MIBI is an acronym for 2-methoxy isobutyl isonitrile and is a pharmaceutical product used in nuclear medicine imaging. A MIBI stress test is used to diagnose coronary artery disease (CAD) or myocardial infarction (MI). As a heart function test it is considered less invasive than an angiography. Current protocols are based on a oneday or two day "stress and rest" test.
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Patients who are not diabetic should fast for four hours before the test. Diabetics should consult their physician about reducing insulin intake for a short time prior to the test. Most importantly, the patient should not ingest any products containing caffeine for 24 hours before the stress part of the test. This includes coffee, tea, chocolate, caffeinated soft drinks and painkillers such as Tylenol. Patients should discuss the possible need to temporarily stop or reduce certain medications before the test, such as blood pressure medication. Patients need to wear gym clothes, and women must ensure that their clothes and underwear have no metal fastenings that could distort the nuclear imaging.
Stress and Rest Test
First, patients are given the stress test. During the test, the heart rate is increased to see how it copes with extra work and the body's increased demand for oxygen-rich blood. For example, a patient may appear to have no heart problems under normal conditions, but the stress test reveals the potential for problems when the heart is under pressure. Patients are given a small injection of the radioactive tracer MIBI in the arm. This has no side effects. This helps to determine if the heart is receiving sufficient blood from the coronary arteries. After 30 minutes the patient's heart is scanned. The patient is then connected to an electrocardiograph (ECG/EKG) machine and a blood pressure monitor. The bike speed is increased every two to three minutes. Shortly before the exercise stops, the doctor administers another MIBI injection. The patient is then given a rest period and a cup of tea or coffee. Diabetics may be given something to eat. Another scan is taken showing parts of the heart not receiving enough blood, or blockages in the arteries leading to the heart. During the rest test, the patient is given another MIBI injection and the heart at rest is then scanned.
The one-day test lasts for approximately three to five hours. The first part takes about one hour followed by a two hour break. The second part of the test takes approximately two hours. The two-day test has test periods of about one and a half hours each day. Patients who are unable to use the exercise bike can still have the test. The doctor injects the patient with a medication that simulates exercise. This is usually Dipyridamole or Persantine. These may produce side effects such as headache, heat flushes and mild angina. According to Heart Scan Information, these side effects are minimised by pedalling gently for a minute or two.
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