By: Abdi Waluyo Hospital

Overview

What is Cardiac Nuclear Imaging?

Cardiac Nuclear Imaging, also known as Nuclear Cardiology or Myocardial Perfusion Imaging (MPI), is a non-invasive diagnostic examination that evaluates blood flow to the heart muscle both at rest and during stress. The test uses a small amount of radioactive tracer (radiopharmaceutical) together with an advanced SPECT/CT gamma camera to produce high-resolution images of the heart and assess its function.

Unlike imaging tests that primarily show the anatomy of the heart, Cardiac Nuclear Imaging provides valuable functional and physiological information, allowing physicians to determine how well blood is reaching the heart muscle. It helps identify areas of reduced blood flow (ischemia), previous heart muscle damage (scar tissue), and abnormalities that may not be visible with conventional anatomical imaging.

The examination is performed using a highly sensitive gamma camera, which detects the radiation emitted by the tracer after it has been absorbed by the heart muscle. The gamma camera creates detailed images that enable physicians to accurately evaluate myocardial perfusion, heart function, and, in selected patients, quantify myocardial blood flow.

At RS Abdi Waluyo, Cardiac Nuclear Imaging is performed using advanced Nuclear Medicine technology with a state-of-the-art SPECT/CT gamma camera and interpreted by experienced Nuclear Medicine physicians and cardiologists to support accurate diagnosis, risk assessment, and personalized treatment planning.

Why is Cardiac Nuclear Imaging Performed?

Your doctor may recommend Cardiac Nuclear Imaging to:

Evaluate chest pain or symptoms suggestive of coronary artery disease.
Assess blood flow to the heart muscle.
Detect narrowed or blocked coronary arteries.
Evaluate damage caused by a previous heart attack.
Determine whether heart muscle remains healthy and viable.
Assess the effectiveness of previous treatments, such as coronary angioplasty, stent placement, or coronary artery bypass surgery.
Evaluate patients with known or suspected coronary artery disease.
Estimate the risk of future cardiac events.
Guide treatment decisions before cardiac procedures.

Details of the Test

Cardiac Nuclear Imaging is a safe, outpatient procedure performed in two phases:

Rest Imaging, performed while your heart is at rest.
Stress Imaging, performed after exercise on a treadmill or after receiving medication that temporarily increases blood flow to the heart when exercise is not possible.

During the examination:

A small amount of radioactive tracer is injected into a vein.
After allowing time for the tracer to circulate, images of your heart are obtained using a specialized gamma camera.
Depending on the protocol, both rest and stress images are compared.

Before the examination, you may be instructed to:

Fast for several hours.
Avoid caffeine for at least 24 hours before the test.
Wear comfortable clothing and walking shoes if an exercise stress test is planned.
Inform your doctor about pregnancy, breastfeeding, allergies, or medications you are taking.

The complete examination usually takes 2 to 4 hours, depending on the imaging protocol.

What Happens During the Test?

During the examination:

An intravenous (IV) line will be inserted into your arm.
The radioactive tracer will be injected.
You will wait for the tracer to circulate before imaging begins.
Images of your heart will be obtained while you lie comfortably under a gamma camera.
If stress imaging is required, you will exercise on a treadmill or receive a stress medication.
A second dose of tracer may be administered, followed by additional imaging.
The images from the rest and stress portions are compared to evaluate blood flow to the heart muscle.

Throughout the examination, your heart rate, ECG, blood pressure, and symptoms will be carefully monitored.

What Should I Expect After the Test?

After the examination:

You may return to your normal daily activities unless instructed otherwise.
Drink plenty of water to help eliminate the radioactive tracer from your body.
The radioactive tracer naturally loses its activity and is eliminated through urine over the following hours.
Most patients experience no side effects.

If stress medication was used, any temporary effects usually resolve quickly after the examination.

What Are the Risks?

Cardiac Nuclear Imaging is considered a safe and well-established diagnostic procedure.

