What Is a Persantine Stress Test?

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.

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.

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.

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.

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.