What is a resting radionuclide angiogram?

Resting radionuclide angiogram (RNA) is a type of nuclear medicine test. Healthcare providers use a tiny amount of a radioactive substance (called a tracer) during the scan. This helps show the heart’s chambers in motion. This test can tell the healthcare provider how well the heart pumps. It can also show how much blood is pumped out of the heart with each heartbeat.

Your healthcare provider injects a radioactive tracer into an arm vein. The tracer marks (tags) blood cells. Then your healthcare provider can track them with a scanner as they move through the heart. A special camera (called a gamma camera) then records the heart muscle at work. Your healthcare provider can match these recordings with the electrocardiogram (ECG). An ECG is a recording of the heart's electrical activity.

If the heart muscle doesn’t move normally, or not enough blood is pumped out by the heart, it may be a sign of one or more of the following:

• Injury to the heart muscle, possibly as a result of decreased blood flow to the heart muscle due to clogged heart arteries

• An enlargement of one or more of the heart's chambers

• A weak area in the heart muscle (aneurysm)

• Toxic effects of certain medicines

• Heart failure

Why might I need an RNA?

Reasons for your healthcare provider to request a resting radionuclide angiogram (RNA) include:

• Chest pain

• Shortness of breath

• Dizziness

• Extreme tiredness (fatigue)

If your provider thinks you have some type of heart disease, a resting RNA may be done.

There may be other reasons for your provider to advise this test.

What are the risks of an RNA?

Your healthcare provider uses only a small amount of the radioactive tracer. So there is no need for safety measures against radiation exposure.

The injection of the radioactive tracer may cause some sight discomfort. Allergic reactions to the tracer are rare.

Tell your provider if you are pregnant or think you could be pregnant. Radiation exposure during pregnancy may lead to birth defects. Also tell your provider if you are breastfeeding. There is a risk of contaminating your breastmilk with the tracer.

There may be other risks depending on your specific health condition. Talk about any concerns with your healthcare provider before the procedure.

Certain factors may interfere with or affect the test results. These include:

• Having caffeine before the test

• Smoking or using any form of tobacco before the test

• Certain heart medicines

How do I get ready for an RNA?

• Your healthcare provider will explain the test and you can ask questions.

• You will be asked to sign a consent form that gives your permission to do the test. Read the form carefully and ask questions if anything is unclear.

• Generally, you won't need sedation. Follow any directions you are given for not eating or drinking before the test.

• Follow your healthcare providers instructions on restricting tobacco and caffeine before testing.

• Tell your provider if you are pregnant or think you could be pregnant. Radiation exposure during pregnancy may lead to birth defects.

• Tell your provider if you are breastfeeding. There is a risk of contaminating breastmilk with the radioactive tracer.

• Tell your provider about all medicines you are taking. This includes any prescription and over-the-counter medicines, vitamins, herbs, and supplements that you are taking.

• Tell the technologist or healthcare provider if you are allergic to or sensitive to medicines, local anesthesia, contrast dyes, iodine, or latex.

• Tell your provider if you have a pacemaker or any other implanted cardiac devices.

• Based on your health condition, your provider may request other specific preparation.

What happens during an RNA?

A resting radionuclide angiogram (RNA) may be done on an outpatient basis. This means you go home the same day. Or it may be done as part of a hospital stay. Steps may vary depending on your condition and your healthcare provider's practices.

Generally, a resting RNA follows this process:

1. You will be asked to remove any jewelry or other objects that may interfere with the test.

2. You may need to change into a hospital gown.

3. A healthcare provider will start an IV (intravenous) line in your hand or arm.

4. A provider will connect you to an ECG machine with leads that stick to your skin and place a blood pressure cuff on your arm.

5. You will lie flat on a table in the procedure room.

6. Your healthcare provider will inject the radioactive tracer into the IV to tag the red blood cells. You will likely not feel anything when the tracer is given.

7. As another choice, a small amount of blood may be taken from your vein. It will be tagged with the tracer. The tracer will be added to the blood. It will be absorbed into the red blood cells. Then the blood will be returned into your vein through the IV.

8. During the test, it will be very important for you to lie as still as possible. Any movement can affect the quality of the scan.

9. Your provider will position the gamma camera over you as you lie on the table. It will record images of your heart as it pumps the tagged blood cells through your body.

10. You may be asked to change positions during the test. But once you have changed position, you will need to lie still without talking.

11. After the scan is done, the IV line will be removed. You can leave, unless your healthcare provider tells you differently.

What happens after an RNA?

Move slowly when getting up from the scanner table. This will help prevent any dizziness or lightheadedness from lying flat during the test.

Drink plenty of fluids and empty your bladder often for 24 to 48 hours after the test. This is to help flush the remaining radioactive tracer from your body.

A nurse will check the IV site for any signs of redness or swelling. If you notice any pain, redness, or swelling at the IV site after you go home, tell your healthcare provider. This may be a sign of infection or other type of reaction.

Your provider may give you other instructions after the test, depending on your situation.

Next steps

Before you agree to the test or procedure make sure you know:

• The name of the test or procedure

• The reason you are having the test or procedure

• What results to expect and what they mean

• The risks and benefits of the test or procedure

• What the possible side effects or complications are

• When and where you are to have the test or procedure

• Who will do the test or procedure and what that person’s qualifications are

• What would happen if you did not have the test or procedure

• Any alternative tests or procedures to think about

• When and how you will get the results

• Who to call after the test or procedure if you have questions or problems

• How much you will have to pay for the test or procedure