Patient Preparation Guide for Exercise Myocardial Perfusion Scan (MPI/MIBI)

What is this test?
This test evaluates the blood flow to your heart muscle at rest and under stress. It helps detect coronary artery disease and assesses how well your heart works during activity.

Why is it important?
An MPI scan helps your cardiologist determine whether your heart receives enough blood during exertion and whether there is damage or reduced blood flow to certain areas. It guides treatment decisions such as medications, angiography, or lifestyle changes.

Before Your Appointment (General)
- Arrive early and bring your photo ID and BC Services Card.
- Avoid perfume, cologne, and scented products.
- Wear comfortable clothes and walking shoes.
- If you need help with English, bring an interpreter who can stay for the entire test. If you do not have anyone who can interpret for you the hposital will arrange this though an app.

Caffeine Restrictions (24 Hours Before Test)
Avoid all caffeine for 24 hours. This includes:
- Coffee or decaf coffee
- Tea or decaf tea
- Energy drinks, cola, and chocolate (ginger ale and 7 Up are ok )
- Some pain medications (Tylenol #1/2/3, Excedrin, Fiorinal, Anacin, Atasol, Cafergot, Dridtan, Ergodryl, Exdol, Novogesic, Frosst 222, 282, 292,  Lenoltec#123, Ratio Tecna, Triatec8/20)


Medication Instructions
Do NOT stop medications unless advised by your doctor.
- Beta blockers and calcium-channel blockers may need to be stopped 24 hours before the test. This is only the case if the cardiologist already asked you to do so. If you are not asked to stop any medications, please continue to take them as usual. In most cases the cardiologist will need to see the scan result with you taking the medication, and patients are rarely asked to stop medications including betablockers.
- Continue using nitroglycerin (tablet or spray) if needed.
- Bring all your medications in their original bottles.
If You Are Diabetic
- Monitor your blood sugar carefully.
- Bring your glucose meter.
- Bring a small snack to prevent low blood sugar.
- Follow the fasting rules but eat minimally if needed to avoid hypoglycemia.
- Inform the staff immediately if you feel unwell during the test.
Fasting Rules (4 Hours Before Test)
- No food or drink except small sips of water.
- Take essential medications with a sip of water.
- If diabetic, follow your usual insulin/medication with a small amount of food if required for safety.
Bring With You
- Two snacks
- All medications in original containers
- Comfortable, loose clothing
- A list of allergies and medical conditions
How Long the Test Takes
Plan for 4–6 hours total, including waiting periods between scans.
What Happens During the Test?
1. **Rest Scan:**
Study: In order for us to be able to see if there is enough blood supply to the heart muscle, you will give a trace amount of a radioactive material that is called call MIBI or Myoview. To do this,  an IV line will be started. Then  the tracer  is injected into your vein through the IV tubing. The IV stays in your arm for both parts of the test.

While waiting for your heart muscle to absorb the tracer, you now need to eat the first snack you brought
or go to the cafeteria. Remember - Nothing with Caffeine!
  - An IV is inserted and the first tracer is injected.
  - You eat a snack and wait 1–2 hours.
  - Rest images are taken (takes ~30 minutes).
 
2. **Stress Scan:**
The 'Stress' Study: You be asked to go to the Cardiopulmonary Department for an exercise test.
Then you are given a second injection of tracer in your IV line.
After the injection of the tracer, you eat the second snack. At this point, you can now have drinks with
caffeine if you want.
The images  is taken about 1 to 2 hours after the tracer injection. The hospital staff tell you what time to be back in the department. You can wait in our waiting room or in the cafeteria but you must not leave the hospital.

It takes another½ hour to do all the images.
  - You exercise on a treadmill or receive a medication that simulates exercise.
  - A second tracer is injected.
  - You eat your second snack (caffeine allowed now).
  - Stress images are taken 1–2 hours later.
Common Side Effects
- Most people feel normal during and after the test.
- If doing exercise, you may feel tired or short of breath temporarily.
- If receiving medication-induced stress (dipyridamole), you may feel:
  • Warmth
  • Flushing
  • Shortness of breath
  • Headache
  These symptoms are temporary and go away quickly.

After the Test
- Drink plenty of water to help flush out the tracer.
- You may return to normal activities unless instructed otherwise.
- The tracer naturally leaves your body over 1–2 weeks.
- Results go to your doctor within 5 business days.

When to Seek Medical Attention
Call your doctor or go to the ER if you experience:
- Severe or persistent chest pain
- Shortness of breath that worsens
- Palpitations that do not settle
- Dizziness or fainting

If You Plan to Travel Soon
If you will travel within 10 days of your test, ask staff for a letter explaining you received small amounts of medical radioisotope, which may be detected by airport security.