Diagnosing atherosclerosis, or the hardening of the arteries, is crucial for preventing serious health complications. Even if you aren’t experiencing noticeable symptoms, your healthcare provider might recommend tests if they suspect you are at risk. The specific tests used will depend on which arteries are believed to be affected by plaque buildup.
Blood Tests for Atherosclerosis
Blood tests are a fundamental step in assessing your risk for atherosclerosis. These tests measure key indicators in your blood that are linked to the condition. Common blood tests include:
- Cholesterol Levels: This test measures your total cholesterol, LDL (“bad”) cholesterol, and HDL (“good”) cholesterol. High LDL cholesterol is a major risk factor for atherosclerosis.
- Triglycerides: Elevated triglyceride levels can also contribute to the development of atherosclerosis.
- Blood Sugar (Glucose): This test checks for diabetes or insulin resistance, conditions that can accelerate atherosclerosis.
- Lipoprotein(a): High levels of lipoprotein(a) are genetically linked to an increased risk of heart disease and atherosclerosis.
- Inflammation Markers: Blood tests can detect proteins like C-reactive protein (CRP), which indicate inflammation in the body. Inflammation plays a significant role in atherosclerosis.
Electrocardiogram (ECG or EKG)
An electrocardiogram (ECG or EKG) is a quick, non-invasive test that records your heart’s electrical activity. It’s valuable for assessing heart health, although it doesn’t directly diagnose atherosclerosis in all cases. An ECG can reveal:
- Heart Rate: How fast your heart is beating.
- Heart Rhythm: Irregularities in your heartbeat.
- Electrical Impulses: The strength and timing of electrical signals as they pass through your heart.
During an ECG, you’ll lie down while a healthcare professional attaches up to 12 electrodes to your chest, arms, and legs. These electrodes are connected to a machine that records the electrical activity. The test is painless and typically takes only a few minutes, with no significant risks.
Imaging Tests for Atherosclerosis Detection
Imaging tests provide visual representations of your heart and arteries, allowing doctors to directly assess plaque buildup and blood flow. Several imaging techniques are used to diagnose atherosclerosis:
- Angiography: This X-ray technique uses a special dye injected into your bloodstream to visualize arteries. It can be used to examine arteries in the heart, neck, brain, and other parts of the body to identify blockages or narrowing.
- Cardiac MRI (Magnetic Resonance Imaging): Cardiac MRI uses magnetic fields and radio waves to create detailed images of the heart. It can detect tissue damage and blood flow problems in the heart and coronary arteries, aiding in the diagnosis of atherosclerosis and understanding the results of other imaging tests.
- Cardiac Positron Emission Tomography (PET) Scan: A PET scan assesses blood flow in the small blood vessels of the heart. This is particularly useful for diagnosing coronary microvascular disease, a condition related to atherosclerosis affecting smaller arteries.
- Coronary Computed Tomographic (CT) Angiography: This CT scan provides a non-invasive way to visualize the coronary arteries. It uses radiation to create images of the heart arteries and can detect plaque buildup without the need for invasive cardiac catheterization. If you are pregnant or may be pregnant, it’s important to discuss this with your doctor due to the radiation exposure.
- Cardiac Intravascular Ultrasonography (IVUS): IVUS involves using a tiny ultrasound device on the tip of a cardiac catheter. This allows doctors to look inside the arteries of the heart from within, providing a detailed view of plaque and artery walls.
- Coronary Calcium Scan: This CT scan specifically measures the amount of calcium in the walls of the coronary arteries. Calcium buildup is a key indicator of atherosclerosis. The results are presented as a calcium score. A score of zero is normal, and higher scores indicate a greater likelihood of coronary heart disease and the presence of atherosclerosis. A high score warrants further discussion with your doctor about additional testing and heart-healthy lifestyle changes.
Stress Tests to Evaluate Heart Function
Stress tests evaluate how your heart performs under physical exertion. These tests are helpful because some heart problems become more apparent when the heart is working harder and pumping blood faster.
During a stress test, you will typically exercise, often by walking on a treadmill or riding a stationary bike. If you are unable to exercise, medication can be administered to simulate the effects of exercise on your heart. Stress tests can be conducted in a clinic, doctor’s office, or hospital.
Ankle-Brachial Index (ABI) Test for Peripheral Artery Disease
The Ankle-Brachial Index (ABI) test is used to diagnose peripheral artery disease (PAD), which is atherosclerosis affecting the arteries in the limbs, particularly the legs. This painless test compares blood pressure measurements in your ankle and arm.
The ABI test is performed using a standard blood pressure cuff and an ultrasound device to listen to blood flow. By comparing the blood pressure readings in your ankle to those in your arm, the ABI test can help determine if you have PAD, a common manifestation of atherosclerosis.
