Imaging Tests for Heart Disease

When you need them—and when you don’t

Imaging stress tests take pictures of the heart while it is working hard. Ultrasound and echocardiography tests take pictures with sound waves. Nuclear cardiology tests use a small amount of a radioactive substance to get pictures.

You may need an imaging stress test if you have symptoms of heart disease, like chest pain. Or you may need one if you already have heart disease, or if you have a high risk for heart disease. These tests can help your doctor decide the best treatment for you.

But if you are a healthy person without symptoms, you should think twice about having these tests. Here’s why:

The tests aren’t always useful.

An imaging stress test is best used to manage severe heart disease. The test can help your doctor find out if blood flow to your heart is blocked. It can also show where any suspected blockages are and how severe they are. It can help you and your doctor make decisions about treatment.

However, if you are at low risk and don’t have symptoms, the test has limited benefits.

Imaging stress tests can lead to other tests that are not needed or have risks.

An imaging stress test is usually safe and can be done using little or no radiation. But the test can cause anxiety. And it can lead to other tests and treatments that do have risks. For example, if something looks wrong on the imaging stress test, your doctor may order a CT scan and an angiogram. These expose you to radiation. Risks from radiation exposure can add up, so it is best to avoid it when you can. Excess testing can lead to unnecessary treatment with drugs as well.

The tests can cost a lot.

An imaging stress test costs between $500 and $2,000. Since the tests can provide more information than routine stress tests, they may be worth it. But if you don’t need one, why waste your money? The tests should be used only when they will help you and your doctor treat and manage your disease.

When should you consider an imaging stress test?

You might need an imaging stress test if:

  • You have symptoms of heart disease—such as chest pain, shortness of breath, irregular heartbeats, or heart palpitations (unusually strong heartbeats).
  • An electrocardiogram (ECG) shows something abnormal and your doctor cannot get useful information from a standard stress test.
  • You smoke or have a combination of health problems related to heart disease, such as diabetes, high blood pressure or peripheral artery disease that put you at high risk.

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.