with dilated blood vessels. In order to obtain the images the patient lies under a gamma camera a second time for another 20 minutes. All aspects of the test may be performed typically over a 2-3 hour period in one day, or if more convenient for the patient, the test can be performed over a two day period in two 1-2 hour sessions. The test involves exposure to radiation from the tracer (Technicium-99), and the amount of radiation is comparable to that from an abdominal CAT scan. This amount of radiation exposure is considered both reasonably safe and within acceptable limits. Women who are or may be pregnant should inform their physicians and the stress test personnel prior to the test. Many people experience no unpleasant effects, but there are some common feelings patients may have with adenosine (or persantine). These include: burning sensation at the IV site, flushing, headache, nausea, chest or abdominal discomfort, etc. The unpleasant effects are usually tolerable and will go away within a short time after the infusion is completed. In addition, a patient who has unpleasant effects may be given a medication to alleviate the effects. Caffeine, cocoa products, and medications (eg. Theophylline) interfere with and block the intended effects of adenosine (or persantine). Patients who are scheduled for a adenosine (or persantine) myocardial perfusion stress test are asked to abstain from the following for a full 24 hours prior to their test:
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