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What Is a Persantine Stress Test?

By Mandi Rogier
Updated Mar 03, 2024
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A Persantine stress test is a medical procedure used to detect any blockages in the heart’s major arteries that may indicate coronary artery disease and other cardiac problems or complications. It works by measuring electrical outputs, both those emitted naturally by the heart and those measured against an injected substance. The procedure is almost entirely passive for the patient. He or she must typically lie still and submit to monitoring, but no other action is usually required. From start to finish the procedure usually takes about around three hours, and usually requires a follow-up after a few days. This sort of stress test is thought to be generally safe, but it is more invasive than other, typically exercise-based, means of heart function measurement. Patients who are able to walk or jog on a treadmill are often encouraged to participate in an activities-based stress test that doesn’t involve intravenous monitoring.

Main Reasons for Performance

Heart disease is a serious concern for many people, and coronary problems are the leading cause of non-accident related death in many parts of the world. Stress tests are one way to measure the heart’s output and how hard it’s having to work in various scenarios. In most cases, the “stress” referred to isn’t related to mental or emotional stress felt by a patient, though this can often lead to heart strain over time. Rather, it refers to the physical strain exerted by the muscle, which is often dictated by things like thickness of the arterial walls and blockages.

There are a number of reasons why doctors and other healthcare providers might suggest that a patient undergo a stress test. Symptoms such as chest pain, upper back pain, and shortness of breath may lead a patient's healthcare provider to order a test for heart problems; age and certain lifestyle choices might also be triggers. Most patients perform an exercise-based stress test, which involves running on a treadmill while attached to monitors. Those who are unable to use the treadmill due to incapacitation, severe arthritis, or exercise intolerance can use the Persantine stress test instead.

How Measurements are Taken

The Persantine stress test can be a rather lengthy procedure, taking up to three hours. Patients taking the test are connected to a series of electrodes on the chest, ankles, and wrists. These small patches are attached to a belt worn around the patient's waist. This allows the technician to monitor heart rate and rhythm with the use of an electrocardiogram (EKG) throughout the test.

After a resting period of 20 to 45 minutes, the patient is given Persantine and thallium, two pharmacological compounds, intravenously. Persantine helps to dilate or widen the coronary arteries in much the same way that exercise would in the more traditional treadmill test. Thallium is mildly radioactive and helps to trace the flow of blood, allowing the practitioner to see which parts of the heart are getting the appropriate amount of oxygen. Some side effects may occur, including headache, chest discomfort, dizziness, and rashes, and, in rarer cases, nausea and vomiting.

How Results are Used

About an hour after the intravenous line is started, a special type of camera is used to take a series of images of the patient's heart. Within the next three days, a second appointment will be scheduled for additional pictures. The follow up appointment can take as long as two hours, though it is often completed in a shorter time.

The images will usually be analyzed by medical professionals and technicians to look for signs of blockages or other problems. Most of the time the images can give a very detailed view of what’s going in the arteries and heart chambers, and are an important diagnostic tool. From here, medical teams can put together personalized care plans to help resolve patient issues.

Tips and Advice for Patients

Physicians will usually provide detailed instructions for test preparation, but in general, prior to the test, patients are usually advised to fast from all food or liquid for at least 3 hours, and caffeine and alcohol should not be consumed for a minimum of 6 hours before the procedure’s start time. Food, beverages, and particularly stimulants can skew the results. In addition, lotions, powders, or oils should not be applied to the chest area the day of the test as these can affect the electrodes attached to the skin. Many medications, such as beta blockers, should be suspended for several days before a Persantine stress test. Patients on a special diet or those taking insulin will also need to adjust their habits to accommodate the test.

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Discussion Comments
By anon934340 — On Feb 20, 2014

I have had this test before and it is a piece of cake. I am a type 1 diabetic and also have had a kidney transplant. I was in and out of the hopstial within three hours of the persantinine stress test and we found out I had a narrowing of one of my arteries. It was no big deal at all and I was so glad to have the test done. The worst part of it was getting the IV. I've been a diabetic for 40 years and I still hate IV's. If you need to have this test done, the sooner the better and there is nothing to be afraid of.

By burcinc — On Jun 29, 2011

@alisha-- Diabetes patients are generally worried about this test but most doctors are more lenient with food when the patient also has diabetes. I know that the doctors at my hospital are. They allow diabetics to have a small breakfast and also a snack while they are at the hospital so that their blood sugar doesn't rise suddenly during the stress test.

Something else that patients usually worry about is the radiation they are getting from the test. A tiny amount of radioactive material has to be given to the patient in this test because that's how the camera can take images of your blood flow and heart. It locates the radioactive material in your bloodstream and follows it. You get the same amount of radiation from this as you would from an x-ray and it doesn't remain in the body for long.

By SteamLouis — On Jun 26, 2011

I had the persantine stress test done recently. My doctor wanted to check what the situation was with my coronary artery disease, if any arteries were blocked or narrower than usual.

The test went along just fine for me. My appointment was in the afternoon, so I had my breakfast but skipped lunch. The nurses attached the patches and gave me one of the medicines via IV, I waited for about half an hour and a camera took images of my heart. Then, the other medicines were given, I waited for about an hour and again more images were taken. That was it.

I took some magazines with me and read those while I waited for the medicines to take effect. But it was not as tiresome as I thought it would be. The doctor and nurses were really great too, they were friendly and I was very comfortable throughout the test. There is nothing to be afraid of. If your doctor needs this heart test, don't shy away from it. If there is a blockage in the arteries, the sooner they find out about it, the better it will be for you.

By discographer — On Jun 25, 2011

Wow, this sounds like a difficult procedure to go through. I have high blood pressure and I have done the treadmill test before. That test was very hard for me, my blood pressure rose very quickly, I turned red and my doctor asked me to stop in the middle of it. I don't think the treadmill test is suitable for me. But I don't know if I would want to do the persantine stress test either.

I already get stressed out in hospital settings and my blood pressure rises more than usual. I'm also a diabetes patient. Not taking my blood pressure medicines for several days, not eating the day of the test and staying at the hospital for six hours seems impossible. I don't think I could get through this test either!

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