Imaging Test Overview

Chest X-rays

Chest x-rays may be performed to detect abnormalities in the size and shape of the heart (e.g., an enlarged heart), to detect fluid around the heart (pericardial effusion), and to detect heart failure. They also may be used to detect abnormalities of the major artery (aorta).

Coronary Angiography

A coronary angiogram is obtained by injecting an iodine-based dye or other contrast agent into the bloodstream and taking x-rays of the coronary arteries. This enables the physician to see blockages, malformations, and stenosis in the vessels.


Echocardiogram (also called cardiac echo) is an ultrasound examination of the heart that produces detailed images of the organ. It uses a microphone-like device (transducer) to transmit and receive sound waves that travel through the chest wall to the heart, and then are reflected back. The reflected sound waves are translated into images of the heart, including the aortic valve, chambers, and walls.

Echocardiogram is used to detect abnormalities in the structure of the heart, to assess thickening of the walls, to measure the pressure change (gradient) between the left ventricle and the aorta, to measure the amount of dilation (increased diameter) of the left ventricle, and to measure the ejection fraction (the percentage of blood ejected from the left ventricle with each heart beat).

Echocardiogram may be used in the diagnosis of aortic stenosis, atrial fibrillation, congestive heart failure, endocarditis, heart attack, and pericarditis.

Transesophageal Echo (TEE)

A transesophageal echo is a type of echocardiogram that uses a long tube with a special microphone-like device mounted on one end. The tube is passed through the mouth and throat and then down the esophagus (organ that connects the throat to the stomach, located directly behind the heart). This allows the imaging part of the transesophageal echo to be placed in close proximity to the heart and enables the doctor to obtain high-quality images of the heart and the heart valves.

During TEE, the mouth and throat usually are sprayed with numbing medicine and patients are given a sedative to help them relax. This procedure is able to detect more than 90 percent of heart valve infections.

Publication Review By: Stanley J. Swierzewski, III, M.D.

Published: 24 Nov 2004

Last Modified: 18 Sep 2015