La heart scan, or myocardial scintigraphy, is a imaging test which allows to observe the quality of heart irrigation by coronary arteries.

When blood circulates poorly in these arteries, such as when they are blocked or narrowed, the heart muscle (the myocardium) does not receive enough oxygen. This leads to a variety of potentially serious symptoms: chest pain, shortness of breath, or even a heart attack (this is thecoronary insufficiency).

Scintigraphy is an imaging technique that consists of administering to the patient a radioactive tracer, which spreads in the body or in the organs to be examined. Thus, it is the patient who “emits” the radiation that will be picked up by the device (unlike radiography, where the radiation is emitted by the device). The scintigraphy makes it possible to observe the functioning of the organs (not only their morphology).

This test is used for the diagnosis of coronary artery disease.

In this context, it is equivalent to exercise echocardiography (cardiac ultrasound).

It also allows to:

• give instructions to the doctor about how the heart is working, its ability to pump or eject blood
• to do a heart health check-up after a myocardial infarction to visualize the zones ofischemia(which have been deprived of oxygen) or to seek these areas if there is a suspicion ofangina pectoris orHeart Failure
• assess the risk of future heart problems, for example before surgery, especially in people with risk factors (diabetes, hypertension, smoking, etc.) and who cannot do an exercise EKG

Note that several types of heart scintigraphies can be performed during a cardiological assessment:

• myocardial perfusion scintigraphy
• Isotope ventriculography or synchronized angiocardioscintigraphy (MUGA), which provides more information on cardiac output and pumping.

La myocardial perfusion scintigraphy is performed after an effort. Indeed, the insufficiency of the blood supply in the event of problems at the level of the coronaries is seen especially during an effort.

It is contraindicated in pregnant or breastfeeding women. Fasting is not necessary, but you may be advised not to consume any stimulants (coffee, tea, etc.) on the day of the exam.

Usually, you will be asked to do a bicycle or treadmill test first, under the supervision of a cardiologist. If this test is contraindicated, your doctor will inject you with a medicine that stimulates the heart as if you were exercising (dipyridamole, adenosine, dobutamine).

During or immediately after the test, a weakly radioactive product (radiotracer) is injected into a vein in the forearm, which attaches specifically to the level of the heart.

Immediately after the effort, then during the recovery phase 15 to 30 minutes after the injection of the radiotracer, you will be asked to lie down on an examination table, under a special camera (scintillation camera) which allows you to view the radiation emitted by the heart.

Depending on the first results obtained, we may take new pictures 3 to 4 hours after the first examination, at rest.

The scintigraphy makes it possible to reveal abnormalities in the blood supply to the heart, but also to evaluate its functioning, in particular during an effort.

Depending on the results, the cardiologist will suggest appropriate treatment and follow-up to limit cardiac risks.

Other examinations may be ordered.