Please Help

Jami RN, BSN, RN · Sep 23, 2004

Try a dypyridamole myocardial perfusion scan. :)

Nursemelo · Sep 23, 2004

Try a dypyridamole myocardial perfusion scan. :)

well there is a 2 line blurb about dipyridamole so i guess that could be it...i don't know how i got "dipymyoview" though....that what it appeared to say on the kardex but i swear some nurses write worse than doctors Thanks! Hopefully dipyridamole is what i'm looking for but at least I tried to know what it is that has to count for something, i'm not really sure how anal my instructor is gonna be it's my first day with her on the floor tommmorrow.

Editorial Team / Admin · Sep 23, 2004

I assume this pt is unable to walk on a treadmill, thus the dipyridamole study is requested instead. This is a chemically-induced stress test. The patient undergoes a resting nuclear medicine scan before the dipyridamole portion of the test. The "dip" (or Persantine, if you prefer) is then administered IV, and increased in measured increments at particular times during the study, which takes about 30 min total for the infusion part. Its purpose is to increase the heart rate to a target rate. After the target heart rate has been reached, the dip is stopped, and the patient is injected with myoview. When the pt's heart rate has returned to 100 bpm or less, he/she is taken back over to Nuclear Medicine for more imaging. The myoview makes a "freeze-frame" picture of the heart muscle after it's been stressed, showing perfusion to the muscle. If the pt has coronary disease (which slows blood flow to the area that vessel supplies), the scan will likely show an area or areas of decreased perfusion.

Of course, the dip is stopped if the pt experiences chest pain or EKG changes.

I've presented it very simply, I hope. Don't want to talk down but want you to understand what's happening. Will you be able to watch the study?

Nursemelo · Sep 23, 2004

I assume this pt is unable to walk on a treadmill, thus the dipyridamole study is requested instead. This is a chemically-induced stress test. The patient undergoes a resting nuclear medicine scan before the dipyridamole portion of the test. The "dip" (or Persantine, if you prefer) is then administered IV, and increased in measured increments at particular times during the study, which takes about 30 min total for the infusion part. Its purpose is to increase the heart rate to a target rate. After the target heart rate has been reached, the dip is stopped, and the patient is injected with myoview. When the pt's heart rate has returned to 100 bpm or less, he/she is taken back over to Nuclear Medicine for more imaging. The myoview makes a "freeze-frame" picture of the heart muscle after it's been stressed, showing perfusion to the muscle. If the pt has coronary disease (which slows blood flow to the area that vessel supplies), the scan will likely show an area or areas of decreased perfusion.
Of course, the dip is stopped if the pt experiences chest pain or EKG changes.
I've presented it very simply, I hope. Don't want to talk down but want you to understand what's happening. Will you be able to watch the study?

oh thank you so much!!!! yes i think i am going to be able to go down with my pt. tommorrow...so it should be interesting. This poor person came in to have a knee replacement and a few days after the surgey suffered and MI. Thank you again so much for clarifying this for me i was reading about the dypyridamole myocardial perfusion but it didn't sound right because i didn't think she was going to be running on the treadmill.

Editorial Team / Admin · Sep 24, 2004

So how did it go? They're trying to find out if she has other problem areas in her heart's circulatory system, besides the one that resulted in the MI. If the scan shows suspicious areas (decreased perfusion, with partial recovery, etc), they'll likely recommend a cardiac cath. Has she ever had chest pressure/pain, sudden overwhelming sense of fatigue, jaw pain, sudden backache? Read up on women's cardiac symptoms VS men's (women's are NOT always textbook!). Is she diabetic? Diabetics may experience no pain/pressure at all, due to neuropathy.

You're working with the whole patient here, butterfly, not just a "simple" knee surgery! :) :) Hope your pt does well. :)

Nursemelo · Sep 25, 2004

I got to go down and see it. All whent well. The dr. said today that he couldn't see any damage to the heart from the test. It almost looks like she didn't have an MI but her CK and troponin levels where very much elevated so he said most likely it was just a very small MI that cause very little damage. My pt. was very happy to hear this. Again thank you very much for your help

Editorial Team / Admin · Sep 25, 2004

Good for her! Good learning experience for you. You're welcome. :)