Heart Diagnostic Imaging: A Guide to the Most Common Cardiac Tests
October 2, 2026 · 2 min read
Medically reviewed by the physicians of Gilead Heart & Vascular · Last reviewed: 2026-10-02
Cardiologists rely on a handful of complementary tests, EKG, echocardiogram, stress testing, CT angiography, and calcium scoring, because no single test tells the whole story of how your heart is functioning.
Why Cardiologists Use More Than One Type of Test
The heart is both an electrical system and a mechanical pump, and no single test captures everything about how it's functioning. Cardiologists rely on a small set of complementary tests, each answering a different question, to build a complete picture of your cardiovascular health.
EKG (Electrocardiogram)
An EKG records the heart's electrical activity over a few seconds using electrodes placed on the skin. It's fast, painless, and often the first test performed, useful for detecting irregular heart rhythms, prior heart attacks, and certain structural clues.
Echocardiogram
This ultrasound-based test shows the heart's physical structure and motion in real time: chamber size, wall thickness, valve function, and overall pumping strength. It's typically the go-to test when a doctor suspects a structural issue.
Cardiac Stress Test
A stress test evaluates how the heart performs under physical exertion, often revealing blood flow problems that don't appear when the heart is at rest.
Cardiac CT Angiography
This imaging test uses a CT scanner and contrast dye to create detailed pictures of the coronary arteries themselves, useful for directly visualizing plaque buildup or blockages, often as a more targeted follow-up to other testing.
Coronary Calcium Score
A quick, low-radiation CT scan that measures calcium buildup in the coronary arteries, giving an early snapshot of atherosclerosis risk, often before symptoms appear.
How These Tests Work Together
In practice, these tests are rarely used in isolation. A typical workup might start with an EKG and physical exam, move to an echocardiogram if a structural issue is suspected, and add a stress test or calcium score if the question is about blood flow or long-term risk. Your physician chooses the sequence based on your symptoms and history, rather than running every test on every patient, so you're not paying for or sitting through testing that isn't going to change your care.
Frequently Asked Questions
Which heart test should I start with?
Most cardiac workups begin with an EKG and often an echocardiogram; your doctor will recommend further testing based on your symptoms and risk factors.
Do I need all of these tests?
No. Each test answers a different question, and your doctor will only order the ones relevant to your specific symptoms or risk profile.
Are these tests covered by insurance?
Most are covered when medically indicated, but coverage varies by plan; our team can help verify benefits before testing.
Related Reading
Want to be seen soon and skip the wait at a place close to home? Gilead Heart & Vascular offers in-office diagnostic imaging, including EKG, echocardiography, and stress testing, at each of our Arizona locations, so your workup happens under one roof with one doctor coordinating your care.
Have a question about your heart health?
Talk it through with your doctor at any Gilead Heart & Vascular location.