Gating errors on cardiac nuclear stress testing

1. Technologist should have noticed that there is a gating problem. 

2. ShouldThe examination should have been converted to a non-gated stress test.

3. See the ratio of accepted to rejected heartbeats. 

4. This test should not have been post-processed.

5. When reported-On reporting it was the most abnormal stress test ever seen.

6. Cardiologist didOn an immediately subsequent echocardiogram and called me the EF isejection fraction (EF) was normal on echo.

7. Then we went backTroubleshooting was performed and analyzed the gating error was found.

The patient was called back for a repeat stress test and another unnecessary radiation exposure.

A very important lesson to always look at the QA page first to look for gating errors.

If the number of rejected beats are high the ejection fraction in a nuclear stress test may not be as accurate as the echocardiographic ejection fraction.

Don'tDo not expect your technologist to catch all the errors.