How is Atherosclerosis Diagnosed?
Your doctor will recommend exams and tests if you have symptoms or if routine tests show signs such as high cholesterol and blood sugar.
- Medical history and physical exam where your doctor will ask about your medical history and the medical history of your family and will perform a physical examination of your body.
- Blood tests to measure the levels of lipoproteins, substances made of protein and fat that carry cholesterol in your bloodstream, triglycerides, blood sugar, or proteins that are signs of inflammation, such as C-reactive protein.
- Diagnostic tests for atherosclerosis where your doctor may order tests to diagnose atherosclerosis and plan your treatment.
These tests may include:
- Electrocardiogram (ECG or EKG) - measures your heart’s electrical activity, rate, and rhythm.
- Echocardiogram (echo) – creates an image of the valves and chambers in your heart and measures the level of pumping of your heart.
- Doppler ultrasound - may be used to measure your blood pressure at different points on your arm or leg to evaluate the level of blockages in your arteries.
- Exercise stress test - measures your heart performance during physical activity. Heart problems may show during an exercise stress test because your heart pump harder than when you are resting.
- Ankle/brachial index - measures blood flow in your limbs. The blood pressure in your ankle will be compared to the blood pressure in your arm. Unusual difference may be a sign of atherosclerosis in the arteries in your legs and feet.
- Angiography – uses special X-rays that help locate and measure blockages in your arteries in the heart, neck, brain and other parts of your body
- Coronary CT scan (computed tomographic) - an imaging test that creates an image of the inside of your body and can show any hardening and narrowing of your large arteries.
- Cardiac MRI (magnetic resonance imaging) - detects tissue damage or problems with blood flow in the heart or coronary arteries.
- Cardiac PET (positron emission tomography) scan - a heart scan that can help diagnose disease in the small blood vessels of the heart.
- Coronary calcium scan - a CT scan that measures the amount of calcium in the walls of your coronary arteries.
- Carotid ultrasound – creates an image of the arteries in your neck (carotid arteries to detect hardening or narrowing of the arteries that supply blood to your brain.
- Abdominal ultrasound - creates an image of your abdominal aorta to detect abdominal aortic aneurysm (ballooning) or plaque build-up in your aorta.
How is Atherosclerosis Treated?
Lifestyle changes may help improve your condition, in addition, your doctor may prescribe medicines and surgery to treat atherosclerosis will be recommended in some cases.
You can make changes to reduce the risk factors of atherosclerosis. Recommended lifestyle changes include:
- Avoiding or quitting smoking
- Maintaining a healthy weight
- Checking and maintaining a healthy blood pressure
- Checking and maintaining healthy cholesterol level
- Checking and maintaining healthy blood sugar level
- Exercising regularly
- Keeping a healthy diet
Medicines often used to treat atherosclerosis or related conditions, including:
- Cholesterol medicines reduce the low-density lipoprotein (LDL) cholesterol, also known as the bad cholesterol, in your blood and can stop, slow, or even reverse, the build-up of plaque in your arteries.
- Anticoagulants, also called blood-thinning medicines, reduce the risk that platelets will accumulate in your arteries and form a blood clot that can cause blockage.
- Antiplatelet medicines are used to lower the likelihood that your blood platelets will stick together and form blood clots.
- Blood pressure medicines are prescribed to lower your blood pressure and prevent complications related to atherosclerosis such as heart attack and stroke. These medicines do not reverse atherosclerosis.
- Other medicines. Specific medications to treat symptoms of atherosclerosis, such as leg pain, may be prescribed as well as medications to treat diabetes and other conditions that increase the risk of developing atherosclerosis.
Procedures and surgery
Certain procedures or surgery are recommended to treat atherosclerosis in more advanced cases.
- Angioplasty and stent placement - also called percutaneous coronary intervention (PCI), opens a blocked artery in the heart. Your doctor will insert a long thin tube called a catheter into the artery. Another catheter with a deflated balloon will be inserted through the first catheter to the blockage. The balloon will be inflated to widen the artery and a stent (mesh tube) will then be inserted the artery to help keep it open.
- Endarterectomy. Surgical procedure may be performed to remove plaque from the walls of an artery.
- Coronary artery bypass surgery is recommended for people who have angina (chest pain) because of plaque build-up in the coronary artery. Your doctor will create a bypass by grafting a piece of a healthy vein from your body and attaching it above and below the blocked part of the coronary artery to allow the blood to flow around the blocked area. Veins for the bypass are usually taken from the leg or chest wall; sometimes, the bypass is made of synthetic material.
To reduce your risk of developing atherosclerosis or making it worse, your diet should be based on fruits, vegetables, whole grains, fish, lean meats and poultry, low-fat dairy products, nuts, seeds, and beans.
Early stages of atherosclerosis may be reversible by making lifestyle changes and making sure to take prescribed medicines regularly. Advanced stages of atherosclerosis seem to be irreversible.
Research shows that at the age of 40, about half of people have cholesterol plaque in their arteries. If you have been diagnosed with atherosclerosis, you can live longer by making lifestyle changes of not smoking, exercising, maintaining a healthy weight, and eating a healthy diet to keep your arteries healthy. If your doctor recommends medicines to treat your condition, take them regularly.