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Tests and diagnosis
By Mayo Clinic staffYour doctor may find signs of narrowed, enlarged or hardened arteries during a physical exam. These include:
- A weak or absent pulse below the narrowed area of your artery
- Decreased blood pressure in an affected limb
- Whooshing sounds (bruits) over your arteries, heard using a stethoscope
- Signs of a pulsating bulge (aneurysm) in your abdomen or behind your knee
- Evidence of poor wound healing in the area where your blood flow is restricted
Depending on the results of the physical exam, your doctor may suggest one or more diagnostic tests, including:
- Blood tests. Lab tests can detect increased levels of cholesterol and blood sugar that may increase the risk of atherosclerosis. You'll need to go without eating or drinking anything but water for nine to 12 hours before your blood test. Your doctor should tell you ahead of time if this test will be performed during your visit.
- Doppler ultrasound. Your doctor may use a special ultrasound device (Doppler ultrasound) to measure your blood pressure at various points along your arm or leg. These measurements can help your doctor gauge the degree of any blockages, as well as the speed of blood flow in your arteries.
- Ankle-brachial index. This test can tell if you have atherosclerosis in the arteries in your legs and feet. Your doctor may compare the blood pressure in your ankle with the blood pressure in your arm. This is known as the ankle-brachial index. An abnormal difference may indicate peripheral vascular disease, which is usually caused by atherosclerosis.
- Electrocardiogram (ECG). An electrocardiogram records electrical signals as they travel through your heart. An ECG can often reveal evidence of a previous heart attack. If your signs and symptoms occur most often during exercise, your doctor may ask you to walk on a treadmill or ride a stationary bike during an ECG.
- Stress test. A stress test, also called an exercise stress test, is used to gather information about how well your heart works during physical activity. Because exercise makes your heart pump harder and faster than it does during most daily activities, an exercise stress test can reveal problems within your heart that might not be noticeable otherwise. An exercise stress test usually involves walking on a treadmill or riding a stationary bike while your heart rhythm and blood pressure and breathing are monitored. In some types of stress tests, pictures will be taken of your heart, such as during a stress echocardiogram (ultrasound) or nuclear stress test. If you're unable to exercise, you may receive a medication that mimics the effect of exercise on your heart.
- Cardiac catheterization and angiogram. This test can 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 (catheter) that's fed through an artery, usually in your leg, to the arteries in your heart. As the dye fills your arteries, the arteries become visible on X-ray, revealing areas of blockage.
- Other imaging tests. Your doctor may use ultrasound, a computerized tomography (CT) scan or magnetic resonance angiography (MRA) to study your arteries. These tests can often show hardening and narrowing of large arteries, as well as aneurysms and calcium deposits in the artery walls.
References
- Atherosclerosis. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/dci/Diseases/Atherosclerosis/Atherosclerosis_All.html. Accessed May 9, 2012.
- Atherosclerosis. American Heart Association. http://www.heart.org/HEARTORG/Conditions/Cholesterol/WhyCholesterolMatters/Atherosclerosis_UCM_305564_Article.jsp. Accessed May 9, 2012.
- The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Bethesda, Md.: National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/guidelines/hypertension/jnc7full.htm. Accessed May 9, 2012.
- Executive summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). The National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/guidelines/cholesterol/index.htm. Accessed May 9, 2012.
- Sanz J, et al. Imaging of atherosclerotic disease. Nature. 2008;451:953.
- Svetkey L, et al. Hypertension improvement project: Randomized trial of quality improvement for physicians and lifestyle modification for patients. Hypertension. 2009;54:1226.
- Villegas R, et al. The cumulative effect of core lifestyle behaviours on the prevalence of hypertension and dyslipidemia. BMC Public Health. 2008;8:210.
- Appel LJ, et al. Dietary approaches to prevent and treat hypertension: A scientific statement from the American Heart Association. Hypertension. 2006;47:296.
- Dietary Guidelines for Americans, 2010. U.S. Department of Health and Human Services. http://www.cnpp.usda.gov/DGAs2010-PolicyDocument.htm. Accessed May 9, 2012.
- Natural medicines in the clinical management of hyperlipidemia. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed May 9, 2012.
- Natural medicines in the clinical management of hypertension. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed May 9, 2012.
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