After a 30-minute rest period in a quiet room, mental stress testing was performed by trained staff. Patients were required to listen to a scripted message that provided instructions for the mental stress task. They were asked to imagine a stressful situation, using a scenario in which a close relative had been mistreated in a nursing home. They then were asked to prepare a statement for 2 minutes and then present it over a 3-minute period in front of a video camera and an audience wearing white coats. Patients were told that their speech would be evaluated for content and duration. Blood pressure and heart rate were recorded at 5-minute intervals during the resting phase and at 1-minute intervals during the mental stress period using an automatic oscillometric device. At 60 seconds into the mental stress task, a regular dose of 99mTc-sestamibi (30–40 mCi based on weight) was injected intravenously and images were acquired 40 minutes to 1 hour later.