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MUGA

September 23, 2011 in Health Library, Medical Tests

A multi-gated acquisition scan (also called equilibrium radionuclide angiogram or blood pool scan) is a noninvasive diagnostic test used to evaluate the pumping function of the ventricles (lower chambers of the heart). During the test, a small amount of radioactive tracer is injected into a vein. A special camera, called a gamma camera, detects the radiation released by the tracer to produce computer-generated movie images of the beating heart. The MUGA scan is a highly accurate test used to determine the heart’s pumping function.

How should I prepare for the test?

  • There is no special preparation required for this test; there are no medication or food restrictions.
  • Wear comfortable clothes that can be easily removed, as you may be asked to wear a hospital gown during the test.

What happens during the test?

  • A technician will attach electrodes (small, round adhesive patches) to the skin of your chest. Men may have their chest hair shaved to allow a better connection. The electrodes are attached to an electrocardiograph monitor (EKG) that charts your heart’s electrical activity during the test.
  • An intravenous (IV) line will be inserted into a vein in your arm.
  • The technician will ask you to lie on the exam table under the gamma camera. A nuclear imaging technician will draw a small amount of blood, combine it with a radioactive tracer, and inject the mixture into your IV. The radioactive tracer tags your red blood cells, so they can be detected by the camera. The tracer stays in your bloodstream for several hours and does not enter your tissue cells.
  • The camera above the table is focused on the heart and analyzes the amount of radio-labeled red blood cells pumped from the heart with each heartbeat. Several images can be taken to look at you different walls of the heart.
  • This test calculates your ejection fraction, a measurement of how well your heart pumps with each beat. A normal ejection fraction ranges from 50-70 percent. An ejection fraction of 65 percent, for example, means that 65 percent of the total amount of blood in the left ventricle is pumped out with each heartbeat. The ejection fraction may be lower when the heart muscle has become damaged due to a heart attack, heart muscle disease (cardiomyopathy), or other causes.

Are there any side effects from the injections during the test?

Because the injected medications contain only a minimal amount of the carrier drug, there are no significant side effects. The radioactive tracer used during the MUGA scan is a diagnostic dose of radiation that is similar to the dose you would receive during a CT scan.

How long will the test take?

The MUGA scan takes about one to two hours to perform.

What happens after the test?

You can resume your normal activities right after the test.

How will I get my test results?

After the cardiologist reviews your test, the results will go into your electronic medical record. Your referring physician will have access to the results and will contact you to discuss them.

 

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ASBESTOSIS

September 16, 2011 in Health Library

General Information

DEFINITION–Inflammation of the lung due to breathing asbestos particles. It is a chronic disorder, but is not contagious. It may lead to cancer of the lung (likelihood greatly increased in cigarette smokers).

BODY PARTS INVOLVED–Lungs.

SEX OR AGE MOST AFFECTED–Men over age 40 who have been exposed to asbestos.

SIGNS & SYMPTOMS

Early symptoms:

Shortness of breath; cough that produces little or no sputum; general ill feeling.

Late symptoms:

Fitful sleep; appetite loss; chest pain; hoarseness; coughing blood; symptoms of congestive heart failure; bluish nails.

CAUSES–Many years of exposure to small particles of asbestos at work or other sources. The outer part of the lung becomes irritated by the asbestos fibers, leading to inflammation and to a thickening and scarring of the lung tissue (pulmonary fibrosis). Up to 20 years or more may elapse between exposure to asbestos and the symptoms of the disease.

RISK INCREASES WITH

  • Occupations involving asbestos-related industry.
  • Smoking.
  • Excess alcohol consumption.

HOW TO PREVENT

  • During exposure to asbestos, wear a protective mask or external-air-supplied hood.
  • Follow recommended industrial procedures to suppress asbestos dust.
  • Don’t smoke.
  • Participate in a regular physical exercise program to maintain good cardiopulmonary fitness.
  • For workers in asbestos industries, regular scheduled x-rays to detect any shadow on the lungs. If so, the person should stop working with asbestos, even if there are no symptoms.

What To Expect

DIAGNOSTIC MEASURES–

  • Your own observation of symptoms.
  • Medical history and physical exam by a doctor.
  • X-ray of the chest.

APPROPRIATE HEALTH CARE

  • Self-care after diagnosis.
  • Doctor’s treatment.

POSSIBLE COMPLICATIONS

  • Tuberculosis (late stages of silicosis).
  • Heart failure due to lung disease.
  • Lung collapse.
  • Pleurisy.
  • Lung cancer.

PROBABLE OUTCOME–This condition is currently considered incurable. However, symptoms can be relieved or controlled. Scientific research into causes and treatment continues, so there is hope for increasingly effective treatment and cure.

How To Treat

GENERAL MEASURES—-The following measures may relieve symptoms and protect against recurrent lung infections:

  • Obtain medical treatment for any respiratory infection, including the common cold.
  • Practice bronchial drainage. Your doctor will provide instructions.
  • Chest physical therapy techniques will be provided by respiratory therapist.
  • Use an ultrasonic, cool-mist humidifier to loosen bronchial secretions so they can be coughed up easily. Clean humidifier daily.
  • Keep influenza and pneumococcal immunizations up to date.
  • Avoid crowds and persons with infections.

MEDICATION–

  • Your doctor may prescribe: Antibiotics for infections. Bronchodilators (inhaled or oral) with inhalation therapy (supervised at first by an inhalation therapist) to open bronchial tubes to the maximum.
  • For minor discomfort, you may use non-prescription drugs, such as acetaminophen or aspirin.
  • Supplemental oxygen may be necessary.

