Atherosclerosis
is a silent disease that progresses slowly, not fully showing signs until about
the 5th decade of life. Over
time as the plaque builds, its potential for harm gradually increases and reaches
its full potential when a thrombus is formed or the lumen of an artery is
completely blocked. Yet, regardless of its tendency to progress slowly, given
its numerous risk factors, it is important to stay up to date and be assessed frequently
for any signs indicating atherosclerosis.
Typically, a diagnosis is formed based on
medical and family history, physical exams and test results. After having
visited a primary care doctor, specialists such as cardiologists, vascular
specialists or neurologists might be recommended in order to diagnose specific issues
that may be associated with atherosclerosis.
During a general physical exam, the doctor
will listen to the arteries to determine abnormal sounds. In this case, they
are listening for a sound called bruit. This
sound indicates inadequate blood flow which could be a result of plaque
buildup. The presence of a blocked
artery can also be determined via the pulse.
A weak pulse, such as in the leg or foot, is a possible indication that
there is a blocked artery. Atherosclerosis
can also be determined through specific diagnostic tests. Such tests include blood tests, an electrocardiogram
(EKG), chest X Rays, the ankle/brachial index, computed tomography scans,
stress testing and angiography. Many of
these tests either allow a clearer view of plaque buildup within arteries, or
assess the heart for abnormal blood flow. Below is a short summary describing how each
of the above tests are used in diagnosing atherosclerosis.
Blood tests: blood
test can show levels of fats, cholesterol, sugar and protein. Abnormal results
may indicate a possibility for atherosclerosis.
EKG: EKG’s can
monitor and record the heart’s electrical activity and whether its rate and
rhythm are normal or irregular. This type of test can show signs of heart
damage that result from cardiovascular heart disease or signs of a previous or
current heart attack.
Chest X Ray: similar
to the EKG, the chest X Ray can show signs of heart failure by taking pictures
of the organs inside the chest (ie: heart, lungs, blood vessels)
Ankle/brachial index: the
ankle/brachial index compares the blood pressures of the posterior tibial artery
and the brachial artery to determine the adequacy of blood flow in contiguous
areas.
Computed tomography scan: this test creates pictures of the heart, brain or other
parts of the body to illustrate hardening and/or narrowing of more prominent arteries.
Stress testing: in
stress testing, through exercise or medication, the heart is made to work
harder. As it does so, it requires more
oxygen and blood. Pictures of the heart are taken during and after exercise. When
there is a presence of plaque in the arteries, certain parts of the heart don’t
receive the blood flow it requires, which is shown in the pictures.
Angiography: an
angiography is a test that uses dye and X rays to help view the inside of the
arteries. This allows a clear view of how
much plaque is progressively building up.
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