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Exercise Ventricular Function Test
The Exercise Ventricular Function Test evaluates the pumping action of the heart. The heart muscle receives blood supply from vessels called coronary arteries. If these arteries become partially blocked or narrowed, the heart muscle may not receive the blood it needs to function properly. This narrowing of coronary arteries is called coronary artery disease (CAD).
With CAD, the heart muscle may not receive sufficient blood supply during exercise, which may result in chest pain called angina or other symptoms, or may not produce any outward physical signs of the problem. An Exercise Ventricular Function Test is useful in detecting the presence of CAD.
You can have a light breakfast with juice the morning of the test but no caffeine (no tea, coffee, decaffeinated products, soda pop, chocolate or cold medications containing caffeine).
You should bring shorts, jogging pants or comfortable exercise clothing and shoes (preferably running shoes) appropriate for exercising on a bicycle.
Bring a list of all present medications.
Your physician may decide to temporarily discontinue certain heart medications prior to the test. These are discontinued because they may offset the effectiveness of the test. Your physician MUST inform you whether to discontinue these heart medications 48 hours prior to the test. DO NOT STOP any medication on your own without checking with your physician. You may resume taking your medications following the exercise portion of the test and throughout the remainder of the test.
Prior to the test, you will be asked to sign a consent form. Please read it carefully and if you have any questions, ask the technologist or the physician supervising the test. He or she can explain the entire procedure before it begins.
The test consists of two injections. The first injection contains a substance called Stannous Pyrophosphate which is taken up by your red blood cells. It takes 20-30 minutes for the Pyrophosphate to circulate in the blood stream. The second injection contains a radioactive substance called Sodium Pertechnetate Tc99m. The Pyrophosphate helps with the labeling of the red blood cells by Technetium-99m.
Several electrode pads will be placed on your chest after the first set of pictures have been taken. These pads will be connected to an electrocardiograph (ECG) monitor so that you can be watched closely throughout the test.
You will have to lie down on a bicycle bed and a gamma camera, that can detect radiation, will visualize the Technetium which is in the blood in your heart. The camera is positioned close to your chest and a set of four pictures will be taken before you start exercising. It takes 2-3 minutes to take each picture and it is important to lie as still as possible during this time to avoid blurring the images.
You will exercise by pedaling a bicycle which increases its resistance in three-minute stages. As exercise increases, your heart rate and blood pressure will rise. This is a normal response and it will be monitored along with your ECG. A second set of pictures will be taken while you are exercising. These pictures are compared with the first set to assess heart function during exercise and at rest.
You will be encouraged to exercise for as long as you can because this increases the effectiveness of the test. If you experience any symptoms at any time, such as chest pain, shortness of breath or lightheadedness, immediately tell the individual monitoring the test so adjustments can be made.
A written report will be sent to your physician upon completion of the test. Your physician will then explain the test results to you.
The entire test last approximately one and a half hours.
The injection of Technetium-99m results in a small amount of radiation exposure to your body. It is comparable to the amount of radiation you already receive from all naturally occurring sources (food, air, water, the ground and materials).
The exercise portion of the test constitutes a risk factor equivalent to 1,500 kilometers of highway driving.
You will be able to drive after the test. Please inform the technologist if you will be traveling by airplane, train or crossing the border within one week after your test.
An adverse reaction to the Technetium-99m has never been reported. However, infrequent cases of rashes due to the Pyrophosphate have been reported. These were treated with no further complications.
If you are pregnant or there is a possibility of pregnancy, or if you are breastfeeding, an Exercise Ventricular Function test may be inappropriate for you at this time.