CPT® Code 78483

1. Indications

The cardiac blood pool imaging procedure is indicated for various clinical scenarios where assessment of cardiac function is necessary. The following conditions may warrant this imaging technique:

• Evaluation of Heart Function: This procedure is performed to assess the overall effectiveness of the heart muscle in pumping blood, particularly in patients with suspected or known heart disease.
• Wall Motion Abnormalities: It is indicated for identifying abnormalities in the motion of the heart walls, which can indicate underlying cardiac issues such as ischemia or infarction.
• Assessment of Ejection Fraction: The procedure is utilized to measure the ejection fraction, which is crucial for evaluating heart performance and determining the severity of heart failure.
• Preoperative Evaluation: Cardiac blood pool imaging may be indicated as part of the preoperative assessment for patients undergoing major surgeries, especially in those with known cardiovascular risk factors.
• Monitoring of Cardiac Conditions: It is also used to monitor the progression of known cardiac conditions and the effectiveness of therapeutic interventions.

2. Procedure

The cardiac blood pool imaging procedure involves several key steps to ensure accurate assessment of cardiac function. The following procedural steps are performed:

• Preparation of the Patient: The patient is prepared for the procedure by placing ECG leads on the chest to monitor heart activity and applying a blood pressure cuff on the arm. An intravenous line is established in a vein, typically in the hand or arm, for the administration of the radionuclide.
• Resting Phase Imaging: Initially, the patient lies flat on a table for the resting phase of the myocardial perfusion imaging. During this phase, the radionuclide is injected into the intravenous line, allowing it to circulate through the heart. Planar images of the heart and great vessels are obtained to evaluate baseline cardiac function.
• Stress Induction: Following the resting phase, the patient undergoes a stress test to evaluate cardiac function under increased workload. This can be achieved through physical exercise on a treadmill or stationary bike, or by administering a pharmacologic agent that simulates exercise, thereby increasing heart rate and workload.
• Stress Phase Imaging: After the stress is induced, additional radionuclide imaging is performed to capture the heart's response to the increased demand for blood flow. Planar images are obtained during this phase to assess wall motion and overall cardiac performance.
• Analysis of Images: The physician reviews the obtained images to evaluate heart wall motion and calculates the ejection fraction using the first pass technique, which captures images during the initial circulation of the radionuclide. This analysis may also include quantification of other parameters of heart function based on the distribution of the radionuclide.
• Reporting Findings: Finally, the physician compiles a detailed written report of the findings, which includes the assessment of wall motion, ejection fraction, and any other relevant observations from the imaging studies.

3. Post-Procedure

After the cardiac blood pool imaging procedure, patients are typically monitored for a short period to ensure there are no immediate adverse reactions to the radionuclide or the stress test. Patients may resume normal activities unless otherwise instructed by their physician. The results of the imaging studies are usually discussed with the patient during a follow-up appointment, where the physician will explain the findings and any necessary next steps in management or treatment based on the results. It is important for patients to follow any specific post-procedure instructions provided by their healthcare team, particularly regarding hydration and any restrictions related to physical activity.