(RNA, MUGA, Gated Blood Pool Scan [Resting and Exercise], Gated Cardiac Scan, Exercise Gated Blood Pool Scan, Cardiac Blood Pool Imaging)
Resting and exercise radionuclide angiogram (RNA) is a type of nuclear medicine procedure. This means that a tiny amount of a radioactive substance, called a radionuclide (radiopharmaceutical or radioactive tracer), is used during the procedure to assist in the examination of the tissue under study. Specifically, resting RNA evaluates the heart’s chambers in motion.
A radionuclide (usually technetium) will be injected into an arm vein to “tag” the blood cells so their progress through the heart can be traced with a scanner. A special camera (gamma camera) will make recordings of the heart wall at work, like a motion picture. These recordings will be synchronized with the heartbeat by using the electrocardiogram (ECG, or recording of the heart's electrical activity).
A cardiologist (a physician who specializes in heart disease) trained in nuclear cardiology will study the films to evaluate the heart's pumping function and ejection fraction (the volume of blood pumped out with each heartbeat).
An RNA procedure with rest and exercise is performed to assist the physician in assessing the heart's function during exercise after comparing it to the heart's function at rest. If the heart muscle does not move in a normal manner, and/or a less-than-normal amount of blood is pumped out by the heart, this may indicate one or more of the following:
Other related procedures that may be used to assess the heart include resting or exercise electrocardiogram (ECG or EKG), Holter monitor, signal-averaged ECG, cardiac catheterization, chest x-ray, computed tomography (CT scan) of the chest, echocardiography, electrophysiological studies, magnetic resonance imaging (MRI) of the heart, myocardial perfusion scans, and ultrafast CT scan. Please see these procedures for additional information.
Coronary artery disease (CAD) is the narrowing of the coronary arteries (the blood vessels that supply oxygen and nutrients to the heart muscle), caused by a buildup of fatty material within the walls of the arteries. This buildup causes the inside of the arteries to become rough and narrowed, limiting the supply of oxygen-rich blood to the heart muscle.
To better understand how coronary artery disease affects the heart, a review of basic heart anatomy and function follows.
The heart is basically a pump. The heart is made up of specialized muscle tissue, called the myocardium. The heart's primary function is to pump blood throughout the body, so that the body's tissues can receive oxygen and nutrients and have waste substances taken away.
Like any pump, the heart requires fuel in order to work. The myocardium requires oxygen and nutrients, just like any other tissue in the body. However, the blood that passes through the heart's chambers is only passing through on its trip through the body - this blood does not give oxygen and nutrients to the myocardium. The myocardium receives its oxygen and nutrients from the coronary arteries, which lie on the outside of the heart.
When the heart tissue does not receive an adequate blood supply, it cannot function as well as it should. If the myocardium's blood supply is decreased for a length of time, a condition called ischemia may develop. Ischemia can decrease the heart's pumping ability, because the heart muscle is weakened due to a lack of food and oxygen.
If the blood supply to the heart muscle continues to decrease as a result of increasing obstruction of a coronary artery, a myocardial infarction, or heart attack, may occur. If the blood flow cannot be restored to the particular area of the heart muscle affected, the tissue dies.
Fortunately, the technology is available to restore blood flow to heart tissue when coronary artery blockages are diagnosed. One of several diagnostic procedures used to diagnose and evaluate coronary artery disease is the RNA.
Reasons for your physician to request a radionuclide angiography include, but are not limited to, the following:
If a screening examination (such as an ECG) suggests a possibility of some type of heart disease process that needs to be explored further, a resting and exercise RNA may be performed.
There may be other reasons for your physician to recommend resting and exercise RNA.
The amount of the radionuclide injected into your vein for the procedure is small enough that there is no need for precautions against radioactive exposure. The injection of the radionuclide may cause some slight discomfort. Allergic reactions to the radionuclide are rare.
If you are pregnant or suspect that you may be pregnant, you should notify your physician due to the risk of injury to the fetus from radionuclide angiography. Radiation exposure during pregnancy may lead to birth defects. If you are lactating, or breastfeeding, you should notify your physician due to the risk of contaminating breast milk with the radionuclide.
Patients who are allergic to or sensitive to medications, contrast dyes, iodine, tape, or latex should notify their physician.
There may be other risks depending upon your specific medical condition. Be sure to discuss any concerns with your physician prior to the procedure.
Nicotine in cigarettes may cause spasm in the coronary arteries, which could affect the test results.
A resting and exercise RNA may be performed on an outpatient basis or as part of your stay in a hospital. Procedures may vary depending on your condition and your physician's practices.
Generally, a resting and exercise RNA follows this process:
You should move slowly when getting up from the scanner table to avoid any dizziness or lightheadedness from lying flat for the length of the procedure.
You will be instructed to drink plenty of fluids and empty your bladder frequently for 24 to 48 hours after the test to help flush the remaining radionuclide from your body.
The IV site will be checked for any signs of redness or swelling. If you notice any pain, redness, and/or swelling at the IV site after you return home following your procedure, you should notify your physician as this may indicate an infection or other type of reaction.
Your physician may give you additional or alternate instructions after the procedure, depending on your particular situation.
The content provided here is for informational purposes only, and was not designed to diagnose or treat a health problem or disease, or replace the professional medical advice you receive from your physician. Please consult your physician with any questions or concerns you may have regarding your condition.
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