Potential risks include:

Exposure to a small amount of radiation from the radioactive tracer.
Rare allergic reactions to the radiopharmaceutical.
Temporary side effects from stress medication, such as flushing, headache, dizziness, or shortness of breath.
Rare exercise-related complications, including abnormal heart rhythms or chest discomfort.

Your healthcare team carefully monitors you throughout the examination to ensure your safety.

Results and Follow-Up

A Nuclear Medicine physician and cardiologist will evaluate the images to assess:

Blood flow to the heart muscle.
Areas with reduced blood supply (ischemia).
Areas of permanent heart muscle damage (scar tissue).
Overall heart function.
Left ventricular pumping function (ejection fraction), when applicable.
Risk of future cardiovascular events.

The findings help your doctor determine whether additional treatment or testing is necessary.

When Will I Receive My Results?

A detailed report is generally available within 24 to 72 hours, depending on the complexity of the examination.

Your doctor will explain the results and discuss the most appropriate treatment or follow-up plan.

If the Results Are Abnormal, What Are the Next Steps?

If the examination identifies reduced blood flow or other abnormalities, your doctor may recommend:

Lifestyle modifications to improve heart health.
Medications to manage coronary artery disease.
Cardiac CT or Coronary CT Angiography.
Coronary Angiography (Cardiac Catheterization).
Coronary angioplasty with stent placement.
Coronary artery bypass graft (CABG) surgery.
Regular follow-up with a cardiologist.

Treatment recommendations will depend on the severity of the findings, your symptoms, and your overall cardiovascular health.

When Should I Call My Doctor?

Contact your doctor promptly if you experience after the examination:

Persistent chest pain.
Shortness of breath.
Severe dizziness or fainting.
Palpitations that do not resolve.
Swelling, redness, or pain at the injection site.
Any new or worsening symptoms.

Seek emergency medical attention immediately if you experience severe chest pain, difficulty breathing, or symptoms suggestive of a heart attack or stroke.

Why Choose RS Abdi Waluyo for Cardiac Nuclear Imaging?

At RS Abdi Waluyo, we are committed to delivering advanced, evidence-based cardiovascular diagnostics through state-of-the-art Nuclear Cardiology technology and a multidisciplinary team of experienced Nuclear Medicine physicians and cardiologists.

Our Cardiac Nuclear Imaging service offers:

Advanced Myocardial Perfusion Imaging (MPI) for accurate assessment of blood flow to the heart muscle.
Stress Myocardial Blood Flow (MBF) quantification, enabling precise measurement of blood flow to the heart muscle during stress.
Coronary Flow Reserve (CFR) / Myocardial Flow Reserve (MFR) assessment, providing quantitative evaluation of the coronary circulation to detect early coronary microvascular dysfunction and multivessel coronary artery disease that may not be apparent on conventional imaging.
Exclusive advanced quantitative cardiac perfusion imaging, making RS Abdi Waluyo the first and currently the only hospital in Indonesia to offer comprehensive assessment of Stress Myocardial Blood Flow (MBF) and Coronary Flow Reserve (CFR/MFR) as part of routine Nuclear Cardiology services.
Early detection of coronary artery disease, including balanced ischemia and coronary microvascular disease, allowing more accurate diagnosis and personalized treatment planning.
Comprehensive cardiovascular evaluation, combining functional and physiological assessment rather than anatomical imaging alone.
Integrated Heart Center services, with seamless collaboration between Nuclear Medicine specialists, cardiologists, interventional cardiologists, and cardiac surgeons.
A patient-centered approach focused on safety, comfort, diagnostic accuracy, and clinical excellence.

By combining conventional myocardial perfusion imaging with advanced quantitative measurements of Stress Myocardial Blood Flow (MBF) and Coronary Flow Reserve (CFR/MFR), RS Abdi Waluyo provides one of the most comprehensive non-invasive evaluations of coronary circulation available today. This advanced technology enables earlier detection of heart disease, more precise risk assessment, and highly personalized treatment strategies to help patients achieve better cardiovascular outcomes.

Cardiac Nuclear Imaging (Nuclear Cardiology)