Accessibility issue - Rise 360 Image plus text blocks

I want to know how text readers for visually impaired learners read the text in image plus text blocks. The generic text part of the image + text block has a boldface paragraph header or title with normal face text under it. Does a text reader "read" the boldface header or title as a title or as plain text? This is important if, for example, I use a series of image + text blocks, and each one is a different case study. If I use the titles "Case Study 1", "Case Study 2" for example, does the text reader announce these to the vision-impaired person as titles? 

I'm trying to decide if I need to introduce each image + text block by inserting a separate "subheading" above it, to maintain hierarchy of information. But that makes the layout look cluttered and unappealing to people without visual disabilities. Thank you!