What Are Heart Imaging Tests?

Car­diac CT, stress test, EKG…you may have heard these terms before, but do you know what they mean?

These are all types of imag­ing tests that your provider may order to get pic­tures of what’s hap­pen­ing in your heart. There are many rea­sons why you might need a heart imag­ing test, from expe­ri­enc­ing chest pain or short­ness of breath to deter­min­ing whether you’ve had a heart attack to mon­i­tor­ing treat­ments. Results of imag­ing tests can help your provider:

• Diag­nose things like coro­nary artery dis­ease, heart fail­ure, or con­gen­i­tal heart defects (prob­lems with how the heart forms before birth)
• Look for buildups of plaque or cal­ci­um that may block blood flow
• Dis­cov­er prob­lems with how your heart or blood valves function
• Visu­al­ize how blood flows through your heart and body
• Find signs of heart dam­age or heart attack
• Pre­pare for an upcom­ing heart procedure

The spe­cif­ic test you need depends on your symp­toms, the results of pre­vi­ous tests, and the type of test that’s safest for you.

Some peo­ple only need one type of test, while oth­ers need mul­ti­ple types. Most of the tests are quick, easy, and pain­less and don’t require an overnight stay in the hos­pi­tal.

Also read: Radi­ol­o­gy – Types of Imag­ing Explained

Here is a run­down of some of the most com­mon heart imag­ing tests.

Elec­tro­car­dio­gram

Elec­tro­car­dio­grams (EKGs, or ECGs) record elec­tri­cal activ­i­ty in your heart with ultra­sound waves to check your heart­beat. A heart­beat that is too fast or slow can help your provider fig­ure out if there’s an issue. EKGs are often the first test you will need if your provider sus­pects a heart prob­lem.

This test involves get­ting sen­sors (elec­trodes) placed on your arms, legs, and chest. It may take about 10 min­utes to get set up, but the test only takes a few seconds. 

Heart CT/​Heart Scan

A car­diac com­put­ed tomog­ra­phy (CT) scan is an imag­ing test that uses X‑rays to cre­ate detailed pic­tures of your heart and blood ves­sels. A com­put­er pro­gram then com­bines the images to make a 3D mod­el of your heart.

Dur­ing a CT scan, you will lay on a table that slides into the cen­ter of a donut-shaped scan­ner and the x‑ray beams will rotate around you. You will not be enclosed in a machine.

Some heart CTs require con­trast, which is a dye that makes your heart and blood ves­sels appear even clear­er in the images. The con­trast is giv­en through an IV, so you might feel a tiny pinch when the nee­dle is insert­ed. You may also feel a warm sen­sa­tion through­out your body or have a metal­lic taste in your mouth for a few sec­onds while the con­trast cir­cu­lates. 

The test itself only takes about 10 min­utes how­ev­er you should plan on at least 30 to 60 min­utes to include time for preparation. 

Car­diac MRI

Mag­net­ic res­o­nance imag­ing (MRI) tests are sim­i­lar to CT scans, since they also take mul­ti­ple images of your heart and com­bine them for a more detailed pic­ture. How­ev­er, MRIs don’t use X‑rays, so there’s no radi­a­tion involved. MRIs take a bit longer than CTs and use a dif­fer­ent type of con­trast. 

When get­ting an MRI, you will lie down on a table that slides into the MRI machine. As the machine scans your body, it’s impor­tant to remain still so that the images are clear. The test can take any­where from 30 to 90 min­utes. You will like­ly hear loud nois­es as parts of the machine move around you to take pic­tures, but you may be able to wear head­phones to block them out. Like a CT scan, your provider may need some images with con­trast.

Lay­ing still in an enclosed space might make you ner­vous, espe­cial­ly if you’re claus­tro­pho­bic (scared of enclosed spaces). But there are micro­phones and speak­ers in the machine, so you will be able to com­mu­ni­cate with the test­ing staff if need­ed. They will also be watch­ing you at all times. Let your provider know ahead of time if you’re feel­ing anx­ious – they might be able to give you med­ica­tion to help you relax. 

Also read: Unrav­el­ing Car­di­ol­o­gy: Break­ing Down Sub­spe­cial­ties With­in Cardiology

Car­diac Catheter­i­za­tion and Coro­nary Angiography

Car­diac catheter­i­za­tion is a test where your provider inserts a small tube called a catheter inside your artery and guides it into your heart. There are sev­er­al types of tests that use catheter­i­za­tion. One of the com­mon ones is a coro­nary angiog­ra­phy. 

Dur­ing a coro­nary angiog­ra­phy, your provider will inject dye into the catheter and use X‑rays to see how it moves through your artery. Usu­al­ly, the test lasts between 30 min­utes to an hour.

You will be awake for the pro­ce­dure and able to fol­low the provider’s instruc­tions, but there’s no need to wor­ry about pain from the catheter – your provider will give you med­i­cine to pre­vent pain and to help you relax. 

Nuclear Car­diac Stress Testing

Despite what the name sug­gests, stress test­ing doesn’t mea­sure how stressed you are – it mea­sures the amount of stress on your heart dur­ing exer­cise or oth­er phys­i­cal activ­i­ties. Stress tests can show your provider how well blood pumps through your heart and if your heart receives enough blood from your body. They can also help your provider deter­mine the right amount and type of exer­cise for you.

Get­ting a stress test involves a lit­tle more effort on your part than some of the oth­er tests. While hooked up to equip­ment that mon­i­tors your heart func­tion, you will walk on a tread­mill or ride a sta­tion­ary bike at increas­ing speed or resis­tance lev­els. You may be asked to breathe into a tube dur­ing the test. After­ward, you will have your blood pres­sure and heart rate checked. 

Not all stress tests are imag­ing tests. When your provider wants to get images of your heart while you take a stress test, they can use nuclear car­diac imag­ing. This is an advanced tech­nique that can show a lev­el of detail that you can’t get from oth­er imag­ing tests. Dur­ing a nuclear test, your provider will inject a small, safe amount of a radioac­tive sub­stance called a trac­er into your blood­stream. The trac­er emits gam­ma rays, which a com­put­er uses to cre­ate images that eval­u­ate blood flow, heart mus­cle func­tion, and coro­nary arter­ies.

Also read: Inno­va­tion in Car­diac Imag­ing

The nuclear tech­nique isn’t just for stress tests – it may also be used as part of a CT scan, MRI, or PET scan.

Fun Fact: Duly Health and Care’s Nuclear Pro­gram was the first one in Illi­nois to be ful­ly accred­it­ed by the Inter­so­ci­etal Com­mis­sion for the Accred­i­ta­tion of Nuclear Med­i­cine Laboratories! 

Whichev­er test your provider orders, make sure to fol­low through. Get­ting test­ed can help them find prob­lems, get you start­ed on treat­ment ear­ly, and pos­si­bly pre­vent heart issues in the future.

At Duly Health and Care, many of our imag­ing tests are avail­able at each of our Radi­ol­o­gy loca­tions or take place at our same-day Car­diac Eval­u­a­tion Cen­ter. The CEC cen­ter offers many same-day test­ing options, such as CT scans, exer­cise and stress test­ing, and EKGs, when you are expe­ri­enc­ing non-life-threat­en­ing heart symp­toms. Your care team, includ­ing a board-cer­ti­fied car­di­ol­o­gist, will care­ful­ly review test results and pro­vide a per­son­al­ized care plan all in one con­ve­nient visit.

The first step toward get­ting an imag­ing test and learn­ing more about your heart health is talk­ing to your car­di­ol­o­gist. Find a Duly Health and Care car­di­ol­o­gist and sched­ule an appoint­ment online.