Stress Nuclear Imaging in the Evaluation of Suspected Coronary Artery Disease
Dante J. Graves, MD, FACC
Stress Nuclear Cardiac Imaging
Stress nuclear imaging is well established as a testing modality in the evaluation of suspected coronary artery disease (CAD), with over 40 years of data correlation. It compares well in effectiveness with other imaging modalities.1,2 Its main usefulness is in patients with abnormal electrocardiogram (ECG) and intermediate pretest risk for CAD. Both exercise and pharmacologic stress can be used, with treadmill exercise being the preferred method.
Contraindications for nuclear stress imagining include:
Unstable angina
Decompensated heart failure
Systolic blood pressure >220 mm Hg
Diastolic blood pressure >110 mm Hg
Uncontrolled cardiac arrhythmia
Severe symptomatic aortic stenosis
Acute pulmonary embolus
Acute pericarditis
Severe pulmonary hypertension
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