Nuclear Treadmill Stress Test Pre-procedure Patient Instructions

The Huntsville Hospital Heart Center is located at 930 Franklin Street, Huntsville, AL 35801. Please check in on the 3rd floor. Call (256) 801-6878 with any questions.

Preparation

You may eat a LIGHT meal up to 2 hours prior to your test. However, no caffeine may be consumed 12 hours prior to the test. This includes decaffeinated or caffeine-free products. No coffee, tea, soft drinks, or chocolates of any kind.
Bring a list of all current medications.
No Persantine (dipyridamole) or theophyline 48 hours before your appointment, unless instructed by your physician. Also avoid Viagra, Cialis, and Levitra 24 hours prior to your test.
You should wear comfortable shoes and two piece clothing.
The test is in two parts. The first part will last approximately 3-4 hours; unusual circumstances may require even longer. The second part must be done on another day and will last approximately 1-2 hours. This part of the test is not always necessary, but usually required.
Please limit the number of family members you bring with you to only one person. Space is very limited in the testing area and family must wait in the lobby while test is performed. You will not see your primary cardiologist at the time of the test. A Nuclear Cardiologist will interpret your test and the results will be sent to your cardiologist and or family doctor.
Please let our receptionist know if you have problems with any of the following: memory, falling, speaking English, hearing or vision. There may be a need for someone to stay with you during the nuclear procedures.
Your physician has requested that you ____may or _____may not take your beta blockers for _____24 or ____48 hours prior to testing. Please refer to the back for a list of Beta Blockers.

Test Time: 3-4 Hours
Up to 1-2 hours --- 2nd Day (if needed)

* All procedure times are subject to change based on fluctuations in our schedule and emergency situations involving your physician. It is our intention to begin your procedure at the time listed above.

Test Description and Procedure

Myocardial Perfusion Imaging will allow the doctor to look at the flow of blood through the heart muscle in a series of computer generated images.

The nuclear stress test will assist you and your physician in determining if any heart arteries are narrowed or blocked. An intravenous line (I.V.) will be started for the administration of a radioactive tracer. This tracer is NOT a dye; therefore, no side effects should be experienced. Your chest will be prepped and EKG pads will be placed on your chest. You will walk the treadmill with the speed and slope increasing every three minutes. The radioactive tracer will be administered one minute before stopping the treadmill. Your I.V. will be removed and you may have up to a one and one-half hour wait; reading material may be helpful since this portion of the test is consumed by waiting. While you wait, you will be provided a snack. You will next lie on a narrow bed for 25 minutes, holding still, while a “detector” rotates around your chest, detecting the tracer. If further images are required, you will need to return on another day for a second injection of the tracer without walking the treadmill. Images will be done up to one and one-half hours later lasting about 20 minutes.

Beta Blocker List: (These medications should be held for 24 hours prior to test)
Generic Name:	Brand Name:
acebutolol	Sectral
atenolol	Tenormin, Tenoretic
bisoprolol	Zebeta, Ziac
carvedilol	Coreg, Coreg CR
labetalol	Trandate
metoprolol	Lopressor, Toprol XL
nadolol	Corgard
nebivolol	Bystolic
propanolol	Inderal, Inderal LA
sotalol	Betapace

Pediatric Cardiology

Huntsville Hospital’s award-winning cardiac care program is now serving newborns to 18-year olds. Our Pediatric Cardiology clinic offers:

Management and treatment of acute and chronic cardiac conditions
Electrocardiography
Echocardiogram
Ambulatory arrhythmia monitoring
Exercise testing and more

Physician referral form Contact & Location Information

Telehealth

In today’s busy world, telehealth allows patients to consult with providers virtually, saving time and resources while ensuring high-quality medical care. To help give you the attention you want, the Heart Center provides telehealth appointments for patients via Zoom, a secure video conferencing service. With Zoom, our cardiologists can see, talk with and evaluate their patients from the comfort and safety of your home.

Zoom can be used on any mobile phone, laptop, desktop or other device with a camera, audio capabilities and internet access. If you have an upcoming appointment, you may be contacted by a member of your health care team to discuss your options for participating in a telehealth appointment.

Iliac Vein Compression

930 Franklin Street · Huntsville, AL 35801 · (256) 801-6911

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Iliac vein compression is a condition that affects blood vessels in the lower abdomen. Your arteries move oxygenated blood away from the heart, and your veins bring the blood back to the heart to be re-oxygenated. These arteries and veins cross over each other in the body. This is normally not a problem, but in some cases, the artery compresses the vein, causing it to narrow and have decreased blood flow. When the flow is restricted, blood has more difficulty flowing back towards the heart. This can put you at a higher risk for DVT, or deep vein thrombosis. Iliac vein compression occurs more commonly in the left iliac vein but can affect the right iliac vein as well.

