Nuclear Cardiology Division

Nuclear cardiology, a major part of nuclear medicine is mainly represented by Myocardial Perfusion Imaging (MPI). MPI is a non-invasive imaging that can detect presence of coronary artery disease at an early stage. Since 1980’s this institute has been the only government owned referral center in Bangladesh for Nuclear cardiac studies. The MPI test is done in close collaboration with Cardiology department of BSMMU.
Cardiac Studies at NINMAS
• Myocardial Perfusion SPECT {Physical Stress (Tread-mill/Ergometer Bicycle) Pharmacological     Stress (Adenosine/Dobutamine)}
• FDG Cardiac PET for myocardial viability assessment
• Radionuclide Ventriculography (MUGA Scan)
Nuclear cardiac studies are conducted through appointments of patients. Leaflets containing detailed information regarding the preparation of the studies and procedure are provided to the patients in these sessions, prior the tests. It is necessary to make an appointment several weeks ahead of the test.
Patient information for Myocardial Perfusion Scan

• This test is done under the supervision of a specialist doctor.

• The test is done in two phase or episodes which are known as ‘stress’ and ‘rest’.

• In the first episode or ‘stress’, the heart rate is increased in a controlled way through the use of Treadmill (ETT) exercise or intravenous dobutamine (DSE) injection. This may cause the patient to feel ‘palpitation’ for a short period of time. Also intravenous injection of adenosine for four to six minutes can be done in appropriate cases which usually makes the patient to feel a transient ‘hot flush’ instead of ‘palpitation’. At the end of the stage, tracer amount of radioactive solution is injected intravenously. Cardiac scan (SPECT) is done about 30 minutes later, for a period of about 30 minutes through by the state of art gamma cameras.

• Patient is required to lie flat, without a pillow with arms around or below the head throughout the scan time.

• The second episode or the ‘rest’ is done after one or two puffs of spray nitroglycerin aerosol under the tongue. There is a second intravenous injection of radioactive solution. The scan method is same as Cardiac scan (SPECT) is done about 30 minutes later, for a period of about 30 minutes. Patient is again required to lie flat, without a pillow with arms around or below the head throughout the scan time.

Patient preparation:

This is important because we need to get the best image of the heart.
1. Avoid caffeine containing food or beverages (such as tea, coffee, chocolate, cocoa etc.) from the day before test.
2. Oral hypoglycemic agents or diabetes pills (for diabetic patients) should be discontinued from the morning of the test day.
3. The usual morning dose of insulin should be reduced by half on the test day (if the patient is diabetic and on regular insulin).
4. Breakfast on the test day should be completed at least four hours before commencing the test. Breakfast should be a light one e.g. bread and vegetables. Tea or coffee is strictly prohibited.
5. It is comfortable to wear loose fitting cotton garments with front buttons during the test. For example male patients can wear half-sleeved cotton shirts without wearing inner vest.
6. It is convenient to wear walking shoes if the treadmill exercise is selected for the patient.
7. All patients are requested to bring with:
• Medical documents
• Prescribed medicines
• Snacks
• 1½ liter of water,
• 500 ml Seven Up / Sprite,
• 500 ml Chocolate milk,
• A glass and
• A companion.
8. Male patients with hairy chest are encouraged to come with shaved chest for the test.
9. Only the patient who will get an ADENOSINE STRESS TEST should bring
• Inj. ADECARD 6mg / 2ml ampoule usually 12-14 pieces
• Disposable syringe 50 cc TERUMO 1 piece
• Extension set PMO LINE ROMSON 1
• Trichannel 1 piece
• i.v. cannula 22 g 1 piece
10. Some instructions that all patients must abide by till 48 hours after the test are:
• Avoid strenuous or exhaustive work
• Stay away from children (under 12 years of age) and from pregnant ladies
• Flash twice after using the toilet
11. Generally reports are available a week after the test.
12. Appointment can be made in room 909 from Sunday to Thursday 9:30 am to 3:00 pm.
13. Total expense is BDT 9000+. BDT 7000 for the scan, BDT 1400 for ETT, BDT 1800 for DSE and BDT 2500+ for Adenosine stress.
14. There will be consultation session (of 20 minutes) with the patient at least two days before the test.
15. For getting an appointment one has to bring following papers:
• Cardiologist’s requisition
• Echocardiogram
• Fasting blood glucose report
• Echocardiogram reports
• Angiogram report (if there is one)
• Document of intervention e.g. Bypass surgery or angioplasty (if there is one)
• Documents of Hospital discharge (if there is one)
• All other documents related to cardiac treatment.