ACTIVITY–

  • Rest in bed with infections.
  • After treatment, resume normal activity as soon as symptoms improve.
  • Regular exercise in whatever form tolerated is important to preserve lung capacity.

DIET–No special diet.

Call Your Doctor If

  • You have symptoms of asbestosis.
  • The following occurs during treatment: Temperature spike of 101F (38.3C) or more. Increased chest pain or breathlessness. Blood in the sputum. Continuing weight loss.
  • New, unexplained symptoms develop. Drugs used in treatment may produce side effects.

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STRESS TEST (Exercise Electrocardiogram)

August 7, 2011 in Health Library, Homepage, Medical Tests

The exercise Stress Test — also called a stress test, exercise electrocardiogram, treadmill test, graded exercise test, or stress ECG — is a test used to provide information about how the heart responds to exertion. It usually involves walking on a treadmill or pedaling a stationary bike at increasing levels of difficulty, while your electrocardiogram, heart rate, and blood pressure are monitored.

 


Category: Cardiovascular system.
Subcategory: Graphic recording.
Material studied: Graphic recording of electrical activity generated by the heart during exercise.
Estimated cost of test: $200.00.
Patient time for test: 45-60 minutes.
Reliability of test results: Good. Other tests, studies and clinical observations are necessary to establish a precise diagnosis.
Available as home self-test? No.

BEFORE THE TEST

Purpose of test:

  • Helps diagnose cause of chest pain.
  • Determines functional capacity of the heart after surgery or myocardial infarction*.
  • Screens for heart disease (particularly in men over age 35) when no symptoms are present.
  • Helps set limitations for an exercise program.
  • Identifies cause of abnormal heart rhythms that develop during physical exercise.
  • Evaluates effectiveness of heart medications.Where is test performed?
  • Commercial laboratory, hospital, doctor’s office, outpatient or free standing surgical facility.Who performs test?
  • Lab technician, nurse, doctor.Risks and precautions:
  • This test places considerable stress on your heart. It may be a hazardous test if you have a heart aneurysm*, uncontrolled disturbances in your heartbeat, inflammation of the sac surrounding your heart, inflammation of the heart muscle, severe anemia*, uncontrolled hypertension*, unstable angina* or congestive heart failure*. Stop the test immediately if you experience any chest pain, extreme fatigue or other complications.
  • A doctor is available in the testing area at all times.Patient preparation:
  • Activity–Do not smoke for 3 hours before the test.
  • Diet–Do not eat any foods or drink any beverage that contain caffeine or alcohol for 3 hours before the test.
  • Medicines–Inform the person performing the test if you have recently taken any medications listed under Taking these drugs may affect test results. You may be asked not to take this medication before the test.
  • Disrobing–Remove all clothing. Put on surgical gown.

    THE TEST

    Sensory factors:

  • Feeling–Some degree of apprehension or fear is normal and should be expected. Discomfort disappears when the test is finished. Test will cause you to feel fatigued, slightly breathless and sweaty. You may stop the test if you feel extreme fatigue or chest pain.
  • Other senses (touch, smell, hearing, taste, sight)–Not affected.Equipment used:
  • Blood-pressure equipment.
  • Shaver.
  • Alcohol solution.
  • Cotton swabs.
  • Chest electrodes.
  • Electrode paste.
  • EKG machine, with monitor.
  • Lead wires.
  • Treadmill or stationary bike.
  • Adhesive tape or rubber belt.Description of test:
  • You or a close relative will be required to sign a consent form after the procedure has been explained to you.
  • A doctor and emergency equipment are in the testing area at all times during the stress test.
  • Several areas on your chest and possibly your back are cleaned and shaved to prepare the skin for the electrodes. The electrode sites may itch slightly, but you won’t feel any current from the electrodes.
  • Your blood pressure and heart rate are checked periodically throughout the test.
  • Monitor is started.
  • Readings are taken while you are in a resting condition. The pattern of the heartbeat segments recorded is compareä to normal heartbeat patterns.
  • An electrogram (EKG) and blood pressure readings are taken while you walk on a treadmill or pedal a stationary bicycle.
  • Treadmill starts at a slow speed with a flat incline. You walk on it, balancing on a support in front of you. Don’t bear your weight on the support.
  • Speed and slope are increased until your heart reaches a predetermined target rate.
  • Exercise stops. EKG continues to monitor you for 10 to 15 minutes.
  • Electrodes are removed.

    AFTER THE TEST

    Immediate post-test care:

  • You are helped to a chair, where your heart rate and blood pressure are monitored for 10 to 15 minutes.Activity after test:
  • Sites where chest electrodes were attached are cleaned.
  • Resume taking any medications that were withheld before the test.
  • Wait at least 1 hour before you shower. Use warm water when showering because hot water may cause you to feel dizzy or faint.
  • Resume normal diet.Time before test results available:
  • Time before results are reported to the doctor or patient varies from a few minutes to a few days.

    TEST RESULTS

    Test values:

  • Test results are determined by study of EKG tracings following monitored, controlled exercise.Normal values:
  • No unexpected changes on EKG tracings.What ABNORMAL may indicate:
  • Multivessel coronary-artery disease*.
  • Left coronary-artery disease*.
  • Dyskinetic left ventricular wall motion.
  • Severe decrease in circulation to heart muscle.Taking these drugs may affect test results:
  • Beta-blockers*.Other factors that may affect test results:
  • Failure to follow pretest restrictions may hinder the heart’s ability to respond to stress. *See Glossary.

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