DEFINITION
Adenosine Stress Test is a type of nuclear cardiac
examination conducted to evaluate the heart's response to stress. People with
decreased heart function or those who can not walk long or exercise, it can be
given stressor form of pharmacological agents that make the heart respond as if
they were exercising. In this way, can still be determined how the heart's
response to stress, although one does not do sports.
Adenosine is one of the most widely pharmacologic agents
used to stress test. Adenosine works by dilating blood vessels of the heart and
cause effects such as moderate exercise.
CAUSE
Stress test with pharmacological agents generally do if
there are contraindications to perform stress test with exercise or if the
person is not able to do the exercises due to various physical constraints.
This includes a variety of conditions as follows:
·
Elderly people with decreased heart function
capacity and is likely to have coronary heart disease.
·
People with chronic physical weakness and the
possibility of having coronary heart disease.
·
Young patients with certain physical problems,
such as injuries, arthritis, orthopedic problems, peripheral nerve disorders,
problems in the muscles (myopathy), or peripheral vascular disease, so that the
target maximum heart rate is not easily achieved with regular exercise.
·
People who consume drugs known as beta-blockers
or the like, thus impeding the heart's ability to achieve the expected target.
·
People with pacemakers
Stress tests can be done to:
·
Determine whether there is sufficient blood flow
to the heart when the body activity increases
·
Evaluating the effectiveness of heart
medications in dealing with angina and ischemia
·
Determine the possibility of someone having
coronary heart disease and further evaluation
·
Examine the effectiveness of measures taken to
improve blood flow to the heart in people with coronary artery disease
·
Identify the presence of abnormal heart rhythms
·
Help determine a safe exercise program
SYMPTOMS
Things to know before doing adenosine stress test:
- This test can not be carried out on:
·
People with acute spasm of the respiratory
tract, for example asthma, due to constriction of the airways can be difficult
to overcome
·
People with heart block with a degree> I,
because it can aggravate existing conditions.
·
People with systolic blood pressure <90mmHg,
because it has the potential to make the blood pressure will be lower.
·
People who consume dipyridamole or
methylxanthines (eg caffeine and aminophylline).
·
Pregnant women, the possibility of pregnancy, or
breast-feeding.
- Preparation needs to be done before the examination:
·
Do not eat or drink anything except water for 4
hours before the test
·
Do not drink or eat foods that contain caffeine,
tea, soda, or chocolate since 12 hours before the examination.
·
On the day of the examination, not taking heart
medications such as isosorbide dinitrate, isosorbide mononitrate, or
nitroglycerin, unless the doctor says otherwise.
·
Consumption of other drugs should be with the
consent from the doctor.
·
Use of drugs known as beta-blockers should
consult with your doctor first, if need be stopped for 24 hours before the
examination.
·
If you use an inhaler to ease congestion
(inhaler), then these drugs need to be taken during the examination.
·
Do not smoke on the day of the examination will
be carried out
·
If you have diabetes, then ask if you need to
take diabetes medication on the day of the examination. The drug may be delayed
or lowered until the inspection is completed.
·
If you have the tools to check blood sugar, then
bring the device to monitor blood sugar levels before and after the stress
test.
- Complications that may occur during the inspection
include:
·
Irregular heart rhythms
·
Chest pain
·
Difficulty in breathing
·
Nausea, dizziness, headache, feeling of warmth
in the body, and abdominal pain
DIAGNOSIS
Things that normally happen during the examination of
adenosine stress test:
·
The doctor will explain the examination
procedure beforehand. Ask if there is anything that is still unclear.
·
You will be asked to sign an agreement for
action. Read carefully and ask questions if something is not understood.
·
All jewelry and objects that could interfere
with the examination needs to be removed.
·
Will be given special clothing to wear during
the examination.
·
You will be asked to lie down on the examination
table and then the electrodes ECG (electrocardiography) will be installed to
monitor the heart during stress tests underway.
·
Blood pressure and heart rhythm (ECG) will be
checked first before the stress test starts.
·
An intravenous line will be placed in a vein in
the arm.
·
Adenosine is then given through an intravenous
line with how slowly.
·
After that, the isotopes are also given through
an intravenous line and done taking the picture of the heart by a special
camera.
·
During the administration of adenosine, you may
feel some symptoms, such as chest pain, heat, or discomfort in the abdomen.
This feeling will disappear when the drug is discontinued. Tell your doctor or medical
personnel are there if you feel a symptom.
TREATMENT
Upon inspection, it is advisable to drink enough water and
frequent urination for about 24 hours later, to help remove radioactive
substances from the body.
Do not perform other tests that use radioactive substances
for 24-48 hours afterward.
In addition, you can move back and eat as usual, unless your
doctor recommends something else.
REFERENCE
- A, David. Pharmacologic stress testing. Medscape. 2012.
- M, Thomas M. Heart Disease and Stress Test. Web MD. 2012.
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