PORT HURON HEART CENTER
CARDIOLOGY ASSOCIATES OF PORT HURON, P.C.
Office (810) 985-9681 Fax (810) 985-5310
PATIENT PREPARATIONS FOR CARDIOLITE STRESS TEST
_________________________ is scheduled for a Cardiolite stress test on _____________ at _______ a.m./p.m. An IV will be started and your first dose of Cardiolite will be administered. The Cardiolite is NOT a dye. It is a low level of radioactive solution which will allow us to see if the heart is getting adequate blood supply. There are no reactions or side effects from the Cardiolite and the radiation exposure is minimal. Imaging will begin approximately 45 to 60 minutes after the injection. You will then have your Pharmaceutical / treadmill stress test, where you will be given your second dose of Cardiolite. About 30 minutes after the stress test, a second set of images will be obtained. The entire test will take approximately 3 hours. Be well rested for this test. 1. CAFFEINE:
DO NOT HAVE ANY ALCOHOL, CAFFEINE, OR DECAFFEINATED PRODUCTS
(COFFEE, TEA, SODA POP OR CHOCOLATE) FOR AT LEAST 48 HOURS PRIOR TO THE TEST. YOU MAY DRINK WATER.
2. MEDICINE: Bring a complete list of all your medications. Long acting theophylline compounds (eg.
caffeine, theophylline and theobromine) must be discontinued 48 hours prior to the Cardiolite test. See medication list on the back of this form. DIABETICS REQUIRING INSULIN: If your test is scheduled at or before 9:30 a.m., You
may take half of the usual dose of your long acting Insulin (Lantus, NPH, Lente, etc.) DO NOT TAKE REGULAR INSULIN, 70/30, NOVALOG OR HUMALOG INSULIN. If your test is scheduled for later than 9:30 a.m. please have a light breakfast 4 hours before the exam and take half your usual morning dose of Insulin. DIABETICS REQUIRING ORAL MEDICATIONS: If your test is scheduled at or before
9:30 a.m. do not take your diabetes medication (pills). If the test is scheduled for later than 9:30 a.m., eat a light breakfast (as above) and take half the dose of your diabetes medication (e.g., Micronase, Glucotrol, Glynase, Glucophage, Actos, Avandia, Starlix, Amaryl, Prandin, Januvia, etc.) NO SMOKING or chewing tobacco for 6 hours prior to the test because the nicotine will alter your heart rate.
Wear comfortable loose fitting clothing and good walking shoes. Avoids shirts with metal buttons or zippers please. Bring a sweater if you like as the testing area can be chilly.
6. FOOD: No eating 4 hours before the test. If you would like a light meal 4 hours before the test, it should consist of 2 pieces of toast, jam or jelly and fruit juice. FOLLOWING THESE GUIDELINES WILL HELP INSURE YOUR SAFETY AND WILL AID THE TEST
If you need to cancel or reschedule your appointment, please give 24 hour notice
You are encouraged to direct any questions about the test to
NUCLEAR MEDICINE DEPARTMENT (810) 985-9681
LIST OF MEDICATIONS These Should Not Be Taken 24 hours prior to testing…UNLESS ADVISED OTHERWISE BY YOUR DOCTOR. BRAND NAMES GENERIC NAMES BETA-BLOCKERS
CALCIUM CHANNEL BLOCKERS Calan, Calan SR, Covera, Isoptin, Verelan Verapamil Cardizem, Dilacor XR, Tiazac, ****************************************************************************** The Following Medications Should Not Be Taken 48 hours prior to testing…UNLESS ADVISED OTHERWISE BY YOUR DOCTOR. ****************************************************************************** If you take the medication PERSANTINE – please stop it 48 hours prior to the test. MEDICATIONS USED FOR EMPHYSEMA** Theodur, Slo-bid, Theobid, Uniphyl and all other Theophylline preparations must be stopped 48 hours prior to the test. Discontinue all breathing treatments and inhalers 48 hours prior to the test. (ie, Combivent, Duoneb, Atrovent Ipratropium bromide) ** If having a Dobutamine test, you may take all inhalers and updrafts the day of testing.
Do not take the following medications containing caffeine for 48 hours: Prescribed Over the counter
Aggrenox Excedrin
Fiorinal No-Doz
Cafergot (all forms) Anacin