Pharmacological Cardiac MRI Stress Test

Before the test

• DO NOT smoke on the day of the test, as nicotine will interfere with the results of your test.
• It is extremely important that you refrain from ALL CAFFEINE or products containing CAFFEINE for 48 hours prior to the test such as:
• Coffee
• Decaffeinated products (also contain small amounts of caffeine)
• Tea
• Soft drinks and soda
• Carbonated drinks
• Coke
• Chocolate (all kinds)
• Energy drinks
• DO NOT eat or drink on the day of the test, but you may drink small sips of water to help you swallow your medications.

Please bring with you to your appointment a copy of all your medications, including over-the-counter medications and supplements that you routinely take.

Please follow these guidelines about taking your medications the day of the test:

Medications with caffeine: DO NOT take any over-the-counter medications that contain caffeine (such as anti-migraine medications (e.g. Excedrin, Anacin), diet pills or anti-sleep tablets) for 24 hours before the test.

If you have asthma: Your physician will ask you NOT to take Theophylline for 48 hours before the test. Please plan to bring your asthma inhaler medication to the test.

If you have diabetes: If you take Insulin to control your blood sugar, ask your physician how much Insulin you should take the day of the test. Your physician may tell you to take only half of your usual morning dose and to eat a light meal four hours before the test. If you take pills to control your blood sugar, do not take your medication until the test is complete. Bring your diabetes medication with you so you can take it when the test is complete. You should skip taking your diabetes medication and skip the accompanying meal. Do not take your diabetes medication and, at the same time, skip a meal, as this could reduce your blood sugar significantly.

If you own a glucose monitor, bring it with you to check your blood sugar levels before and after your test. If you think your blood sugar is low, inform the lab personnel immediately. Plan to eat and take your blood sugar medication following your test.

If you take heart medications: DO NOT take the following heart medications on the day of the test unless your physician tells you otherwise, or unless it is needed to treat chest discomfort the day of the test:

• Isosorbide dinitrate (e.g., Dilatrate, Isordil)

Isosorbide mononitrate (e.g., Imdur, ISMO, Monoket) Nitroglycerin (e.g., Minitran, Nitro patches, Nitrostat) Dipyridamole (Persantine, Aggrenox) Stop taking 48 hours before the test Beta-blockers (e.g., Bisoprolol, Carvedilol, Labetalol, Nadolol, Propranolol, Metoprolol, Metoprolol XL or ER, Atenolol)

Your physician may also ask you to stop taking other heart medications on the day of your test. If you have any questions about your medications, ask your physician. Do not discontinue any medications without seeking your physician's advise.

About the test

What is this test?

A Pharmacological Cardiac Magnetic Resonance Imaging (MRI) Stress Test is a diagnostic test used to evaluate blood flow to the heart for people who are unable to exercise or cannot increase their heart rates adequately. The test can help determine if you are getting enough blood to your heart when you are active versus when you are resting. The MRI scan will take about 45 minutes, and your total time in the MRI area may last up to two hours.

What will happen to me during the test?

An MRI nurse will place two intravenous (IV) lines into your arm before starting the MRI scan. A nurse and an MRI technologist will place electrodes (small, sticky patches) on your chest to monitor your electrocardiogram (EKG), and a blood pressure cuff on your arm to monitor your blood pressure.

Then, you will be asked to lay very still inside the MRI scanner for a total of about 45 minutes. You also will be asked to do a series of short breath holds while the MRI scanner takes images of your heart.

Before you receive the medication through the IV, the nurse will talk to you about the possible side effects of the medication so you will know what to expect.

During your test, you will receive a small amount of medication Adenosine, Dipyridamole or Regadenoson to make your coronary arteries widen (dilate), which increases blood flow, in a way similar to the way they do when you exercise. The medication slightly increases your heart rate. A small amount of MRI dye called gadolinium is injected into a vein when you're resting and after you receive the medication. An MRI scanner takes pictures of the gadolinium dye as it passes through your heart muscle, creating computer images of your heart.

Your heart rate, EKG and blood pressure will be monitored throughout the test. The testing area is supervised by a physician.

During the examination, the MRI scanner will take pictures of your heart size, function, blood flow through your heart during rest and during cardiac stress, and it will help determine permanent damage to your heart muscle.

Are there after-test restrictions for me to follow?

There are no restrictions after the imaging test. You may resume your regular diet.

How will I know the results of my test?

Your test results will be sent to the physician who ordered the test. During your follow-up appointment, your referring physician will discuss the results of your test.