What happens during a resting and exercise radionuclide angiogram (RNA)?

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A resting and exercise radionuclide angiogram (RNA) -- a type of nuclear medicine procedure that evaluates the heart's chambers in motion -- 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:
  1. You will be asked to remove any jewelry or other objects that may interfere with the procedure.
  2. If you are asked to remove clothing, you will be given a gown to wear.
  3. An intravenous (IV) line will be started in your hand or arm.
  4. You will be connected to an electrocardiogram (ECG) machine with electrodes (leads) and a blood pressure cuff will be attached to your arm.
  5. You will lie flat on a table in the procedure room.
  6. The radionuclide will be injected into the vein to "tag" the red blood cells. Alternatively, a small amount of blood will be withdrawn from your vein so that it may be tagged with the radionuclide. The radionuclide will be added to the blood and will be absorbed into the red blood cells.
  7. During the procedure, it will be very important for you to lie as still as possible, as any movement can adversely affect the quality of the scan.
  8. The gamma camera will be positioned over you as you lie on the table.
  9. The gamma camera will obtain images of the heart as it pumps the blood through your body.
  10. You may be asked to change positions during the test; however, once you have changed position, you will need to lie still without talking.
  11. After the resting scan has been completed, you will be asked to exercise on the treadmill or stationary bicycle. If you notice any discomfort, such as chest pain, dizziness, headache, shortness of breath, or extreme fatigue while exercising, you should let the technologist or physician know.
  12. Once all the heart images have been obtained, your vital signs (heart rate, blood pressure, and respiration rate) will be monitored for a period of time.
  13. The IV line will be discontinued, and you will most likely be allowed to leave, unless your physician instructs you differently.