STRESS TEST / PET-CT
I will receive an infusion of the drug Lexiscan (Regadenoson). In patients with coronary artery disease, the administration of this medication increases the coronary blood flow in normal vessels, but not in vessels with obstruction, thus uncovering differences in myocardial blood flow that can be diagnosed by the distribution of injected radioisotope.
The possibility of certain changes exists, which may occur during the test. They include flushing, chest discomfort, dyspnea (shortness of breath), headache, throat, neck, or jaw discomfort, nausea, vomiting, blurred vision, EKG changes, chest pain, and in very rare instances, heart attack. The side effects terminate quickly. Every effort is made to minimize possible side effects by the physician’s preliminary examination and by observation during testing. Emergency equipment and trained personnel are available to deal with unusual situations that may arise.
The test also consists of the radioactive isotope, Rubidium-82, being injected into my vein through an intravenous site at two separate intervals during the test. This test is performed by trained cardiac personnel under the supervision of a physician and a nuclear medicine technologist. As part of this test, my heart rate, blood pressure, and respirations are increased by using the pharmacologic agent, Regadenoson, as described above. While having the stress test, my electrocardiogram, heart rate, and blood pressure are monitored. There are no risks associated with the radioactive isotope injection.
CONSENT:
The information obtained is treated as confidential and will not be released to any person without my written consent. This information may, however, be used for statistical or scientific purposes without violating my right to privacy.
I have read the above and consent to proceed with this test. In the unlikely event that injury or complications result, I will not hold the physicians or staff of Southeast Cardiovascular Associates responsible.
