There are several types of imaging tests for the heart. These tests give doctors a detailed image of your heart and help them detect and diagnose things like blockages, diseases, clots, tumors, and other cardiac abnormalities.
1. Coronary calcium scan.
Why it’s ordered: this preventive scan is sometimes ordered if you have unclear, low, or moderate risk of heart disease.
How it works: during a coronary calcium scan, a CT (computerized tomography) scan creates multi-slice X-ray images of the heart, looking for evidence of calcium-containing plaque.1 This scan takes about 10 minutes and is painless and non-invasive.2 The cardiac CT is scored to determine if there are risk factors for coronary artery disease and, if so, how significant they are.3
What this heart scan shows: early phases of plaque buildup in the arteries. This kind of imaging is valuable because it can reveal your risk of heart disease before you have any signs or symptoms, giving you and your doctor the opportunity to intervene before it poses a serious risk to your health. Left undetected and untreated, plaque can burst or build up, restricting blood flow to the muscles of your heart. This increases your risk of blood clots, heart attacks, and other types of coronary artery disease.
2. Cardiac MRI.
Why it’s ordered: this diagnostic scan can help doctors detect or monitor cardiovascular diseases, coronary artery disease, congenital heart disease, and heart failure.
How it works: during a cardiac MRI (magnetic resonance imaging) scan, radio waves bounce off of a large magnetic field, creating a series of computerized images of the heart that radiologists can study from various angles. Unlike X-rays and CT scans, MRIs do not use radiation. They may, however, call for the use of IV contrast dye. MRIs tend to be more precise than other scans when imaging the intricacies of the heart and its surrounding structures and tissues.
What this heart scan shows: a clear difference between normal and diseased tissue. Cardiac MRIs help doctors visualize and evaluate heart function and diagnose tumors, infections, inflammatory disease, masses, constrictions, effusions, heart failure, coronary artery disease, arrhythmias, and a number of other cardiac pathologies.
3. Nuclear stress test.
Why it’s ordered: this diagnostic scan can help doctors assess the presence and extent of heart disease.
How it works: during a nuclear stress test, you’ll have a radiotracer injected that shows if you have adequate blood flow to your heart, both while you are active (you will likely be walking on a treadmill or riding on a stationary bike) and while you are at rest. The path the radiotracers take as blood moves toward your heart is imaged using PET (positron emission technology) scans or SPECT (single-photon emission computed tomography) scans. If your heart does show signs of coronary artery disease or other factors that increase your risk of a heart attack, your doctor can use your test data to determine how much exercise and physical activity your heart can safely tolerate.
What this heart scan shows: whether or not you have coronary artery disease. Normal blood flow during both exercise and rest indicates your heart doesn’t have arterial blockage or damage. Normal flow at rest but not while exercising suggests one or more arteries are blocked, and that would qualify you for a diagnosis of coronary artery disease. Low flow both exercising and resting is indicative of severe coronary artery disease or a prior heart attack. If blood and radiotracers don’t flow to certain parts of your heart, those areas may be damaged from a prior heart attack.
It can be useful to get a heart scan as a proactive, preventive health tool. Lifestyle changes to diet, exercise, and certain medications can also support heart health.
Heart scans are also helpful as diagnostic tools for people who already have major risk factors for developing coronary artery disease, such as:
So how can you tell you might need a heart scan?
Heart symptoms present differently depending on the nature of the heart issue or disease. However, certain symptoms should prompt you to seek medical attention immediately and may necessitate a heart imaging scan as well. Here are some warning signs to look out for: