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The Role of Nuclear Cardiology in Treating Heart Disease

Heart disease is the leading cause of death in the US, with more than 500,000 men and women dying from coronary artery disease each year. During the past two decades, major strides have been made in the diagnosis and treatment of heart disease. Nuclear cardiology has played a pivotal role in improving the diagnosis of heart disease, assessing the extent of disease, and in determining patients' prognoses.

Nuclear cardiology uses non-invasive techniques to assess blood flow and potential blockages in the coronary artery, evaluate the pumping function of the heart, and visualize the size and location of a heart attack. It provides your doctor with accurate and detailed information about your heart, and is commonly utilized to evaluate symptoms of chest pain, shortness of breath, congestive heart failure, and arrythmias.

Nuclear Stress Testing

Bruce Mirbach, MD, monitoring patient walking on treadmill during exercise stress

As the patient exercises during nuclear stress testing, images are taken of the heart to assess blood flow to the heart muscle. Exercise may be in the form of walking on a treadmill or riding a stationary bicycle. A “chemical” stress test utilizes the drugs adenosine or dobutamine to provide similar information about the heart's blood flow. This form of nuclear stress testing is used with patients who are unable to exercise rigorously.

A nuclear stress test uses a small amount of an imaging agent [thallium or tetrofosmin (Myoview^TM)], which is injected intravenously during both rest and exercise (or chemical stress). A scanning device called a gamma camera is used to measure the difference in the heart's uptake of the imaging material during rest and exercise (or chemical stress).

Nuclear image of normal cardiac pumping function

If there is significant blockage of a coronary artery, the heart muscle may not receive enough of a blood supply during exercise or chemical stress. This decrease in blood flow will be reflected in the nuclear images. In this way, nuclear stress tests can identify areas of the heart muscle with an inadequate blood supply, as well as areas that are scarred from a heart attack. In addition, because nuclear stress tests measure the amount of heart muscle with a limited blood supply, they can provide valuable information about the pumping function of the heart.

Radionuclide ventriculography (RVG,or “MUGA” scan) is another type of noninvasive nuclear cardiology study. Performed at rest, this study provides more detailed information about the pumping function of the heart and the size of heart chambers.

The Nuclear Cardiology Laboratory at Lahey Clinic

Nuclear stress test demonstrating normal bloodflow to the heart muscle at rest and with exercise

Lahey Clinic's Nuclear Cardiology Laboratory employs the newest, state-of-the-art equipment available today to provide patients and their physicians with the most comprehensive diagnostic information possible.

Nuclear cardiology testing is conveniently available at both Lahey Clinic Medical Center in Burlington, Mass. and Lahey Clinic Medical Center, North Shore, in Peabody, Mass. Recently, both locations have undergone multi-million dollar upgrades to add new cameras and computers and purchase the most advanced imaging agents and medications.

For additional information on Lahey's nuclear cardiology services, please contact the Department of Cardiovascular Medicine at 781-744-8460.