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Two primary stress tests utilized are a treadmill test using ECG/electrophysiology metrics and nuclear testing, each have unique sensitivity and specificity values. The treadmill test, employing the modified Bruce protocol , [ 20 ] demonstrates a sensitivity range of around 73-90% and a specificity range of around 50-74%.
Myocardial perfusion imaging or scanning (also referred to as MPI or MPS) is a nuclear medicine procedure that illustrates the function of the heart muscle (). [1]It evaluates many heart conditions, such as coronary artery disease (CAD), [2] hypertrophic cardiomyopathy and heart wall motion abnormalities.
Gated SPECT is a nuclear medicine imaging technique, typically for the heart in myocardial perfusion imagery. [1] An electrocardiogram (ECG) guides the image acquisition, and the resulting set of single-photon emission computed tomography (SPECT) images shows the heart as it contracts over the interval from one R wave to the next.
In stable patients whose symptoms have resolved by the time of evaluation, Technetium (99mTc) sestamibi (i.e. a "MIBI scan"), thallium-201 chloride or Rubidium-82 Chloride can be used in nuclear medicine to visualize areas of reduced blood flow in conjunction with physiologic or pharmacologic stress.
Cardiac magnetic resonance imaging perfusion (cardiac MRI perfusion, CMRI perfusion), also known as stress CMR perfusion, [1] is a clinical magnetic resonance imaging test performed on patients with known or suspected coronary artery disease to determine if there are perfusion defects in the myocardium of the left ventricle that are caused by narrowing of one or more of the coronary arteries.
The underlying principle is, under conditions of stress, diseased myocardium receives less blood flow than normal myocardium. MPI is one of several types of cardiac stress test. As a nuclear stress test, the average radiation exposure is 9.4 mSv, which when compared with a typical 2 view chest X-ray (.1 mSv) is equivalent to 94 Chest X-rays. [83]
A physician may recommend cardiac imaging to support a diagnosis of a heart condition. Medical specialty professional organizations discourage the use of routine cardiac imaging during pre-operative assessment for patients about to undergo low or mid-risk non-cardiac surgery because the procedure carries risks and is unlikely to result in the change of a patient's management. [1]
In a stress MUGA, patients with coronary artery disease may exhibit a decrease in ejection fraction. For a patient that has had a heart attack, or is suspected of having another disease that affects the heart muscle, this scan can help pinpoint the position in the heart that has sustained damage as well as assess the degree of damage.