Arteriosclerosis / Atherosclerosis

Diagnosis

To diagnose atherosclerosis, your healthcare professional will examine you and listen to your heart. You will be asked about symptoms and family medical history. Referral to a cardiologist—a specialist in heart diseases—may be needed.

Your healthcare provider may hear a whooshing sound when listening to your heart with a stethoscope.

Tests

Blood tests. These check cholesterol and blood sugar levels. High levels increase the risk of atherosclerosis. A C-reactive protein (CRP) test may also detect artery inflammation.

Electrocardiogram (ECG or EKG). A painless test measuring electrical activity of the heart. Sensors are attached to the chest, arms, or legs, connected to a machine that displays results. It can detect reduced blood flow to the heart.

Exercise stress tests. Involve walking on a treadmill or using a stationary bike while your heart is monitored. These tests can reveal heart conditions missed at rest. If exercise isn’t possible, medicine may simulate its effects.

Echocardiogram. Uses sound waves to visualize blood flow and heart structures. Sometimes performed during stress tests.

Doppler ultrasound. Checks blood flow in arteries and can detect narrowed or blocked areas.

Ankle-brachial index (ABI). Compares blood pressure in the ankle and arm to detect peripheral artery disease. Differences may indicate atherosclerosis in the legs.

Cardiac catheterization and angiogram. A thin tube is inserted into a blood vessel (groin or wrist) and guided to the heart. Dye highlights arteries on imaging to show blockages.

Coronary calcium scan. A CT scan detects calcium buildup in artery walls, often before symptoms appear. Results are scored; higher scores indicate greater heart attack risk.

Other imaging tests. Magnetic resonance angiography (MRA) or positron emission tomography (PET) can also evaluate artery narrowing, hardening, or aneurysms.

Treatment

Treatment for atherosclerosis may include:

• Lifestyle changes like a healthy diet and regular exercise

• Medications

• Heart procedures or surgery

For some, lifestyle adjustments alone may be sufficient.

Medications

Statins and cholesterol-lowering medicines. Reduce LDL cholesterol and slow plaque buildup. May even reverse fatty deposits in arteries. Common types include statins, niacin, fibrates, and bile acid sequestrants.

Aspirin. Low-dose therapy may prevent blood clots and reduce risk of heart attack or stroke. Consult your doctor before starting.

Blood pressure medicines. Control complications of atherosclerosis, such as heart attack risk.

Other medicines. Treat conditions that raise risk, such as diabetes, or relieve symptoms like leg pain during activity.

Fibrinolytic therapy. Emergency clot-dissolving medications may restore blood flow in blocked arteries.

Surgery or Other Procedures

Severe blockages may require procedures or surgery:

• Angioplasty and stent placement. A balloon widens the artery, and a stent keeps it open. Some stents release medicine to prevent re-narrowing.

• Endarterectomy. Surgery removes fatty deposits. Neck artery surgery is called carotid endarterectomy.

• Coronary artery bypass graft (CABG) surgery. A healthy vessel from another part of the body is used to bypass blocked arteries. Usually for patients with multiple blocked heart arteries.