Athar ansari, md

California Heart & Vascular Clinic
Athar Ansari, M.D., INC.
790 W. Orange Ave, Ste. B
El Centro, CA 92243
(760) 353-3222
Patient Prep for Adenosine and Exercise Stress Scans
Absolutely no caffeine or decaffeinated beverages for 36 hours prior to the stress procedure, for example no
sodas, diet sodas, chocolate, tea, coffee, even if they are caffeine free soda.
Absolutely no smoking or alcoholic beverages for 24 hours prior to the stress procedure, for example no wine,
beer, malt drinks or hard liquor.
Nothing to eat after midnight the day before the test. It is ok to drink a little water in the morning before the
test. If you take blood pressure medication it is ok to take it prior to the test.
SCHEDULED DATE:________________________________ TIME:__________________________
NOTHING TO EAT OR DRINK AFTER:___________________________
Please notify the technician before you begin your test if you are asthmatic.
It may be necessary to give you another
type of medication. If you are asthmatic and use inhalers or other bronchial dilators you should avoid taking them
for 24 hours prior to procedure.
If you are scheduled to have an exercise stress test (treadmill) you should wear shoes and clothing that are
comfortable to walk in.
This study may be performed over 2 days, if this is the case you will be scheduled for the stress test one day and the
resting part of the test another day. We will do everything possible to schedule the test in only day. The total time
required for the test is about 3 hours.
For the resting part of the exam you will receive one injection. Imaging will begin about 20-30 minutes after the
injection. On the day of the Stress exam you will receive additional injection with treadmill. EKG’s will be
performed each minute of the infusion. Once the injections have been given and the EKG’s are complete the IV will
be removed. (If your test is being done over 2 days you will be given an appointment to come back for the second
If you are unable to walk you will be given IV adenosine over a period of six minutes. During this time you may feel
flushed, chest pressure/pain, shortness of breath or some other discomfort. This is normal, but inform the
doctor/nurse of just what you are feeling. It is possible that you may feel some of the medication’s effects up to 24
hours after the test.
Do not take the following medications on the day of your exam:

*Metroprolol (Lopressor) *Propranolol BRING A SWEATER
*Digoxin (Lanoxin) *Atenolol (Tenormin)
*Cardizem *Nadolol (Corgard)

*Lebetolol *Pindolol (Visken)
*Toprol XL

It is extremely important that you keep your appointment. If unable to do so you must notify our office at least
24 hours in advance. The medication is especially ordered for each patient and we need time to cancel it. If you
have any questions please do not hesitate to call our office.
I understand that I am responsible for calling in 24 hours in advance to cancel the appointment. If I do not call
to cancel I will be responsible for paying for the cost of the medication which is $200.00. This is not covered by
any insurance.

Patient signature



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