Adenosine Stress Electrocardiography

An Adenosine stress test is a diagnostic exam used to evaluate the supply of blood to the heart muscle. If the arteries that carry this blood become partially blocked or narrowed, your heart will not receive the blood that it needs for proper function. This test may be useful in detecting the presence and significance of coronary artery disease.

You will not be walking on a treadmill. Instead of exercise, you will be given a drug, Adenosine, to stress your heart. Adenosine does have some side effects/symptoms that the technologist will go over with you before the test. These may include: shortness of breath, flushing, nausea, lightheadedness, headache, and/or angina pain. The Adenosine will be given over 4 minutes, and these effects/symptoms will go away quickly when it is stopped. The stress images will be taken 40-50 minutes after the Adenosine infusion.

Two sets of images are taken to allow your physician to compare your heart during rest and stress. There will only be one Adenosine injection. Before both sets of images, you will have to drink approximately 16 ounces of water. This is done to enhance your image quality. You will be asked to lie still on a table for approximately 12 minutes with your arms over your head. Your first images (the resting set) are taken at this time.

When your resting images are completed, the Adenosine is slowly injected over a 4 minute period. If you are experiencing side effects due to the Adenosine, it is important to inform the testing staff. Any possible side effects are short-lived, and there are no lasting effects.

You will be monitored for 4 additional minutes to ensure that your heart rate and blood pressure are within normal limits and any side effects have dissipated. You will then need to wait in the waiting room again. Please bring a book or magazine to read. You may drink water or juice at this time. The second images (the stress set) are obtained in the same way as the first.

LET YOUR CAREGIVERS KNOW ABOUT THE FOLLOWING:

  • Allergies (including allergy to latex)

  • Medications taken including herbs, eye drops, over the counter medications, and creams

  • Use of steroids (by mouth or creams)

  • Previous problems with anesthetics or novocaine

  • Possibility of pregnancy, if this applies

  • History of blood clots (thrombophlebitis)

  • History of bleeding or blood problems

  • Previous surgery

  • Other health problems

RISKS AND COMPLICATIONS

You may develop chest discomfort, shortness of breath, sweating, or lightheadedness during the test. On rare occasions, you could experience a heart attack or your heart may go into a very fast or irregular rhythm. This could cause you to collapse. To ensure your safety, your health care provider will supervise the test. Your blood pressure and electrocardiogram are constantly watched. The test team watches for and is able to treat any problems.

BEFORE THE PROCEDURE

  • For an Adenosine Stress Test, avoid caffeine for 12 to 24 hours before the procedure. This includes Coke Classic, Diet Coke, Pepsi, Diet Pepsi, Mountain Dew, Dr. Pepper, and other caffeinated drinks; all coffee (roasted, instant, decaffeinated roasted, decaffeinated instant); hot chocolate (cocoa); tea; all chocolate (including milk, dark, and Baker's).

  • Do not eat anything 6 hours prior to the test. You may have juice or water at anytime.Eating may cause an unclear image and may also cause nausea. Diabetic patients may have a piece of dry toast and some fruit 2 to 4 hours prior to the test. Consult your doctor as to your insulin dosage on that day.

  • Do not smoke on the day of your test! Smoking on the day of your test may change your test results.

  • Do not take Dipyridamole/Persantine and/or Aggrenox for the 48 hours prior to your test. Take your other medications at your usual time unless your caregiver has indicated otherwise.

  • Bring a list of your current medications, as you may be asked for it.

  • Weara short sleeve, button down shirt that contains no metal, or a loose-fitting T-shirt. Do not wear an under-wire bra or necklace. A hospital gown can be provided.

  • Bring a bookto read, as there are some waiting periods during the test.

  • Shower prior to your appointmentto reduce the spread of bacteria to our equipment.

  • Your total test time will vary, but usually takes approximately 3-4 hours.

PROCEDURE

When you arrive for your appointment, the first step will be to place an IV in a vein of your arm.

Your skin will be gently scratched in preparation for the electrodes that are placed on your chest. These electrodes will be connected to a monitor so that your heart rate and rhythm can be watched closely throughout the test.

AFTER THE PROCEDURE

When your test is completed, you may be asked to schedule an office visit with your physician to discuss the test results, or your physician may choose to call you with the results. Please do not ask the testing staff for your test results, as they are not allowed to discuss them.

SEEK MEDICAL CARE IF:

  • You experience intermittent episodes of palpitations or rapid heart beat without any other symptoms.

  • You develop any type of new rash anytime within 3 days of having the test completed.

  • You experience chest discomfort that is new or unusual.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You have severe chest pain, especially if the pain is crushing or pressure-like and spreads to the arms, back, neck, or jaw.

  • You have sweating, nausea (feeling sick to your stomach), or shortness of breath.

  • Your chest pain gets worse and does not lessen with rest as your angina usually does.

  • You have an attack of chest pain lasting longer than usual despite rest and treatment with the medications your caregiver has prescribed.

  • You wake from sleep with chest pain.

  • You feel dizzy or faint.

  • You have chest pain not typical of your usual angina.