From the Guidelines
General precautions for a DSMA scan include careful consideration of the patient's medical history, current medications, and potential allergies to minimize risks associated with the procedure. When considering a DSMA scan, it is essential to inform the healthcare provider about any allergies, current medications, and pregnancy or breastfeeding status before the procedure 1. Patients should stay well-hydrated before the scan but may need to limit fluid intake shortly before the procedure as directed. Children may require sedation to remain still during imaging. The radiotracer used in DSMA scans contains a small amount of radiation, but the benefits typically outweigh the minimal radiation exposure risk.
Some key considerations for DSMA scans include:
- Informing the healthcare provider about any allergies or sensitivities to contrast materials or radiotracers
- Disclosing current medications, including those that may interact with the radiotracer or contrast material
- Notifying the healthcare provider about pregnancy or breastfeeding status
- Staying well-hydrated before the scan
- Limiting fluid intake as directed before the procedure
- Considering sedation for children to ensure they remain still during imaging
After the scan, patients should drink plenty of fluids to help eliminate the radiotracer from the body. Most patients can resume normal activities immediately following the procedure. The scan itself is painless and typically takes 2-3 hours to complete, with additional imaging sometimes required 24 hours later. Patients with severe kidney dysfunction may need dose adjustments or alternative imaging methods, as highlighted in a study published in the Journal of the American College of Radiology 1.
It is also crucial to consider the potential risks associated with DSMA scans, including:
- Allergic reactions to the radiotracer or contrast material
- Radiation exposure
- Kidney dysfunction or disease
- Interaction with current medications
By taking these precautions and considering the potential risks, healthcare providers can help ensure accurate results while minimizing risks associated with the procedure, as recommended by the American Heart Association 1 and the European Society of Cardiology 1.
From the Research
General Precautions for DSMA Scan
- The use of iodinated contrast media (ICM) in DSMA scans poses risks to patients with renal disease or contrast allergy 2, 3, 4, 5.
- Alternative contrast media, such as carbon dioxide, gadolinium, and dilute ICM, can be used in these cases, but each has its own unique features and limitations 2.
- Patients with renal disease or contrast allergy require individual risk assessment and precautions to minimize the risk of adverse effects 3, 4, 5.
- Hydration is a crucial preventive measure for patients at risk of contrast-induced nephropathy 3, 5.
- The choice of contrast media should be based on the patient's medical history, the severity of the reaction, and the availability of alternative contrast media 6.
Risk Factors and Prevention
- Risk factors for immediate reactions to ICM include poorly controlled bronchial asthma, concomitant medication, and rapid administration of the ICM 6.
- Patients with advanced renal insufficiency require ensuring euvolemia to minimize the risk of contrast-associated kidney injury 5.
- Skin and in vitro tests should be performed for diagnosis of both immediate and nonimmediate reactions to ICM 6.
- The timing of contrast media injection and dialysis sessions in patients with end-stage renal disease is necessary only after MRI contrast media use 5.