Cardiac Imaging

Cardiovascular imaging allows physicians at Prisma Health to diagnose cardiovascular disease and evaluate cardiovascular anatomy and function noninvasively. Prisma Health cardiovascular imaging physicians have trained at leading institutions and use the newest technologies to diagnose heart disease. We employ the following imaging techniques to diagnose cardiovascular disease and to aid our cardiovascular surgeons and interventional cardiologists during procedures.


An echo is an ultrasound of the heart. We look at your heart in different views. We look at the walls of the heart, the four heart chambers, the four heart valves, and the blood flow through the heart. We measure the thickness of the walls of the heart, measure the size of the heart chambers, and measure the velocity of blood flow through the heart valves. This test gives us a good idea of your heart function.

This test is a noninvasive test. It takes approximately 30 to 45 minutes to perform. You can eat and take your regular medicines.

Questions you may have about the procedure

Q: Why do I need to have this procedure?
A: To evaluate your heart function.

Q: When and how will I find out about my results?
A: Your echo will be read and interpreted by the cardiologist usually within 24 hours. Your test results will either be called to you or we will send you a letter.

Stress Echo

This test incorporates ultrasound images into a stress test. We take a set of resting images of your heart. Then we have you walk on the treadmill and when your heart rate reaches its peak at stress, we stop the treadmill and take another set of images. We then compare the two sets of images to see how well the heart squeezes. This gives us an idea if there is a potential for your heart to have blockages in the coronary arteries.

If you are unable to walk on a treadmill due to physician limitations, a medication is given to stimulate your heart and make it think you are on a treadmill.

Steps for the procedure

  • Wear comfortable clothes and shoes to walk on the treadmill i.e. tennis shoes.
  • Withhold Beta blockers, i.e. Toprol XL for 48 hours.
  • You can have a light breakfast or lunch 2 hours before procedure.
  • If this is a Dobutamine stress echo, do not eat before the procedure, unless you are a diabetic; then follow your normal diabetic diet.

This is a noninvasive test. It takes approximately an hour to perform.

Questions you may have about the procedure

Q: Why do I need to have this procedure?
A: To rule out the possibility of coronary artery disease.

Q: When and how will I find out about my results?
A: The doctor will give you the results immediately after the test.

Nuclear Stress Test

A nuclear stress test is approximately a four hour procedure that will ultimately allow a cardiologist to evaluate the blood flow patterns to the heart.

Upon arrival, the patient will have IV access started in either the hand or arm. A small dose of Cardiolite, a radioactive tracer, will be injected. There are no side effects to the Cardiolite. The patient will then wait for about an hour in the waiting room while eating crackers and drinking water.

Next resting images of the heart will be obtained. The patient will lie flat on their back with their arms above their head for approximately 15-20 minutes. A nuclear medicine gamma camera will slowly rotate around the chest to acquire images during this time.

The stress portion of the procedure occurs next. A patient will either walk on a treadmill or have a medication injected to stress the heart. For the treadmill, a patient will walk until a target heart rate is achieved. The treadmill starts out at a low incline and slow speed; then every three minutes speed and inclined are increased until the target heartrate is attained. A second dose of the Cardiolite will be injected in order to obtain a second set of images. If a patient is having a chemical stress test, a medicaition to dilate the blood vessels of the heart will be injected followed by a second dose of the Cardiolite. The stress medication can have a few side effects – flushing, nausea, headache, or vomiting. If side effects do occur, they normally resolve in just a few minutes. After the stress portion, the patient will be asked to wait a second time in the waiting while eating and drinking.

Finally, stress images will be acquired in the same manner as the resting images usually taking 15-20 minutes again.

Questions you may have about this procedure

Q: Why do I need this procedure?
A: If you are experiencing any heart symptoms, such as chest pain or shortness of breath, this test can be valuable in evaluating any problem with blood flow to the heart. Is is also a good diagnostic tool if you have a high risk of heart problems such as diabetes, hypertension, or family history of heart problems.

Q: How long does the procedure take?
A: The test takes approximately four hours. The patient will be moving throughout the department during this time for different steps of the test.

Q: What should I wear?
A: Comfortable clothes are recommended as well as a jacket or sweater as the office can be cool at times. A tshirt or other shirt that can be raised up are highly encouraged so that staff can have easy access to the patient’s chest in order to apply electrodes. Dresses and skirts are discouraged. It is also recommended to avoid shirts that have snaps, zippers, metal embellishments, or other metal items as these can interfere with the images.

If a patient is scheduled to walk on the treadmill, shoes with backs must be worn.

Q: What items should I bring with me?
A: Bring daily medications if possible as the office does not have medication here for patient use.

Patients are welcome to bring books, magazines, tablets, etc. with them. Wifi is available in the building.

Q: When will I find out my results?
A: Results are not given by the testing facility. Tests are read by a cardiologist and forwarded to the patient’s ordering doctor. Results can usually be obtained in 3-5 business days. If a patient has not received results in that time frame, it is recommended that the patient contact their physician who ordered the test.

Q: What if I have more questions?
A: Please feel free to contact the Nuclear Medicine department at (864) 522-3300, option 3. We are happy to answer any questions you might have about your procedure to make it an easy and enjoyable experience when you arrive for testing.

NOTE: If you need to reschedule or cancel your procedure, please do so at least 24 hours in advance. Each dose of Cardiolite is specially ordered for the patient, and we need notice to cancel it. Thank you.

Treadmill Stress Test

An exercise stress test measures the function of the heart during exertion. This test specifically shows the changes in the electrical system of the heart during exercise. The changes seen on during exercise provide information about the heart that may not show up on a resting EKG.

When the patient arrives, he or she will have electrodes placed on the chest and hooked up to an EKG machine. A resting EKG will be taken as well as a blood pressure reading. Next, the patient will start walking slowly on the treadmill at a low incline and speed. Every three minutes, the speed and incline will be increased gradually until the patient has reached the target heart rate. Staff will be monitoring heart rate response, blood pressure response, EKG, and any patient symptoms throughout the test.

A treadmill stress test takes approximately 30 minutes from beginning to end.

CT Angiography

CT (Computed Tomography) Angiography (CTA) is an examination that uses x-rays to visualize blood flow in arterial and venous vessels throughout the body, from arteries serving the brain to those bringing blood to the lungs, kidneys, and arms and legs. CT combines the use of x-rays with computerized analysis of the images. Beams of x-rays are passed from a rotating device through the area of interest in the patient’s body from several different angles to create cross-sectional images, which then are assembled by computer into a three-dimensional picture of the area being studied.

Calcium Scoring

Coronary Calcium Scoring is a technique used to determine if coronary calcification is present in your coronary arteries. It is a CT scan that captures cross-sectional images of the heart at sub-second rates. This unique CT technology allows the detection of calcium in the coronary arteries which is directly related to the total atherosclerotic plaque buildup and compares it to standards for your age and gender.