4 heart tests that diagnose heart conditions

According to the American Heart Association’s 2024 Heart Disease and Stroke Statistics: A Report of U.S. and Global Data, heart disease continues to be the leading cause of death in the U.S. for more than 100 years. Even when heart disease and heart conditions don’t result in death, they cause disabilities and contribute to additional illnesses.

Heart health mortality and disability rates are a stark reminder that cardiovascular imaging and screenings are a critical piece in detection and management of a multitude of heart conditions. Advances in technology and innovations in cardiovascular imaging are available at Allina Health Minneapolis Heart Institute to help diagnose and begin treatment or continue to guide treatment of heart problems before they turn into life-threatening conditions.

Why heart risks often go undetected

Heart disease and other heart problems are often silent killers, with unnoticed symptoms like plaque buildup, vascular narrowing and valve dysfunction that build up over years until they’re eventually detected after a heart attack or stroke.

What is cardiovascular imaging?

Cardiovascular imaging is the window into the heart and blood vessels — a set of advanced, noninvasive imaging techniques that let us see how the heart looks, moves and functions. It includes tests such as echocardiography (ultrasound of the heart), cardiac MRI, CT angiography and nuclear imaging, each offering unique insights into the heart’s structure, blood flow and tissue health.

These powerful tools are not just diagnostic — they are life-saving. Cardiovascular imaging helps detect heart disease early, guide treatment with precision and monitor recovery over time. From uncovering hidden blockages to assessing the effects of therapy, it transforms data into decisions that protect lives.

In essence, cardiovascular imaging is how we turn invisible disease into visible knowledge — and knowledge into better heart care.

Tests and scans that detect hidden heart risks

Over the past 50 years, advancements in technology have given doctors more precise ways to proactively look at the heart to assess disease or damage and take preventative action before it becomes worse. Performed early, heart tests can catch symptoms of heart disease or dysfunction before they become life-threatening.

Cardiac imaging allows a doctor to better visualize:

• blood flow and effects of your blood pressure
• heart size, function and structure
• muscle strength and endurance, or muscle damage
• damage from past heart attacks
• valve performance
• blockages in the arteries or plaque buildup
• inflammation, infection or scar tissue
• measure the effectiveness of a particular treatment (medication, surgical procedure or less invasive transcatheter intervention in the arteries or valves)

Each imaging tool below reveals a different dimension of heart health — structure, function, flow or tissue. Together, they empower clinicians to detect disease early, personalize treatment and improve outcomes.

1. Echocardiography (ultrasound)

An echocardiogram uses high-frequency sound waves to create a moving picture of the heart. During this screening, an imaging specialist places a hand-held ultrasound probe in various locations on a patient’s chest. The resulting images can be two-dimensional or three-dimensional depending on the type of ultrasound used.

Strengths:

• Real-time images of heart motion and valves.
• Portable, safe, no radiation.

Helps identify:

• Heart failure.
• Valve diseases, like stenosis or regurgitation.
• Wall motion abnormalities after heart attack.

Guides treatment:

• Starting heart failure therapy.
• Timing valve repair or replacement.
• Monitoring of treatment response.
• Guidance for minimally invasive procedures.

2. Cardiac MRI

Cardiac magnetic resonance imaging (MRI) uses magnetic fields and radio waves to create highly detailed images of the heart and blood vessels. During an MRI, a patient lies flat on a table that slides into a tube-shaped scanner.

Strengths:

• Best test to understand what’s wrong with your heart muscle.
• Detailed and exquisite evaluation of three-dimensional heart structure and function.
• No radiation.

Helps identify:

• Myocarditis or scarring after heart attack.
• Causes for weak heart function.
• Cardiomyopathies (e.g., hypertrophic, dilated).
• Quantify how bad the leakiness of your valves is, especially when echocardiogram is indeterminate or difficult imaging quality.

Guides treatment:

• Determining viability of the heart muscle before opening obstructed arteries.
• Tracking progression of valvular disease, cardiomyopathy.
• Allows for precise monitoring of treatment response.

3. Cardiac CT angiography (CTA)

Cardiac computed tomography (CT) uses X-ray technology to create multiple cross-section views of your heart and blood vessels. During a cardiac CT angiogram, contrast dye is injected into a patient’s bloodstream to help doctors visualize arteries. The patient then lies still on a table while an X-ray machine revolves around their body taking images from various angles.

Strengths:

• High-resolution images of coronary arteries, aorta, heart muscle and valves.
• Fast and accurate plaque detection.

Helps identify:

• Coronary artery disease and blockages.
• Aortic aneurysms and congenital defects.

Guides treatment:

• Deciding on preventive therapies or interventions.
• Planning procedures, like Transcatheter Aortic Valve Replacement (TAVR).

4. Nuclear cardiology (SPECT / PET)

Nuclear cardiology uses a special gamma camera along with an injection of dye to create detailed images. Cardiac positron emission tomography (PET) and single photon emission computed tomography (SPECT) both create detailed 3D pictures of the heart. During these scans, a patient lies flat on a table that slides into the scanner. The result allows doctors to visualize how a heart and its surrounding structures function together.

Strengths:

• Measures blood flow and metabolism.
• Detects problems like lack of blood flow (ischemia) into your heart muscle or heart muscle inflammation.

Helps identify:

• Areas of low perfusion or viable myocardium.
• Inflammation (e.g., sarcoidosis, infection).

Guides treatment:

• Selecting patients for stents or bypass.
• Monitoring response to therapy.

Take a proactive approach to heart health

When it comes to heart health, an important first step is living a healthy lifestyle, but heart disease and abnormalities can affect anyone. Some simple ways to keep your heart healthy include:

• Keep up with your preventative heart care.
• Discuss changes in your body and health with your provider.
• Eat healthy and move your body.
• Quit smoking or vaping and limit alcohol use.
• Know your family’s heart health history.
• Schedule heart tests as directed by your provider.