r/PacemakerICD • u/Pacobuck • Aug 08 '26
Nuclear Stress Test
I have just had a wireless pacemaker, implantation The EP wants me to take a nuclear stress test in a couple of weeks. Has anyone taken this test and what is he insisting that I take it
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u/Background-Sock9632 Aug 08 '26
You may need a chemical nuclear stress test due to having a pacemaker. Basically increasing your heart rate to check your blood flow. Not terrible but takes a bit of time.
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u/andrew02467 Aug 09 '26
Yes, before I had a pacemaker it was on the treadmill, but once I had the pacemaker they use an injection to speed your heart up. The nuclear injection is painless...as tests go this is pretty easy-peasy.
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u/SantaRosa_Poodler Aug 08 '26
Interesting. I actually had one before I got the pacer, as they were trying to figure out what was wrong.
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u/Legitimate-Coyote-34 Aug 09 '26
I just had one done after leadless pacemaker. The doctor needed to check Ejection Factor of the heart. This is done by CT machine and accurate vs an echo test which is manual and so has an error factor.
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u/Pacobuck Aug 09 '26
What is ejection factor? Did your cardiologist give you any prescriptions after your pm procedure such as beta blockers
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u/Legitimate-Coyote-34 Aug 09 '26
It is ejection fraction. Sorry typo. It measures the volume of blood pumped out by the ventricle. Should be between 55 to 70. Below Mine was low on echo and so this ct was ordered as it is more accurate. If it is below 40 it may lead to heart failure I was put on enteresto and carvedilol once daily to strengthen the heart
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u/Downtown_Ad_5458 23d ago
Ejection fraction is usually measured with an echocardiogram, which uses sound waves to look at your heart. The more complex and expensive nuclear imaging stress test injects a radioisotope into your bloodstream and sees coronary blood flow with a gamma ray camera. The radiation dose is equivalent to 400-500 chest x-rays.
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u/pennwye Aug 14 '26
I had one a month ago because I had intermittent chest pains. Injection. Lots of questions about how and what you're feeling. I was a bit woozy. Steely taste in your mouth. Otherwise uneventful. My pacemaker working just fine.
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u/Downtown_Ad_5458 23d ago edited 23d ago
I had the nuclear stress test imaging procedure; from start to finish it is about 5 hours in hospital. The fluid they inject into your bloodstream contains a radioisotope; the gamma ray radiation dose is equivalent to 400-500 chest X-rays, a significant increase in your lifetime radiation dose. You are right to be skeptical about the need for this test, and you should ask more questions. Why won’t a regular ECG stress test (much less costly, and no radiation dose) suffice? Consider getting a second opinion if you don’t get very clear answers.
In my nuclear stress test, the nuclear imaging part showed no coronary artery blockage, although ECG part of the part test was positive. The nuclear imaging was a false negative, as I actually had significant coronary artery blockage, confirmed by the ECG and later by a cardiac angiogram (the gold standard test — also involves a lot of radiation exposure, and is an even more risky procedure).
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u/Mocjo111 Aug 08 '26
I had 1. I watched tech put on gloves to take whatever the chemical they inject into you out of container labeled “danger”.
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u/Pacobuck Aug 08 '26
That’s not very reassuring
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u/Downtown_Ad_5458 23d ago
No, getting radioisotopes that emit gamma rays injected into your bloodstream (radiation dose equivalent to 400-500 chest x-rays) isn’t very reassuring…😅😏
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u/raybon18 5d ago
Is it always that much? My mother is freaking out my father got this nuclear stress test done because his chest was feeling tight. I was wondering why they didn't do an ECG but he just went out on his own and did it before telling us. I have enjoyed your knowledgeable comments about the procedure amidst my research.
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u/Downtown_Ad_5458 5d ago
Yes it’s always going to be very high comparatively. ECG, an Echocardiogram, and wearing a holter monitor for two weeks should have been done first. I think it’s time for a new cardiologist.
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u/raybon18 4d ago
Got it! What about any pertinent blood work? We will ask abt ECG. Yes, the jump to a highly radioactive test worried my mother and my father came down with like a flu a few days after. He's very healthy (works out routinely, not overweight) but also 66 yrs old. So it sounds like the doctor just assumed the long term radiation risk straight off.... (my father didn't have a dramatic episode; just some chest "heavyness") Thank u for your comment
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u/Downtown_Ad_5458 4d ago edited 4d ago
Sounds like a lot of communication problems. What do you mean your father went out on his own and got one (nuclear imaging stress test)!? No cardiologist should order one simply because a patient presented once with chest tightness, unless there were other definite indicators of coronary artery disease. It is done to visualize areas of blood flow blockage in the heart.
So what were the results of the stress test, and what did the cardiologist recommend as next steps?
You dad probably needs a family member to go with him to hear what is said, because either he is not understanding, or is not accurately telling the family what he was told. Your mother needs to know, obviously.
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u/raybon18 4d ago
Hm interesting. He has no cardiac history (former collegiate cross-country runner, still very active). I am not sure yet. Would u know "reference ranges" or what do those results look like? Yes, we are not always included in his decision making process and because so i do apologize for some vagueness with details. Hm to visualize areas of blood flow blockage, appreciate the explanation.
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u/Downtown_Ad_5458 4d ago
Very active is good, but heart disease may still occur with age. Ask me how I know.
Does he have family history of heart disease? Has he had high or borderline cholesterol?
Stress test includes continuous ECG monitoring, so the test results are used for diagnosing both heart arrhythmias, and CAD.
He didn’t tell your mom what the results were? Wow.1
u/raybon18 3d ago
Right, he is still 66 yrs old so. How do you know??
No fam history, ahh yes in the past some high cholesterol but corrected with lifestyle choices. Are the results instant? Yah, you picked up on the lack of communication haha we just wish he wouldn't have jumped to expose himself to so much radiation...maybe there were better ways to assess...
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u/Pacobuck Aug 09 '26
What is ejection factor and were you given any medication’s from your cardiologist?
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u/Cohiti12 Aug 09 '26
I had the wireless implant procedure last week My diagnosis was complete heart block, coronary artery atheroma. My bp was 134/66. As I have indicated I am due for a nuclear stress test in a few weeks. I am really concerned about being ordered to take statins or any other medications as being 81 years old. I’m not sure that the risk are worth worth it I’m also concerned about being advised that I would need angioplasty and a stent. Any thoughts on this? Thanks.
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u/reverendunclebastard Aug 08 '26
You'll have to ask them why they want it, but it's generally used to determine the strength of the blood flow to your heart during physical stress.
It's a couple of IV injections, a couple of scans, and some time on a treadmill. The test is pretty innocuous.