Can You Eat Breakfast Before a Myocardial Perfusion Scan?

Can I have breakfast on the morning of a myocardial perfusion scan?

Hello Dr.
Cheng,
I would like to ask if I can have breakfast on the morning of the myocardial perfusion scan.
Recently, I have been experiencing chest tightness and shortness of breath at night, along with unexplained tooth pain, ear pain, and a feeling of bloating in the upper abdomen.
After seeing a dentist with no findings, I consulted a cardiologist who performed an electrocardiogram, echocardiogram, and a treadmill exercise test.
I was unable to complete the treadmill test due to shortness of breath.
The doctor then scheduled me for a myocardial perfusion scan and mentioned that I should avoid coffee, tea, chocolate, etc., the day before the test, but I could have a small breakfast on the day of the scan, including foods containing eggs.
However, after researching the guidelines from various hospitals regarding this type of test, most indicate that fasting is required.
I am unsure why there are different SOPs for the same test.
Will having breakfast or consuming foods containing eggs affect the test results?

Miss X, 40~49 year old female. Ask Date: 2022/03/26

Dr. Zheng Xiaoyi reply Nuclear Medicine

Hello, Ms.
X.
There are actually many different methods for myocardial perfusion imaging, depending on the radiopharmaceutical used, primarily Tl-201 and Tc-99m MIBI.
Additionally, the stress phase of the examination can be induced by either pharmacological agents or exercise, and in some cases, the resting and stress phases may be performed on separate days.
This varies by the protocols of each hospital's nuclear medicine department.

In myocardial perfusion imaging using Tc-99m MIBI, this radiopharmaceutical tends to be excreted more through the biliary system into the intestines.
Consuming egg-based or fatty foods can accelerate the excretion of the drug from the biliary system into the intestines, which helps achieve better image quality during the examination.
Therefore, although they are all myocardial perfusion scans, there are slight differences in the examination process based on the specific radiopharmaceutical used.
If you have any further questions, please feel free to contact the nuclear medicine staff conducting your examination.

Finally, I wish you good health and all the best.

Reply Date: 2022/03/26

More Info

When preparing for a myocardial perfusion scan, the dietary restrictions can indeed vary based on the specific protocols of different medical facilities. Generally, a myocardial perfusion scan is a type of imaging test that shows how well blood flows to the heart muscle, and it is often used to diagnose coronary artery disease or to assess the heart's function after a heart attack.

In your case, it seems that your physician has advised you to eat a small breakfast that includes eggs on the day of the scan. This recommendation may be based on the need to ensure that you have adequate energy levels for the test, especially if you have experienced symptoms such as chest tightness and shortness of breath. Eating a light breakfast can help maintain your blood sugar levels, which is particularly important if you are undergoing a stress test as part of the scan.

However, many medical facilities do recommend fasting for a certain period before the scan, typically for 4 to 6 hours. This is because food intake can influence the results of the scan, particularly if the test involves the use of a radioactive tracer. The presence of food in the stomach can alter blood flow patterns and potentially lead to misleading results. For instance, if you consume a large meal, it may divert blood flow to the digestive system, which could affect the interpretation of how well blood is perfusing to the heart muscle.

The discrepancy you noted between different hospitals' protocols may arise from various factors, including the specific type of myocardial perfusion scan being performed, the patient's overall health status, and the physician's clinical judgment. Some doctors may prioritize patient comfort and energy levels, especially if the patient has been experiencing significant symptoms, while others may adhere strictly to fasting protocols to ensure the most accurate results.

If you are concerned about how eating breakfast might affect your scan, it is essential to communicate this with your healthcare provider. They can provide personalized advice based on your medical history and the specifics of the scan you are undergoing. If your doctor has indicated that a small breakfast is acceptable, it is likely that they believe it will not significantly impact the results of your test.

In summary, while some facilities may require fasting before a myocardial perfusion scan, others may allow a light breakfast, particularly if it includes protein-rich foods like eggs. It is crucial to follow your physician's instructions, as they are tailored to your individual health needs and the specifics of the test. If you have any lingering doubts or questions, don't hesitate to reach out to your healthcare provider for clarification. They can help ensure that you are adequately prepared for the scan while also considering your overall well-being.

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