Leg Symptoms

Swelling
Pain
Heaviness or cramping
Changes in skin color or texture
Redness and warmth
Bulging veins

Iliac vein compression is more likely if you

Are female
Have scoliosis
Just had a baby
Have had more than one child
Take oral birth control
Have a condition that causes your blood to clot

Diagnosis
To determine the presence of iliac vein compression, your physician may first order an ultrasound of the lower extremities. If this test is negative, your physician may order a CT scan or Venogram to get a more in-depth look at the vessels in the pelvis.

Treatment
Angioplasty and stent is a common treatment for iliac vein compression. This procedure is performed at Huntsville Hospital Heart Center by cardiologist Michael Ridner, MD. It is done on an outpatient basis and does not require general anesthesia. You can expect to be at the Heart Center for 4-6 hours and then discharged home. You will be scheduled for follow-up visits to check the stents at one week, one month, three months and six months and you will be prescribed blood thinners for a period of at least 6 months. After that time, you may be able to stop blood thinners and will only be required to have yearly monitoring. Since the stents are permanently placed, they will require lifelong yearly monitoring by your physician.

Vascular Services

930 Franklin Street · Huntsville, AL 35801 · (256) 801-6788

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What is Peripheral Arterial Disease (PAD)?

Peripheral arterial disease, also known as PAD, is a narrowing of the arteries in the legs, stomach, arms and head. It is caused by atherosclerosis, which also causes coronary artery disease. Atherosclerosis is commonly called “hardening of the arteries.” This condition is caused by fatty buildup (plaque) in the inner walls of the arteries and causes the arteries to become narrowed or blocked. PAD affects an estimated 18 million people in the United States, including up to 20% of people over age 60. Men and women are affected equally. PAD can occur in any blood vessel but is most common in the legs.

Signs and Symptoms of PAD

Intermittent claudication, which includes leg discomfort, pain, or cramping that occurs with activity, is relieved with rest, and recurs upon resuming activity. The discomfort is often felt in the calves but may also be felt in the buttocks or thighs.
Redness or discoloration of the skin in the lower extremities.
Burning or aching in the feet and toes at rest, especially at night while lying flat.
Cold or numb toes.
Foot or toe sores or ulcers that do not heal.

Risk Factors for PAD

Age (50 or older)
Current or past smoker
Diabetes
High blood pressure
High cholesterol
Coronary artery disease
Family history of stroke or vascular disease
Inactive lifestyle

If two or more of the risk factors above apply to you, your doctor may order tests to determine if you have PAD.

Diagnosis of PAD

PAD is diagnosed with a test called the ankle-brachial index, or ABI, which compares the blood pressure in the ankle and the arm at rest and after exercise. In most healthy adults, the ratio is between 1.0 and 1.4. If PAD is present, the ratio is less than 0.9. When the ABI test indicates PAD, one or more of the following tests may be performed.

Doppler ultrasound. A transducer uses sound waves to image blood vessels to evaluate for blockages.
CT angiogram. A CT scan is taken after administering an X-ray dye to produce detailed pictures of the arteries.

Treatment of PAD

Lifestyle and medical treatments
A diagnosis of PAD indicates that you are at risk not only for mobility problems but also for heart attack and stroke. Here is what you need to do to reduce your risk:
-Exercise. If intermittent claudication makes it hard to walk or bike, you can increase your leg strength and walking speed with a targeted, preferably supervised, exercise program.
-Don’t smoke. Quitting smoking can reduce the risk of PAD by 60% within 10 years.
-Manage chronic conditions. Manage the conditions that contribute to PAD such as diabetes, high cholesterol and high blood pressure.
-Take medications to prevent blood clots. Low-dose aspirin is strongly recommended. Your doctor may also prescribe clopidogrel (Plavix).
Restoring blood flow (Revascularization)
In some cases where PAD is causing severe symptoms, restoring blood flow is needed. This is done by opening up narrowed or blocked arteries with angioplasty, or creating a bypass around the blockage.

Our interventional cardiologists provide comprehensive specialty care in an outpatient setting for patients with PAD. In one convenient location, we offer a full array of diagnostic tests as well as advanced vascular procedures in our state-of-the-art Cath Lab, including:

Angiography, an X-ray based test that produces images of the inside of your arteries to determine if there are blockages.
Angioplasty, where a balloon catheter is used to open blocked arteries.
Stent implantation, where a metal mesh tube is used to support or help keep the artery open.
Atherectomy, where a catheter is used to remove plaque from diseased arteries.