Editing Cardiac stress test (section)

== Stress testing using injected nuclear markers ==
A nuclear stress test uses a [[gamma camera]] to image radioisotopes injected into the bloodstream. The best known example  is [[myocardial perfusion imaging]]. Typically, a [[radioactive tracer|radiotracer]] ([[Technetium (99mTc) sestamibi|Tc-99 sestamibi]], [[Myoview]] or [[Thallium(I) chloride|thallous chloride 201]]) may be injected during the test. After a suitable waiting period to ensure proper distribution of the radiotracer, scans are acquired with a gamma camera to capture images of the blood flow. Scans acquired before and after exercise are examined to assess the state of the coronary arteries of the patient. By showing the relative amounts of radioisotope within the heart muscle, the nuclear stress tests more accurately identify regional areas of reduced blood flow.<ref>{{Citation |last1=Gupta |first1=Amol |title=Dipyridamole Nuclear Stress Test |date=2023 |url=http://www.ncbi.nlm.nih.gov/books/NBK544321/ |work=StatPearls |access-date=2023-11-10 |place=Treasure Island (FL) |publisher=StatPearls Publishing |pmid=31335041 |last2=Samarany |first2=Samir}}</ref>

Stress and potential cardiac damage from exercise during the test is a problem in patients with ECG abnormalities at rest or in patients with severe motor disability. Pharmacological stimulation from vasodilators such as dipyridamole or adenosine, or positive chronotropic agents such as dobutamine can be used. Testing personnel can include a cardiac radiologist, a nuclear medicine physician, a nuclear medicine technologist, a cardiology technologist, a cardiologist, and/or a nurse. The typical dose of radiation received during this procedure can range from 9.4 to 40.7 [[Sievert|millisieverts]].<ref>{{cite journal |last1=Mettler FA |first1=Jr |last2=Huda |first2=W |last3=Yoshizumi |first3=TT |last4=Mahesh |first4=M |date=July 2008 |title=Effective doses in radiology and diagnostic nuclear medicine: a catalog. |url=https://pubs.rsna.org/doi/pdf/10.1148/radiol.2481071451 |journal=Radiology |volume=248 |issue=1 |pages=254–63 |doi=10.1148/radiol.2481071451 |pmid=18566177 |s2cid=7018130 |archive-url=https://web.archive.org/web/20140804074158/https://pubs.rsna.org/doi/pdf/10.1148/radiol.2481071451 |archive-date=2014-08-04|url-access=subscription }}</ref>