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In the current scenario of ever rising affluence in the Indian Society and promotion in the economic status of all cadres of our society, there is a certain hike in consumption of a rich / fatty diet and progressively reducing physical activity. As it is health consciousness and the concept of keeping fit has never been a hall mark of Indian Society. In this back drop psychosomatic and metabolic disorders like diabetes mellitus, dyslipidemia and liver dysfunction are on the rise, to the extent that India very soon is going to be a diabetic capital of the world. Similarly coronary artery disease has also increased multifold in the past two decades amongst the Indian Society and there has been a reduction in the age of peak incidence of Coronary Artery Disease (CAD), with more and more younger people falling prey to this dreadful disease. The rising mental stress levels are also contributory to this effect.
Rising incidence of CAD envisages a concrete and reliable investigation which could be used for a large, mass scale screening of high risk patients. This investigation should be relatively non-invasive and affordable by the patients. Myocardial perfusion imaging is one such investigation where the exact blood flow and the perfusion to the myocardial muscles can be determined on exercise and rest.
Myocardial Perfusion Imaging
Increasing prevalence of obesity, diabetics, high blood pressure, high cholesterol and smoking world wide, especially in a developing country like India is leading to an increased risk of coronary artery disease which is caused by inadequate blood supply to the heart, usually caused by blocked arteries. Myocardial Perfusion Imaging (MPI) is one method for identifying the risk of heart disease. The test is usually done in a Nuclear Medicine Departments or Cardiac Clinics. It involves an injection of a small amount of Radiopharmaceutical/Radioactive material, labelled cardiac tracer, which circulates in the bloodstream and shows whether the heart muscle is receiving adequate blood supply under stress and/or in rest conditions.
Diagnostic Radiopharmaceutical
It is a product which, when injected, temporarily collects in a particular organ of the body, (for example, the liver, the lungs, the heart or other organ). As the radiopharmaceutical contains a small amount of radioactivity it can be detected from outside the body using special medical equipment called a gamma camera, and a picture, known as a scan, can be taken. This scan will show exactly the distribution of the radiopharmaceutical within the organ and the body, giving the doctor valuable information about the structure and function of that organ.
Myocardial Perfusion Test
Any stress procedure has some risks and one should always consult a physician regarding the risks and benefits of the procedure. The radioactive materials, Tc99m labelled cardiac tracer for injection and Thallium, have been seen to be safe with low incidence of adverse reactions.
Under certain circumstances, a regular stress test may yield indeterminate results. To improve the diagnostic accuracy, physician may request a myocardial perfusion stress test.
The test usually consists of two parts, after exercising and under resting conditions. The entire test may take one or two days to be completed. Tc99m labelled cardiac tracer for injection are administered by injection during peak exercise and once again while one is at rest. As in a regular stress test, ECG electrodes are attached to the chest which allow the physician to monitor heart rate before, during, and after one has exercised. A blood pressure cuff is placed on the arm to monitor blood pressure before, during and after exercise.
Exercise/Stress Test
The exercise part of the examination is usually done with a treadmill, very similar to a treadmill used at a health club. Exercising begins slowly, and approximately every three minutes, the pace gradually increases. As one exercise’s, heart rate and blood pressure changes. This is normal and is monitored throughout the test. At peak exercise, Tc99m labelled cardiac tracer for injection is injected through an I.V. and the patient is asked to continue exercising for an additional one or two minutes.
Some people, due to disabilities, are unable to exercise adequately enough on a treadmill machine to achieve a diagnostic test result. In such cases, a physician usually decides a course of action for testing. Over the decade with changing life style there has been a increasing trend in heart ailments which has prompted a need for reliable diagnostic measures and access to professional health care. This new approach coronary heart disease diagnosis will add a new dimension to this field, where by one can enjoy better health and longer life.
*Freelance Writer on Nuclear Medicine
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