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Nuclear Stress Test - Risks & Limitations

Are there any risks associated with nuclear stress tests?

The tests involves exposure to radiation. The amount of radiation you are exposed to during cardiac diagnostic tests is considered safe. The benefits of the test far outweigh any potential risks, and the technicians are trained to minimize your radiation exposure. For information on radiation safety, see National Institutes for Health Radiation Fact Sheet.

Does the nuclear stress test have any limitations?

If you are obese or have large breasts, the tissue may muffle the radioactive energy of the thallium or sestamibi, making it appear that it is not being absorbed as well, leading to a false positive—the tests detects a problem but in reality there is none. Some obese patients may be too heavy for the scanner table; the weight limit is about 300 pounds (lbs).

References

1. Geleijnse ML, Elhendy A, van Domburg RT, et al. Prognostic significance of normal dobutamine-atropine stress sestamibi scintigraphy in women with chest pain. Am J Cardiol. 1996;77:1057-1061.
2. Groutars Ra, Verzijlbergen Jb, Muller Ab, et al. Prognostic value and quality of life in patients with normal rest thallium-201/stress technetium 99m-tetrofosmin dual-isotope myocardial SPECT. J Nucl Cardiol. 2000;7:333-341.
3. Amanullah AM, Berman DS, Erel J, et al. Incremental prognostic value of adenosine myocardial perfusion single-photon emission computed tomography in women with suspected coronary artery disease. Am J Cardiol. 1998;82:725-730.
4. Giri S, Shaw LJ, Murthy DR, et al. Impact of Diabetes on the Risk Stratification Using Stress Single-Photon Emission Computed Tomography Myocardial Perfusion Imaging in Patients With Symptoms Suggestive of Coronary Artery Disease. Circulation. 2002;105:32-40.
5. Hachamovitch R, Berman DS, Kiat H, et al. Gender-related differences in clinical management after exercise nuclear testing. J Am Coll Cardiol. 1995;26:1457-1464.
6. Hachamovitch R, Berman DS, Kiat H, et al. Effective risk stratification using exercise myocardial perfusion SPECT in women: gender-related differences in prognostic nuclear testing. J Am Coll Cardiol. 1996;28:34-44.
7. Berman DS, Kang X, Hayes SW, et al. Adenosine myocardial perfusion single-photon emission computed tomography in women compared with men. Impact of diabetes mellitus on incremental prognostic value and effect on patient management. J Am Coll Cardiol. 2003;41:1125-1133.
8. Grady D, Chaput L, Kristof M. Results of Systematic Review of Research on Diagnosis and Treatment of Coronary Heart Disease in Women. Evidence Report/Technology Assessment N. 80. Rockville, MD: Agency for Healthcare Research and Quality; May 2003. AHRQ Publication No. 03-0035.
9. Taillefer R, DePuey EG, Udelson JE, et al. Comparative diagnostic accuracy of Tl-201 and Tc-99m sestamibi SPECT imaging (perfusion and ECG-gated SPECT) in detecting coronary artery disease in women. J Am Coll Cardiol. 1997;29:69-77.



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