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. There are two kinds of imaging stress tests. One takes pictures
with sound waves. Another kind uses a little bit of a radioactive substance to get pictures.

You may need an imaging stress test if you have symptoms of heart disease, like chest pain. You may need one if you are at high risk for heart disease or already have heart disease. This type of test can help your doctor decide on the best treatment for you.

If you are healthy and have no symptoms, you should think twice about having an imaging stress test. Here’s why:

The tests aren’t always useful.

The best reason to have an imaging stress test is 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 blockages are and how severe they are. It can help you and your doctor make decisions about

If you are at low risk and don’t have symptoms, the test isn’t very useful.

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

An imaging stress test is usually safe. But it can cause anxiety. It can also lead to other tests and treatments that do have risks. For example, you might have a follow-up test to view the blood vessels in your heart. This test is called coronary angiography. During this
test, a very thin tube is inserted into the heart through a vein. Dye is injected, and X-rays are taken. The risks are low, but exposure to X-rays adds up over your lifetime, so it’s best to avoid them 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 hundreds or thousands of dollars, depending on where it’s done. It can provide more information than a routine stress test, so it 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 can’t get useful information from a standard stress test.
  • You are at high risk of heart disease due to risk factors like smoking.
  • You have health problems linked to heart disease, such as diabetes, high blood pressure, or peripheral artery disease.

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

© 2017 Consumer Reports. Developed in cooperation with the American College of Cardiology.