Thursday, October 1, 2015

Diagnosis of Atherosclerosis

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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