Methods of Diagnosis
Your healthcare provider diagnoses coronary artery disease (atherosclerosis) based on your medical and family histories, a physical exam, or results from the following tests.
- Physical Exam: During a physical exam, your health professional may use a stethoscope to check your arteries for an abnormal whooshing sound called heart murmur, which may indicate poor blood flow due to plaque (it should be noted that, the plaque in the heart arteries are different from dental plaque) buildup. He or she also may check to see whether any of your pulses (for example, in the leg or foot) are weak or absent, which can be a sign of a blocked artery.
- Diagnostic Tests: Your healthcare provider may recommend one or more tests to diagnose atherosclerosis. These tests can help define the extent of your disease and the best treatment plan.
- Blood Tests check the levels of certain fats, cholesterol, sugar, and proteins in your blood. Abnormal levels may put you at risk for atherosclerosis.
- Ankle/Brachial Index compares the blood pressure in your ankle with the blood pressure in your arm to see how well your blood is flowing. Used to help diagnose Peripheral Arterial Disease (PAD).
- EKG (Electrocardiogram) detects and records the heart’s electrical activity. It shows how fast the heart is beating and its rhythm (steady or irregular).
- Echocardiography uses sound waves to create a moving picture of your heart. The test provides information about the size and shape of your heart, how well your heart chambers and valves are working, and areas of poor blood flow.
- Computed Tomography Scan creates computer-generated pictures and can show hardening and narrowing of large arteries.
- Stress Testing You exercise (or are given medicine if you are unable to exercise) to make your heart work hard and beat fast while heart tests are done. A stress test can show possible signs of Coronary Arteries Disease (CAD).
- Angiography: Angiography uses dye and special X-rays to reveal the insides of your arteries. It can show whether plaque is blocking your arteries and how severe the blockage is.
- Follow a Healthy Diet. This can prevent or reduce high blood pressure and high blood cholesterol and help you maintain a healthy weight.
- Exercise Regularly. Regular physical activity can lower many atherosclerosis risk factors, including LDL (“bad”) cholesterol, high blood pressure, and excess weight. It also can lower the risk of diabetes and raise your HDL (“good”) cholesterol, which helps prevent atherosclerosis. