Heart and Vascular Institute – Cardiovascular Imaging and Diagnostic Tests

Depending on your condition, you may need one or more tests to help us identify problems and plan treatment. Advanced imaging techniques allow doctors to see heart structure, veins and arteries to identify problems or plan treatment strategy. Other technologies and tests help us further assess your condition, its causes and possible treatment options.

Make an appointment

To schedule an appointment at any Penn State Heart and Vascular Institute location, please call 
1-877-467-7484

Our team will talk to you about your specific treatment options. We’ll make sure you have the information you need to be an active member of your own health care team.

Computed tomography (CT) angiography

CT angiography uses X-rays to create detailed images of the heart and blood vessels that go to and from the heart and throughout the body. This test can show blocked areas, bulges (aneurysms) or plaque, a fatty substance that can block veins and arteries.

During a CT angiogram, you lie on a table that passes through a scanner. A special dye is injected into a vein in your arm or hand to make the blood vessels easier to see.

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Coronary artery calcium (CAC) scoring

CAC scoring is a quick, painless test using a high speed CT scanner to measure calcium deposits in the coronary arteries. Calcium is a sign of atherosclerosis, or “hardening of the arteries,” which can lead to a heart attack.

Your CAC score can help predict your future risk of having a heart attack. We can help you take steps to prevent one if needed.

You may need CAC scoring if you are a man over age 45 or a woman over age 55 and you:
•    Smoke
•    Have high blood pressure
•    Have high cholesterol
•    Have a family history of coronary artery disease

If you don’t have any of these risk factors, or if you have already had a heart attack, you probably don’t need CAC scoring.

If you think you might need this test, talk to your doctor. To schedule an appointment, call 717-531-3799 and choose option #1.

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Cardiac computed tomography angiography (CTA)

Cardiac CTA uses X-ray images and computer modeling to produce three-dimensional views of a person's heart. Doctors use these images to check for coronary artery disease or assess its risk.

Cardiac CTA allows physicians to be able to see the structure of the heart with a noninvasive technique. Cardiologists and radiologists work together to get the images and interpret them. 

Please talk with your physician to find out if this study is right for you. See what to expect from cardiac CTA at Hershey Medical Center

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Echocardiography

An echocardiogram, or “echo,” is a noninvasive test that uses ultrasound (sound waves emitted from a small probe) to check the structure and function of the heart. You can’t hear the sound, but the sound waves bounce off your heart to create a detailed picture. 

To see an example of an echocardiogram picture, click the image to the right. (The clip takes about 30 seconds to download.) 

Our Echocardiography Laboratory is one of a select group accredited by the Intersocietal Accreditation Commission (IAC) for all adult echocardiography. It is also one of only 60 labs in the United States with an associated adult congenital heart disease program. 

Services are available Monday through Friday from 7:30 a.m. to 5 p.m. All the cardiologists are board certified with special expertise in echocardiography.

The lab offers a wide range of service, including:

Adult congenital echocardiography

A-V and V-V optimization 

A-V and V-V optimization are noninvasive procedures that make a series of changes to your pacemaker settings. We’ll assess how your heart function responds to these changes. After reviewing the settings and data, we’ll know which pacemaker change will be best for your heart function and quality of life. 

This study takes about 30 minutes longer than a standard echocardiogram, and there might be more people in the room. A doctor will read the echo data and order changes to the pacemaker settings.

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Stress echocardiography

A stress echocardiogram uses ultrasound imaging to take pictures of the heart before and after stress. The stress can be from physical exercise or from a medication called dobutamine that stimulates the heart. A stress test lets doctors see how your heart responds to stress. That can help them assess your heart’s strength and your risk for coronary artery disease. They can also see how your heart’s valves are working and whether your heart medicine is working.

A metabolic stress test is like an exercise stress test, but you also breathe into a mouth piece during exercise to measure your lung function. A metabolic stress test is also called a cardiopulmonary exercise stress test.

The test takes about an hour to an hour and a half. First, a picture is taken of your heart at rest.
If you are having an exercise stress echocardiogram, you will exercise by walking on a treadmill or riding a stationary bike while your heart rate, rhythm and blood pressure are monitored. If you are having a metabolic stress test, you’ll breathe in and out of a special mouthpiece. An exercise physiologist will monitor your exercise. After the exercise, you’ll relax while we take more images of your heart.

If you’re having a dobutamine stress echocardiogram, a nurse will place an IV line for the dobutamine. You may feel like you’ve been exercising even though you’ve been still. The cardiac sonographer will take pictures of the heart at different doses of the medication. When you’ve reached the target heart rate, we’ll stop the medication. Sometimes, another medicine is used to stop the effects of the dobutamine.

To prepare for the test:

  • Wear comfortable clothes.
  • Wear sneakers to walk on the treadmill.
  • Bring a list of your medications.
  • Do eat or drink for several hours before your test.
  • Do not take certain medicines. Talk to your doctor about which medicines you should take.
  • If you have your pacemaker or defibrillator, have it checked or reprogrammed.

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Transesophageal echocardiography (TEE)

In this test, a small ultrasound probe is passed through your esophagus to get more detailed images and information. The doctors can see the structure of the heart’s chambers, valves and nearby blood vessels. They can check for signs or infection, blood clots or diseases. They can even use the live images to see clearly during surgery or other procedures. Images obtained from the TEE help the cardiologist find and evaluate problems that may be difficult to identify with a transthoracic echocardiogram from the chest’s surface.

For this test, a nurse will start an intravenous (IV) line to give you medicine to help you feel calm and relaxed. We’ll place stickers on your chest to monitor your heart rhythm, and spray your throat with anesthesia medicine to numb it for the test. You’ll relax on your left side, and when you’re sedated and almost asleep, a cardiologist will pass the ultrasound down your throat and through your esophagus. The probe will take moving images of your heart. We’ll keep monitoring your vital signs until you’re fully awake and recovered. The test takes about two hours, including preparation and recovery time.

To prepare for the test:

  • Wear comfortable clothes.
  • Bring a list of your medications.
  • Do not eat or drink for several hours before your test.
  • Arrange for a ride home, as you cannot safely drive right after being sedated.

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Transthoracic echocardiography 

This is the most common type of echocardiography and only takes about 30 to 45 minutes. You lie on your left side, and a sonographer moves an ultrasound probe over your chest and abdomen. It’s painless and noninvasive.

Electrocardiographic Services

The Heart and Vascular Institute provides a full range of non-invasive diagnostic cardiac procedures for both adult and pediatric patients. 

Services include Nuclear Stress Testing and Stress Echocardiography with and without pharmacologic agents, Stress Testing, Metabolic Stress Testing, Holter application and Holter Scanning, EKG and Signal Averaged EKG. The Cardiology Services Department also includes Pacemaker Clinic services that include transtelephonic monitoring of pacemakers and arrhythmia event monitors as well as implantable pacemaker and defibrillator device programming and interrogation.

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Magnetic resonance (MR) angiography

MR angiography is a useful, noninvasive way to see blood flow through arteries and veins, with limited radiation iodinated contrast exposure. 

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Nuclear cardiology

The Heart and Vascular Institute works with the Department of Radiology to provide nuclear cardiology studies.

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Vascular ultrasound

This test uses ultrasound to view the structure of the body's blood vessels and measure the flow within them. Vascular ultrasound (“duplex”) scans are painless and safe, and help show whether blood vessel conditions are changing over time. 

This laboratory is one of a few in central Pennsylvania to be nationally accredited in all five types of vascular ultrasound. All staff are certified as registered vascular technologists (RVT) by the American Registry for Diagnostic Medical Sonography (ARDMS). The lab is accredited by the Intersocietal Accreditation Commission.

Test we offer include:

Ankle/brachial index

An ankle/brachial index assesses blood flow in the legs. You’ll relax on your back and wear special blood pressure cuffs on your ankles and your arms. The cuffs will inflate and deflate several times while the sonographer takes measurements. The test takes about 30 minutes. Don’t smoke for at least an hour before the test.

Duplex scan of the carotid and vertebral arteries

While you relax on your back, a sonographer applies gel on your neck and uses an ultrasound probe to take images of the arteries. The test takes about 45 minutes to an hour. It is painless and involves no needles or dyes. Wear a loose-fitting shirt (no turtlenecks) so the sonographer can see your neck.

Duplex scan of the intracranial arteries

This test helps doctors see the major arteries inside the brain, also called the Circle of Willis, to check for blockage and spasm. While you relax on your back, the sonographer places a small ultrasound probe against your temple, at the base of your skull and under your chin. The sonographer can take pictures and measure blood flow within the arteries. It takes about an hour, and it’s painless and noninvasive.

Extremity peripheral arterial examinations

This test is used to assess blockages in the main arteries in the legs or arms. While you relax on your back, the sonographer puts gel on your skin and places an ultrasound probe against your skin over the arteries in your arms and legs. The sonographer takes images and measures the blood flow in the arteries.  We’ll also monitor your blood pressure throughout the exam. The test takes about 45 minutes per extremity (arm or leg), and it’s painless and noninvasive. Don’t smoke for at least an hour before the test.

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Extremity venous deep vein thrombosis (DVT) examination

This test scans all of the veins of an arm or leg for blockages or clots. For a leg, the sonographer starts at the top of the leg near the hip or groin, and follows the veins to the ankle. For an arm, the sonographer scans all the veins from the neck to the wrist. The test takes about 45 minutes to one hour, and you’ll be given a gown or sheet to cover with.

Intracranial Doppler or monitoring (transcranial monitoring)

You may need this test if doctors think you may have had a stroke or transchemic ischemic attack (TIA or “mini-stroke”). It’s used to check for small clots in arteries that can lead to stroke.

While you relax on your back, the sonographer places a type of brace on your head that holds an ultrasound probe in place. The sonographer locks the probe into place over the artery the doctor wants to see. We’ll monitor the artery for about an hour, measuring and recording the blood flow. The entire test takes about an hour and a half, and it’s painless and noninvasive. You’ll need to be still, so you might want to bring a book or magazines to read.

Superficial temporal artery imaging

This test can help diagnose and assess temporal arteritis, also called giant cell arteritis, a disorder that causes inflammation in arteries that can narrow them and reduce blood flow. The sonographer uses an ultrasound probe to get images of arteries in your neck, temple and forehead. The test takes about one hour, and it’s painless and noninvasive.

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Venous duplex reflux, lower extremities

In this test, a sonographer scans all of the veins of the legs starting at top of the legs near the hip or groin and following them to the ankle. The test checks for venous reflux, or backward flow into a vein. It takes about one hour per leg, and you’ll be given a gown or sheet to cover with.

Visceral vascular duplex and organ transplant

This exam looks at the arteries and veins in the abdomen. While you relax on your back or side, the sonographer will press on your abdomen with an ultrasound probe to check the arteries and veins. Sometimes pressure from the probe can be uncomfortable. The test takes about one hour. You’ll probably need to fast for eight hours before the test. If you’re on any kind of medication, talk to your doctor about whether you should take it before the test.

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Make an appointment

We serve patients at multiple convenient locations