Cardiovascular Imaging + Noninvasive Testing

A cardiac MRI uses a magnetic field and radio waves to create images of your heart and blood vessels. This helps us find conditions that could affect your heart health. Your care team will guide you on how to prepare, including removing metal objects. People with certain pacemakers or implanted defibrillators may not be able to have an MRI. Typically, people with titanium implants are cleared for the test. A contrast agent may be injected to highlight tissues and detect abnormalities.

A CT scan uses X-rays to create detailed images of your heart. It helps us look for blockages or narrowing in your blood vessels and coronary arteries. A contrast agent may be used to get clearer images. Although there is some radiation exposure, the benefits of the detailed results outweigh the minimal risks.

An echocardiogram, or echo, is an ultrasound of your heart used to assess your heart valves, heart muscle thickness, and pumping efficiency. A transducer sends sound waves through your body, creating real-time images of your heart.

An electrocardiogram, also called an EKG, monitors your heart's electrical activity, helping diagnose conditions like heart failure and hypertrophic cardiomyopathy. It translates your heart rhythm into a graph for your doctor to analyze.

A stress echocardiogram combines an EKG and an echocardiogram to see how your heart functions under stress. We also conduct an exercise stress echocardiogram to evaluate how your heart rate responds to physical activity.

This test helps your doctor detect heart blockages when your heart rate increases. You’ll run on a treadmill while connected to an EKG. If running is not an option, a chemical stress test can be used to artificially stress the heart. It’s often done if a regular echocardiogram shows a thickened heart muscle with no blocked blood flow at rest.

What to expect during an exercise stress echocardiogram

A care team member will be with you throughout the exam, monitoring your blood pressure and electrocardiogram (EKG) as you exercise. You’ll start by walking on a treadmill at a slow pace. Every few minutes, the treadmill will increase speed and tilt upward like a small hill. We’ll check in with you during the test by asking how you’re feeling, including:

• Are you short of breath?
• Do you feel faint or dizzy?
• Do you have any chest pain?

Once you reach your maximum level of exercise, you’ll lie on your left side on a nearby bed while the specialist takes additional pictures of your heart.

How to prepare for an exercise stress echocardiogram

Your care team will guide you through the preparation process, which includes:

• Not eating or drinking for 4 hours before the test
• Pausing any heart medications on the day of the test so we can see how your heart functions without the influence of medications
• Wearing comfortable, loose-fitting clothing and sneakers

Nuclear cardiac imaging is a type of nuclear medicine that uses a small amount of safe radioactive substance to take pictures of your heart. These images help us check if parts of your heart aren’t getting enough blood or aren’t working properly. The test is often done alongside an exercise stress test, where you either walk on a treadmill or take a medication that makes your heart react as if you were exercising. This helps us see how well blood flows to your heart.

How to prepare for a nuclear cardiac imaging stress test

Your care team will guide you on how to prepare for your test, including:

• Ask your doctor which medications you should take on the day of the test.
• Wear light clothes and comfortable shoes since you’ll be exercising on a treadmill.
• Eat a light breakfast for a morning test or a light lunch for an afternoon test.
• Avoid caffeine on the day of the test.

What to expect during a nuclear cardiac imaging stress test

This test is often combined with an exercise stress echocardiogram, where you either walk on a treadmill or take a medication to simulate exercise. After exercising or taking the medication, a small amount of radioactive tracer is injected into your bloodstream. The radiation is low, and the test is generally safe, with the benefits outweighing the risks.

You’ll then lie on a table while a special camera takes pictures of your heart. The camera tracks the tracer to show areas that might not be getting enough blood. The test is done in two parts: once when your heart is under stress and again when it’s at rest. Comparing the images helps your doctor see how your heart is functioning and identify any issues.