Atherosclerosis

Diagnosis

In order to accurately diagnose atherosclerosis, a healthcare provider will:

• Physical examination: A physical examination and inquiries about the patient’s personal and family medical history will be conducted by the healthcare provider. They will assess for any whooshing sound (bruit) at the carotid arteries using a stethoscope, this sound could indicate a plaque. They might suggest to see a physician who focuses on heart conditions (cardiologist).
• Blood tests: The usual purpose of blood testing is to measure cholesterol and blood sugar levels. The risk of atherosclerosis is increased by high blood sugar and cholesterol levels. The presence of a protein linked to artery inflammation may also be checked for using a C-reactive protein (CRP) test.
• Electrocardiogram (ECG or EKG): The heart’s electrical activity is measured by this test. Electrodes are placed to the arms, legs, and even on the chest during an ECG. The sensors are connected to a device by wires that shows or prints the results. If there is decreased blood flow to the heart, an ECG can assist identify it.
• Echocardiogram: Sound waves are used in this examination to display the heart’s blood flow. Exercise stress testing has been used in this procedure.
• Doppler ultrasound. The healthcare provider may take blood pressure readings at several positions along the arm or leg using a specialized ultrasound machine called a doppler ultrasound. These measures can reveal how quickly blood is flowing through the arteries.
• Exercise stress test: The healthcare provider could recommend this test if the symptoms typically worsen during physical activity. While having their heart rate monitored, the patient will either use a stationary bike or a treadmill. Exercise stress testing can detect heart abnormalities that might otherwise go undetected since it forces the heart to beat harder and quicker than it does during the majority of daily activities. If the patient is unable to exercise, they may be prescribed a drug that replicates the effects of exercise on the heart.
• Ankle-brachial index (ABI): This test compares the ankle and arm blood pressure readings. It is carried out to examine the arteries in the legs and feet for signs of atherosclerosis. Peripheral vascular disease, typically brought on by atherosclerosis, may explain a discrepancy between ankle and arm blood pressure measures.
• Cardiac catheterization and angiogram: If the coronary arteries are clogged or narrowed, this test may indicate it. In order to reach the heart, a long, thin, flexible tube (catheter) is placed into a blood vessel, typically in the groin or wrist. The catheter allows dye to flow into the heart’s arteries. On images captured during the test, the dye makes the arteries more visible.
• Coronary calcium scan (heart scan): This examination, produces detailed images of the heart using computer tomography (CT) imaging. It might reveal arterial wall calcium deposits. Scores are provided for test results. A higher score indicates a greater risk of heart disease when calcium is present.
• Other imaging tests: The arteries can also be studied using positron emission tomography (PET) or magnetic resonance angiography (MRA). These tests can detect aneurysms as well as the hardening and narrowing of major arteries.

Treatment

The treatment approach for atherosclerosis often involves lifestyle modifications, such as adopting a healthy diet and engaging in regular exercise. However, in certain cases, surgical intervention or the use of medication may be necessary as part of the treatment plan.

• Medications: There are numerous medications that can be used to lessen the adverse effects of atherosclerosis or even reverse them. The following medicines are used to treat atherosclerosis:
  • Statins or other cholesterol drugs: Low-density lipoprotein (LDL) cholesterol, also known as the “bad” cholesterol, can be reduced to slow, stop, or even reverse the formation of fatty deposits in the arteries.

There are numerous kinds of cholesterol-lowering medication. Niacin, fibrates, and bile acid sequestrants are some of them. However, statins are the frequently used to reduce cholesterol, maintain the health of the arteries, and avoid atherosclerosis. Patient can require many types of cholesterol medications.

• • Blood pressure medications: Atherosclerosis cannot be reversed by blood pressure-lowering medications. As an alternative, they handle the disease’s complications or prevent them. The risk of a heart attack can be lessen with the use of some blood pressure drugs.
  • Aspirin: The daily low-dose aspirin therapy may be suggested as the main prevention of heart attack or stroke. Aspirin use on a regular basis may cause serious adverse effects, such as bleeding in the intestines and stomach. Aspirin should not be taken without consultation and prescription from the healthcare provider.
  • Other medications: Other medical conditions that increase the risk of atherosclerosis, such diabetes, may be treated with medications. Specific atherosclerotic symptoms, like as leg pain during exercise, may also be treated with medication.
• Surgery or other procedures: The patient can require a procedure or surgery if they have serious symptoms or an obstruction, such as:
  • Angioplasty and stent placement: A blocked or clogged artery can be opened using this treatment, commonly known as percutaneous coronary intervention (PCI). Typically at the groin or wrist, a long, thin, flexible tube (catheter) is introduced into a blood vessel and directed to the obstruction. After that, the artery can be opened by inflating a balloon on a catheter’s tip. The artery is frequently maintained open using a mesh tube (stent).
  • Coronary artery bypass graft (CABG) surgery: A detour around blockages is created in the heart by a surgeon using a healthy blood vessel from another part of the body. The blood then travels around the coronary artery that is obstructed or narrowed. This procedure is an open heart surgery and is the option for those with many narrowed cardiac arteries.
  • Endarterectomy: A narrowed artery’s plaque can occasionally only be removed surgically. Carotid endarterectomy procedure involves the carotid arteries, which are located in the neck.
  • Fibrinolytic therapy: Healthcare provider may administer a clot-dissolving medication to break up an arterial clot that is preventing blood flow.