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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 with 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 or one that's in progress. 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, blood pressure and breathing are monitored.
- 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 a magnetic resonance angiogram (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 April 30, 2010.
- Atherosclerosis. American Heart Association. http://www.americanheart.org/presenter.jhtml?identifier=4440. Accessed April 30, 2010.
- The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/guidelines/hypertension/express.pdf. Accessed April 30, 2010.
- 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). National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/guidelines/cholesterol/atp3xsum.pdf. Accessed April 19, 2010.
- Sanz J, et al. Imaging of atherosclerotic disease. Nature. 2008;451:953.
- Lopez L, et al. Lifestyle modification counseling for hypertensive patients: Results from the National Health and Nutrition Examination Survey 1999-2004. American Journal of Hypertension. 2009;22:325.
- 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.
- Natural medicines in the clinical management of hyperlipidemia. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed April 28, 2010.
- Natural medicines in the clinical management of hypertension. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed April 28, 2010.
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