Imaging Tests After a Heart Procedure

When you need them—and when you don’t

If you’ve had bypass surgery or a stent inserted to open a blocked artery in your heart, you may wonder if you need regular imaging tests to see how well your treatment is working.

Imaging tests take pictures of your heart. Ultra-sound and echocardiography tests take pictures using sound waves. Coronary CT scans use x-rays to take pictures. And nuclear stress tests use a small amount of a radioactive substance to get pictures.

If you don’t have symptoms of heart disease, you usually don’t need any of these tests. Here’s why:

The test rarely shows a problem unless you have symptoms.

Chest pain and other symptoms of heart disease can return even after you’ve had heart surgery or another procedure. If that happens, an imaging test can show if the area that was treated is blocked again, or if there is a new blockage. The tests can also help you and your doctor decide if you need to increase your medicine or have another procedure.

However, many people who have had a procedure, but do not have symptoms, get an imaging test every year. They have the test to see if their heart problem has come back. But, without symptoms, the tests rarely find a problem. Actual symptoms are the best sign of a returning heart problem.

The tests have risks.

The tests are usually very safe, and some can be done with little or no radiation. But the test may show a false positive, especially if you don’t have symptoms. This can cause you unnecessary worry and stress. And it can lead to unneeded follow-up tests, such as coronary angiography. This is an invasive procedure that exposes you to added risk and radiation.

Finally, the tests can lead to having another proce­dure, including heart surgery. Each procedure has risks. And if you don’t have symptoms, having more procedures has not been proven to help prevent another heart attack or help you live longer.

The tests can cost a lot.

A nuclear stress test costs between $500 and $2,000. A CT scan costs $500 to $600. And a false result can lead to other costly procedures. Coronary angiography costs more than $1,000, and unneces­sary surgery costs more than $10,000. Imaging tests do give your doctor information if you have symptoms. But if you don’t, why waste the money?

When is an imaging test a good idea after a heart procedure?

You might need an imaging test if your symptoms come back or get worse. This includes symptoms such as chest pain, shortness of breath, feeling tired, or having trouble climbing stairs.

If you don’t have symptoms, you may still need an imaging test if:

  • It has been more than five years since your bypass surgery.
  • It has been more than two years since your stent procedure.
  • You have blockages that weren’t treated during your first heart procedure.
  • You have diabetes or aggressive heart disease.

The tests should be used only when they will help you and your doctor manage your heart disease.

This report is for you to use when talking with your health-care provider. It is not a substitute for medical advice and treatment. Use of this report is at your own risk.

© 2012 Consumer Reports. Developed in cooperation with the American College of Cardiology. To learn more about the sources used in this report and terms and conditions of use, visit ConsumerHealthChoices.org/about-us/.

12/2012