Cardiac perfusion dobutamine scan What is a cardiac perfusion dobutamine scan? A cardiac perfusion dobutamine scan is a test that helps your doctor see if you have coronary artery disease. Coronary artery disease is a narrowing of the blood vessels that supply oxygen to the heart muscle. If the heart muscle doesn't get enough oxygen, it can cause chest pain or angina. Typically, angina occurs during exercise. We often do this test with a person exercising. However, if exercise is not possible (as in your case), we give dobutamine to simulate exercise. Dobutamine is a substance that affects the heart in the same way as exercise. During the test, a radioactive substance is used to take pictures of the heart. This substance is injected into your blood and travels to the heart muscle through the coronary arteries. We will take pictures of your heart that will help your doctor decide if you have coronary artery disease. How do I prepare for this test? Do not eat or drink anything containing caffeine for 12 hours before this test. This includes coffee, tea, colas, and chocolate. Other things that are not allowed are listed in the box to the right. No caffeine for 12 hours Do not take any of these for 12 hours before your test. Please note: Many “decaffeinated” drinks are also not allowed! Do not smoke for two hours before this test. Do not eat or drink anything (except sips of water) for two hours before the test. May I take my medication? Coffee: regular or decaffeinated, any variety Tea – regular or decaffeinated, any variety Soft drinks – regular or decaffeinated, any variety, of the following: cola, Dr. Pepper, Mellow Yellow, Mountain Dew, Mr. Pibb, Tab Foods – chocolate or cocoa Medicines – Anacin, Excedrin, No Doz, Cafergot (all forms), Darvon Compound, Fiorinal, Synalog DC, Wigraine (all forms) You may be asked to decrease or stop certain medicines for this test. Follow your doctor's instructions about your medication. Do not stop your medication unless your doctor tells you to. You should start all your medicines again after the test is over. Please bring a complete listing of all your medication and doses with you. If you are a diabetic taking insulin or another diabetes medication, please check with your doctor for advice regarding doses before and after this test. Please bring your insulin or oral diabetes medicine to the hospital so you can give yourself the doses recommended by your doctor. 1 What should I wear? Please wear comfortable clothes that break at the waist (shirt or blouse). Electrodes will be placed on your chest so that we can monitor your heart. Women must remove their bras before the test. What happens during the test? There are three parts to this test: taking pictures, receiving the dobutamine, and taking more pictures. 1. For this part of the test, we will put an intravenous (IV) line in your arm. This will feel like a pinprick, like when you have blood drawn. The radioactive substance is then injected through the IV. You will not feel anything from this injection. We will wait 30-45 minutes while the radioactive material circulates through your body. Then we will take pictures of your heart with a special camera for about 30 minutes. You will be lying down for this part of the test. 2. You will be connected to an EKG monitor. We will take your blood pressure many times during this part of the test. Dobutamine will be injected into your IV. You should tell someone if you feel any symptoms. Possible side effects include slight nausea, chest pain, palpitations (fluttering in the chest), or dizziness. If you have symptoms that are severe, we can give you a medicine to reverse the effects of the dobutamine. Immediately after getting the dobutamine, the radioactive substance will be injected again into your IV. You will not feel anything from this injection. You will be monitored for another 15 minutes. You will then wait another 15 minutes in the waiting room while the radioactive substance circulates in your bloodstream. 3. The third part of the test is taking more pictures. You will lie down as before and the camera will take pictures for about 30 minutes. How long will the test take? The test takes a total of 2-3 hours. How should I care for myself after the test? Get help right away if you have any of these problems after your test: chest pain, lightheadedness, dizziness, palpitations (fluttering in the chest), unusual shortness of breath, nausea, or vomiting redness, swelling, or pain from the IV site 2 How do I get the results? Doctors from cardiology and nuclear medicine will review the results and report them to your doctor. Your doctor will explain the results to you. How safe is this test? Nuclear medicine procedures are very safe. Your body is able to eliminate the radioactive materials that are used very quickly. The radioactive dose from this test is about 1.9 rem. This is about the same dose that you would get from most x-rays. The risks from the dobutamine infusions are similar to that of a standard exercise test. During this type of testing, 1 in 5,000 patients have the risk of a serious life threatening complication. However, all precautions are taken to minimize the risk to you. Please visit our website at http://www.bidmc.harvard.edu/radiology/ This material was prepared by clinicians from radiology at Beth Israel Deaconess Medical Center. It is produced and distributed by the Beth Israel Deaconess Learning Center. © 2008, Beth Israel Deaconess Medical Center. All rights reserved. MC0986 09/08 3