How Is Atherosclerosis Diagnosed?
Your doctor will diagnose atherosclerosis based
on:
- Your medical and family histories
- Your risk factors
- The results of a physical exam and diagnostic
tests
Specialists Involved
If you have atherosclerosis, a doctor, internist, or
general practitioner may handle your care. Your doctor may send you to other
health care specialists if you need expert care. These specialists may
include:
- A cardiologist (a doctor who specializes in
treating people with heart problems). You may see a cardiologist if you have
coronary
artery disease (CAD).
- A vascular specialist (a doctor who specializes
in treating people with blood vessel problems). You may see a vascular
specialist if you have
peripheral
arterial disease (PAD).
- A neurologist (a doctor who specializes in
treating people with disorders of the nervous system). You may see a
neurologist if you've had a stroke due to
carotid artery disease.
Physical Exam
During the physical exam, your doctor may listen to
your arteries for an abnormal whooshing sound called a bruit (broo-E). Your
doctor can hear a bruit when placing a stethoscope over an affected artery. A
bruit may indicate poor blood flow due to plaque.
Your doctor also may check to see whether any of
your pulses (for example, in the leg or foot) are weak or absent. A weak or
absent pulse can be a sign of a blocked artery.
Diagnostic Tests and Procedures
Your doctor may order one or more tests to diagnose
atherosclerosis. These tests also can help your doctor learn the extent of your
disease and plan the best treatment.
Blood Tests
Blood tests check the levels of certain fats,
cholesterol, sugar, and proteins in your blood. Abnormal levels may show that
you have risk factors for atherosclerosis.
EKG (Electrocardiogram)
An
EKG
is a simple test that detects and records the electrical activity of your
heart. An EKG shows how fast your heart is beating and whether it has a regular
rhythm. It also shows the strength and timing of electrical signals as they
pass through each part of your heart.
Certain electrical patterns that the EKG detects can
suggest whether CAD is likely. An EKG also can show signs of a previous or
current
heart
attack.
Chest X Ray
A chest x ray takes a picture of the organs and
structures inside the chest, including your heart, lungs, and blood vessels.
A chest x ray can reveal signs of
heart
failure.
Ankle/Brachial Index
This test compares the blood pressure in your ankle
with the blood pressure in your arm to see how well your blood is flowing. This
test can help diagnose PAD.
Echocardiography
This test uses sound waves to create a moving
picture of your heart.
Echocardiography
provides information about the size and shape of your heart and how well your
heart chambers and valves are working.
The test also can identify areas of poor blood flow
to the heart, areas of heart muscle that aren't contracting normally, and
previous injury to the heart muscle caused by poor blood flow.
Computed Tomography Scan
A computed tomography, or CT, scan creates
computer-generated images of the heart, brain, or other areas of the body. The
test can often show hardening and narrowing of large arteries.
Stress Testing
During
stress
testing, you exercise to make your heart work hard and beat fast while
heart tests are performed. If you can't exercise, you're given medicine to
speed up your heart rate.
When your heart is beating fast and working hard, it
needs more blood and oxygen. Arteries narrowed by plaque can't supply enough
oxygen-rich blood to meet your heart's needs. A stress test can show possible
signs of CAD, such as:
- Abnormal changes in your heart rate or blood
pressure
- Symptoms such as shortness of breath or chest
pain
- Abnormal changes in your heart rhythm or your
heart's electrical activity
During the stress test, if you can't exercise for as
long as what's considered normal for someone your age, it may be a sign that
not enough blood is flowing to your heart. But other factors besides CAD can
prevent you from exercising long enough (for example, lung diseases,
anemia,
or poor general fitness).
Some stress tests use a radioactive dye, sound
waves, positron emission tomography (PET), or
cardiac
magnetic resonance imaging (MRI) to take pictures of your heart when it's
working hard and when it's at rest.
These imaging stress tests can show how well blood
is flowing in the different parts of your heart. They also can show how well
your heart pumps blood when it beats.
Angiography
Angiography (an-jee-OG-ra-fee) is a test that uses
dye and special x rays to show the insides of your arteries. This test can show
whether plaque is blocking your arteries and how severe the plaque is.
A thin, flexible tube called a catheter is put into
a blood vessel in your arm, groin (upper thigh), or neck. A dye that can be
seen on x ray is then injected into the arteries. By looking at the x-ray
picture, your doctor can see the flow of blood through your arteries.
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