ABI. CT. MRI. When you first enter the wide world of heart screenings, it may sound like alphabet soup.
But together, these tests spell out key information about your health.
Here’s an alphabetical guide to the most common tests and screenings your cardiologist might use.
1. Angiogram, aka cardiac catheterization
An angiogram, also known as cardiac catheterization, lets your cardiologist get a close-up view of your blood vessels and blood flow.
The procedure involves inserting a small catheter into your wrist or groin and injecting contrast dye, which allows for an X-Ray movie to be taken of your heart vessels. The whole process takes about 30 to 60 minutes.
Alphabetically, angiogram comes first — but because it’s usually later in the lineup of tests your cardiologist might use.
“If other non-invasive tests suggest a significant blockage in your artery, we’ll often turn to angiography,” says Jeffrey Berman, MD, cardiology chair at St. Vincent’s Medical Center.
2. Ankle-Brachial Index (ABI)
The ankle-brachial index (ABI) is a quick, non-invasive test that checks for narrowing or blockages in your leg arteries, using blood pressure cuffs on your arms and legs. The whole test should only take a few minutes.
“This simple test is a screening test for peripheral artery disease, or PAD,” says Dr. Berman.
“It should be considered for people with leg discomfort while walking.”
3. Blood test for cholesterol
A blood test for cholesterol is another simple, but important assessment. Your blood will be drawn and analyzed to determine the cholesterol level in your blood.
“Everyone should know their cholesterol level — especially their LDL, or “bad,” cholesterol — because it’s a major risk for development of coronary artery disease,” says Dr. Berman.
> Related: What You Need to Know About HDL and LDL Cholesterol Levels
4. Calcium score
Calcium score tests use a CT scan to detect build-up in the arteries in just five to 10 minutes, with no IV required.
Coronary artery disease is the leading cause of death in the U.S., often developing silently over many years. This simple test makes sure it doesn’t sneak up on you.
“Everyone above a certain age should consider a calcium score,” says Dr. Berman. “It allows us to identify signs of coronary artery disease long before symptoms occur.”
5. Cardiac MRI
A cardiac MRI offers a comprehensive look at the heart’s structure and function.
Rather than using X-rays to create an image (like a CT scan), it uses a magnetic field and radio waves to give a detailed 3D image of the heart.
“Cardiac MRI is a very valuable test for a range of conditions, from congenital heart disease to valvular disease and heart muscle disease,” says Dr. Berman.
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6. Coronary CT angiography
Similar to the cardiac catheterization, coronary CT angiography provides detailed views of the heart arteries, helping your doctor diagnosis any blockages.
One key advantage: It’s noninvasive.
The test involves a CT scan with an injection of X-ray dye, and takes 15 to 20 minutes.
“Coronary CT angiography is becoming the go-to test for patients with chest pain who may have coronary disease,” says Dr. Berman.
7. Echocardiogram
An echocardiogram is often one of the first ways your cardiologist will take a look at your heart — using sound.
“An echocardiogram uses sound waves to produce images of your heart,” says Dr. Berman. “It can help us diagnose heart valve problems, heart failure and other cardiac conditions.”
The ultrasound, which takes anywhere from 10 minutes to two hours, shows your doctor the size and shape of heart chambers, how well the heart is pumping blood and more.
> Related: 5 Signs You Might Need a Cardiologist
8. Electrocardiogram (ECG or EKG)
As a reminder, your heart is powered by electricity. That’s where an ECG comes in (or “EKG” in Germany, where it was invented).
The test involves placing small electrode patches on your chest, arms and legs and takes just a few minutes.
“This simple test is usually part of an office visit. It gives us a lot of information about how the heart is functioning,” says Dr. Berman.
9. Holter monitor
A Holter monitor achieves much of the same results as a standard ECG, but you can take it with you.
The monitor is usually worn for 24 to 48 hours, and collects valuable information about your heart’s activity.
“This longer-term monitoring often used to diagnose problems with the heart’s rhythm,” says Dr. Berman.
> Related: Best Foods for Heart Health
10. Stress test (exercise or pharmacological)
Get your workout clothes ready if you’re scheduled for a stress test. This particular test involves doing physical activity while your heart is monitored, and will reveal how your heart functions under stress.
“During an exercise stress test, you’ll walk on a treadmill or pedal a stationary bike while your heart rate, blood pressure and ECG are monitored,” says Dr. Berman. “This is a very important test for patients with chest pain and exercise-related symptoms.”
If you’re unable to exercise, your team can also use medication to simulate the effects of exercise.
Why so many types of imaging?
Each type of tests reveals slightly different details about how your heart and arteries look.
Some of the technology is also much less expensive. Your doctor will often start with the least expensive and invasive option — usually, echocardiogram — and move on from there.
Which tests and screenings will my cardiologist use for me?
“It depends,” says Dr. Berman. “We have a wide range of tools to really look at and understand your heart. We tailor the testing plan to each individual patient.”
So for all the ABCs of cardiology tests, the most important letter is… you.
