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What Is The Effect Of Diltiazem On Cardiolite Exercise Stress Test?

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Posted on Wed, 1 Apr 2015
Question: My cardiologist has prescribed a cardiolite exercise stress test. His instruction sheet list 21 beta blockers that I should not take for 24 hours before the test. It does not mention any calcium channel blockers. I am currently taking 3 120 (mg ER 24 hours capsules) per day of Diltiazem for SVT. Should I also quit taking them and if so, when. What effect would either taking or not taking them have on the results of the test? The reason for the test is to look for causes of chest pain that I experience when I am exercising. The SVT is being controlled by the Diltiazem. Thanks for your reply.
doctor
Answered by Dr. Ilir Sharka (1 hour later)
Brief Answer:
There may exist tolerance for Diltiazem treatment.

Detailed Answer:
Hello! Thank you for asking on HCM!

Regarding your concern I would explain that beta-blockers and even calcium channel blockers have antianginal properties and as such they lower the diagnostic accuracy of the stress test (85% of maximum, age-adjusted predicted heart rate could not be achieved, and hence inconclusive test may result). As a general rule they should be stopped at least 48 hours before performing stress testing. In your case Diltiazem is used to control SVT, and the decision whether to continue or stop it before stress testing should be discussed with your prescribing doctor (severity of SVT episodes, your basal heart rate on treatment and the probability to achieve a conclusive stress test, etc. all count in resolving this issue). Nevertheless cardiolite exercise stress testing uses imagine nuclear patterns to distinguish signs of myocardial ischemia and there may exist a greater tolerance for continuing Diltiazem. So you need to discuss with your doctor regarding Diltiazem regimen.

Hope to have been helpful to you! Greetings! Dr. Iliri
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Ilir Sharka (2 days later)
Hello Doctor

Previously we have discussed the advisability of continuing to take calcium channel blockers while preparing for a cardiolite exercise stress test. I thank you for your work on that. Now I would like to know if the drug induced version of the stress test is as effective as the treadmill one. Do you loose any information by using it? In both of them the nuclear injection would be used to look at the blood flow to the heart. I am 80 years old but in reasonably good health. I took an exercise stress test in 2013 and the drug induced one in 2014. I passed both of them.

Please give your general opinion of the two methods.Thank you very much
XXXX
PS If you need any additional information!
doctor
Answered by Dr. Ilir Sharka (13 hours later)
Brief Answer:
Cardiolite stress testing offers optimal information in your situation.

Detailed Answer:
Hello again dear Mr. XXXX!

The proposed cardiolite exercise stress test is the most optimal testing to study your possible heart ischemic problem, as it incorporates myocardial perfusion imagine with stress testing in a situation when decreased functional capacity (the ability to appropriately exert) may be reduced. So it is more comfortable to you (considering your age), more safe, and offers advantages of imagine information in addition of ECG and clinical data (obtained by the traditional exercise stress testing).

In the pharmacological radionuclide stress testing we use several drug-induced stressing stimuli (adenosine, dipiridamole, regadenosine, sometimes dobutamine, enoximone,etc) that discriminate better between optimally and sub-optimally blood-supplied cardiac regions.

If you need additional information after you perform your test feel free to ask me! My Best Wishes! Dr. Iliri
Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Answered by
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Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 9544 Questions

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What Is The Effect Of Diltiazem On Cardiolite Exercise Stress Test?

Brief Answer: There may exist tolerance for Diltiazem treatment. Detailed Answer: Hello! Thank you for asking on HCM! Regarding your concern I would explain that beta-blockers and even calcium channel blockers have antianginal properties and as such they lower the diagnostic accuracy of the stress test (85% of maximum, age-adjusted predicted heart rate could not be achieved, and hence inconclusive test may result). As a general rule they should be stopped at least 48 hours before performing stress testing. In your case Diltiazem is used to control SVT, and the decision whether to continue or stop it before stress testing should be discussed with your prescribing doctor (severity of SVT episodes, your basal heart rate on treatment and the probability to achieve a conclusive stress test, etc. all count in resolving this issue). Nevertheless cardiolite exercise stress testing uses imagine nuclear patterns to distinguish signs of myocardial ischemia and there may exist a greater tolerance for continuing Diltiazem. So you need to discuss with your doctor regarding Diltiazem regimen. Hope to have been helpful to you! Greetings! Dr. Iliri