Atherosclerosis diagnosis

In order to diagnose^[28] atherosclerosis, your healthcare will likely begin with a physical exam. During this exam, he or she may find signs of narrowed, enlarged, or hardened arteries. These signs may be:

• A weak or absent pulse below the narrowed area of your artery
• When a peripheral artery is affected, decreased blood pressure in the affected limb
• Whooshing sounds (called bruits or vascular murmurs) over your arteries, which are heard with a stethoscope

Depending on the results of your physical exam, your healthcare provider may suggest that you undergo diagnostic testing. Some of the tests used to diagnose atherosclerosis include:

• Blood tests: Lab testing can detect increased levels of cholesterol and blood sugar, which may increase the risk of developing atherosclerosis. These tests require you to go without eating or drinking anything but water for at least 9 hours before your blood test.
• Doppler ultrasound: Doppler ultrasound is a special ultrasound device used to measure your blood pressure at various points along your arm or leg. These measurements can help gauge the degree of any blockages and test the speed of the blood flow in your arteries.
• Ankle-brachial index: This test, which compares the blood pressure in your ankle to the blood pressure in your arm, can determine whether you have atherosclerosis in the arteries of your legs and feet. An abnormal difference between the two blood pressures may indicate peripheral vascular disease (which is usually caused by atherosclerosis).
• Electrocardiogram (ECG or EKG): An electrocardiogram^[29] records electrical signals as they travel through the heart. This test can often reveal evidence of a previous heart attack. If your signs and symptoms of atherosclerosis occur most often during exercise, your healthcare provider may ask you to take an exercise stress test during an ECG.
• Stress test: A stress test (also called an exercise stress test) gathers information about how well your heart works during physical activity. Because exercise makes your heart pump harder and faster than it does while you are at rest, an exercise stress test can reveal problems within your heart that might not be noticed otherwise. The test usually involves walking on a treadmill or riding a stationary bike while your heart rhythm, blood pressure, and breathing are monitored.
• Cardiac catheterization^[30] and angiogram^[31]: These procedures together show if your coronary arteries are narrowed or blocked. A liquid dye is injected into the arteries of your heart through a long, thin tube (called a catheter) that’s fed through an artery in the groin, leg, arm, or neck to the arteries in the heart. The dye makes your arteries visible on X-ray, revealing areas of blockage.
• Other imaging tests: Your healthcare provider may opt to perform an ultrasound, a computerized tomography (CT) scan, or magnetic resonance angiography (MRA) to examine your arteries. These tests can often reveal hardening and narrowing in large arteries, as well as aneurysms and calcium deposits in the artery walls.

If you suspect that you may have atherosclerosis, it’s important that you discuss any signs, symptoms, or concerns you may have with your healthcare provider. He or she can provide the proper diagnosis and determine the best course of action for you.