Nuclear Medicine Stress Test

Coronary artery disease (CAD) remained the leading cause of death in the United States and was responsible for 840,768 deaths in 2016. Cardiovascular disease is the number one cause of mortality worldwide, with 17.6 million deaths annually. Cardiac stress testing is an important diagnostic tool for known or suspected coronary artery disease. Eight million nuclear stress tests are performed annually in the United States.While stress testing can be performed in a variety of ways, more commonly performed and widely available are exercise electrocardiography (EKG) and exercise or pharmacological stress testing along with imaging such as echocardiography or radionuclide myocardial perfusion imaging (rMPI). It can help establish the diagnosis, risk stratify, and guide therapy in patients with coronary artery disease.An intravenous radioactive tracer is administered, and gamma photons are captured using single-photon emission computer tomography (SPECT) or positron emission tomography (PET).Myocardial perfusion images are obtained during rest and after stress with either exercise or pharmacological agents, preferably vasodilators. Both the images are then compared to detect myocardial perfusion, viability, and global left ventricular systolic function, which generally signifies the presence and extent of coronary artery disease.