Cardiac Stress Profusion Test

Yesterday I had to have an MRI Cardiac Stress Perfusion test at Southampton General Hospital.

Cardiac Stress Perfusion.

I set off from home at 7:30 in the morning as I know how bad the traffic gets around Southampton. The previous day I had driven here & searched for the place I would have to go, so finding somewhere to park was easy, the cost of parking, however, was disgusting.

I was seen almost immediately & after changing into a fetching gown I was soon stretched out on the bed with three lovely nurses getting me ready for the scan. The biggest problem they had, you guessed it, was me. I have had so many blood tests over the last 25 years my veins have all but disappeared & getting a cannula in each arm took quite a while. Eventually, I had to have both fitted in my hands, one in my right, one in my left. If you don't know your hands are one of the most painful places to have them fitted.

When everything had been set up & tested the drug that they put your heart under pressure with was injected into me. At first, I felt no different but quickly got very warm & the nurse told me I had gone bright red. After about a minute my chest got heavy, my breathing became difficult & I felt very hot. The nurses then moved me into the MRI scanner & ran all the tests while getting me to breathe in, hold my breath for different amounts of time, or for as long as I could. The scans were soon done & after being removed from the scanner I was allowed to spend a few minutes resting before getting up & changing back into my clothes & going home.

The scanner feels like you have been jammed inside a large electronic toilet roll & is very tight, there is no room to even move your arms. The nurses speak to you through headphones that they put on you before the scan & can hear your replies. I didn't have a problem at all with the test as I have had them on more than one occasion but I can imagine it would be very frightening for anyone who suffers from claustrophobia.

Now all I have to do is wait for the result.

What is a Cardiac Stress Perfusion MRI?

Magnetic resonance imaging uses high strength magnets & radio waves to scan the body and produce pictures or images. MRI does not use radiation, required for many other types of imaging, and is not known to have any long term harmful effects.

A Stress Perfusion MRI involves the injection of a special dye, often called contrast medium or contrast agent, during the scan. The contrast highlights the heart muscle in areas receiving a good blood supply. Areas receiving relatively less blood do not highlight on the images as well with the contrast, which can be an indicator of ischaemic heart disease (undersupply of blood and oxygen to the heart).

The blood flow (perfusion) to the heart is assessed both at rest and under stress. The stress stage of the test is performed during the injection of a medication called adenosine. This drug has an effect on the heart that simulates or copies physical exercise & combined with contrast that has been injected, can reveal parts of the heart muscle not receiving an adequate blood supply. The rest component of the test is usually performed afterwards, without adenosine, and is used for direct comparison with the stress images.

The test provides your doctor with an indication of what happens to the blood supply to the heart when demand on the heart is increased. This information helps in identifying the presence of ischaemia, and can often indicate the actual blood vessel causing the problem.