Atherosclerosis is diagnosed based on history (medical and family history), a physical examination and test results.
Physical Exam: During the physical exam, your doctor will check your blood pressure, peripheral pulses and perhaps listen to the flow of blood in the arteries by placing a stethoscope (auscultate) over an affected artery. If the artery is affected and narrowed by plaque build-up, an abnormal whooshing sound called a bruit may be heard on auscultation. If any of your peripheral pulses (for example, in the leg or foot) are weak or absent, it may be a sign of a blocked artery.
Diagnostic Tests: Tests are generally recommended to assess the extent of your disease and prepare a treatment plan.
- Blood Tests: Blood tests may be done to check the levels of certain cholesterol (good and bad cholesterol), sugar and proteins in your blood. Elevated levels of fat and bad cholesterol (LDL cholesterol) may be a sign that you're at risk for atherosclerosis.
- ECG (Electrocardiogram): An ECG is a simple and painless test that records the electrical activity of the heart. It records and prints electrical signals as they travel through your heart on a paper. The test can show how fast the heart is beating and its rhythm (steady or irregular), evidence of a previous heart attack or one that's in progress and many other cardiac problems. Evidence of coronary heart disease (CHD) on ECG is suggestive of atherosclerotic damage to the coronary arteries.
- Ankle/Brachial Index: In this test, the blood pressure in your ankle and blood pressure in your arm is checked. It can indicate how well your blood is flowing in your limbs and help to diagnose P.A.D.
- Echocardiography: This is a painless and non-invasive test that uses sound waves to produce moving pictures of your heart. It can help the doctor to determine the size and shape of your heart, how well your heart chambers and valves are working and if all the parts of the heart’s wall are functioning well and contributing to your heart's pumping activity. It can show parts that move weakly (damaged by heart attack or decrease in blood supply and oxygen).
- Stress test: Stress test may be done if your signs and symptoms become evident most often during exercise or physical straining. During this test, you will be made to walk on a treadmill or ride a stationary bike during an ECG. If you can't exercise, your doctor may give you a medicine to make the heart work harder and beat faster. Stress test may indicate signs and symptoms of CHD such as:
- Abnormal increase or decrease in your heart rate or blood pressure.
- Shortness of breath or chest pain.
- Abnormal alterations in your heart rhythm or heart's electrical activity.
Your doctor may do an echocardiogram before and after stress test to assess the function of your heart.
- Angiography: This test can help your doctor to know the location and extent of the blockages in your arteries. For the test, a dye is injected and special x rays are done to show the insides of your arteries. During the procedure, a thin, flexible catheter is inserted into an artery, usually in the groin (upper thigh). The catheter is carefully threaded through the blood vessel in the groin into the artery, which is suspected to be narrowed such as the coronary artery. The doctor then injects a special dye through the catheter. This dye is visible on x-ray pictures. X-ray pictures are done as the dye flows through your coronary arteries. These X-rays pictures can show if there is any blockage and its location and severity.
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