Stress testing is a widely used non-invasive diagnostic method that provides reliable information about the severity of symptomatic cardiac artery disease or coronary artery disease (CAD). As the name indicates, stress testing is carried out by putting the body under physical stress. A myocardial perfusion scan is a combined procedure that combines stress testing and a nuclear heart scan.
Myocardial perfusion scan is a non-invasive cardiac imaging method that is performed during rest and stress. For the stress testing, patients are injected with a radioactive tracer during the exercise (running on a treadmill). Radionuclide which circulates through the blood stream will show the possible damages and blockages present in the heart muscle. During the stress testing, the patient will be continuously monitored by keeping track of heart rate, blood pressure and ECG changes. Pharmacologically-induced stress testing is opted in some cases, when the patients can’t exercise on a treadmill due to medical conditions. Medications are injected to make the coronary arteries dilate and promote vasodilatation. Non-invasive adenosine myocardial perfusion is a case in point. A resting scan will be performed after some hours to compare the heart functioning and blood flow. The risk of this diagnostic procedure is often associated with the stress part of the test which may lead to rare instances of adverse cardiac events.
When it comes to cardiac or coronary artery disease treatment, percutaneous coronary intervention or PCI (angioplasty and stenting) and coronary artery bypass graft (CABG) surgery are the standard options. Cardiologists rely on the catheterization lab results and reports to devise the right treatment plan. With tremendous advancements in the interventional and catheterization procedures, PCI has gained wide interest among the medical community. Not only it is not as aggressive as CABG, but it also cuts down the recovery time and treatment costs.
The novel idea of fully degradable bioresorbable stents that can overcome the major limitations of bare metal stenting (BMS) and drug-eluting stenting (DES) has also been fascinating the interventional community from a long time. Bioresorbable or bioabsorbable stents are supposed to improve the endothelium function during a critical period. When no longer needed, it will be bioabsorbed to the body thereby negating the risks of thrombosis and the need for antiplatelets therapy. Clinical trials and experiments are still going on and until then drug eluting stents and bypass surgery remain the preferred revascularization procedures.
