KENTUCKY CARDIOLOGY PLEASE READ THESE INSTRUCTIONS VERY CAREFULLY AT LEAST 24 HOURS BEFORE EXAM!
You have been scheduled for a NUCLEAR STRESS TEST on __________ at ________ am / pm. On the day of your test please report to 160 N. Eagle Creek Drive, Suite 307 15 minutes before your appointment time and expect your test to take 3-4 hours. PREP INSTRUCTIONS:
NO FOOD, DRINK or SMOKING for 4 HOURS before the exam.
NO CAFFEINE for 24 HOURS before the exam. This includes any
food, drink, or medications containing caffeine: Coffee, tea, soda, chocolate, yogurts with coffee/cappuccino flavoring, NoDoz, Vivarin, diet medications, Excedrin and Anacin. Even coffee, tea and soft drinks labeled ‘caffeine free’ have caffeine! Do not drink these or your test may have to be canceled.
DO NOT TAKE ANY OF THE FOLLOWING MEDICATIONS LISTED IN THE YELLOW BOX FOR 24 HOURS BEFORE THIS EXAM: BETA BLOCKERS: -Atenolol (Tenormin) -Acebutolol (Sectral) -Bystolic (Nebivolol) -Betapace (Sotalol) -Coreg (Carvedilol) -Inderal (Propanolol) -Labetalol -Lopressor -Metoprolol -Nadolol (Corgard) -Timolol -Toprol -Zebeta (Bisoprolol) CALCIUM CHANNEL BLOCKERS: -Calan -Cardizem (Diltiazem) -Cartia -Tiazac -Verapamil -Verelan OTHERS: -Aggrenox -Clonidine -Trental Please call your PHARMACIST with any medication questions IF YOUR MEDICATION IS NOT LISTED IN THE YELLOW BOX, DO NOT HOLD IT PRIOR TO THIS EXAM!
Please take all other medications as prescribed with water only!!
Bring your medications and a bottle of water with you.
Please wear comfortable clothing and walking shoes. Please NO shirts
with metal snaps, NO overalls, NO dresses or full slips.
Please notify scheduling if you are pregnant, breast feeding or over 300 pounds. PROCEDURE:
The technologist will take you back to the Nuclear Medicine Department where the test will be explained to you. An IV will be started in a vein for the medications. There will be periods of time where you will wait between certain portions of the test. Your heart will be scanned at both rest and stress. The technologist will let you know when you can eat, drink and take your medications.
CANCELLATION POLICY:
All medications for the test are patient specific and must be ordered 24 hours in advance. 24 hours notice of cancellation is required or you, the patient, will be charged a missed appointment fee of $200.00 for the unused pre-packaged medication. (This $200 fee cannot be billed to your insurance for missed appointments). I hereby acknowledge that I have read and understand the instructions and cancellation policy: ____________________________________
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KENTUCKY CARDIOLOGY 
Please notify scheduling if you are pregnant, breast feeding or over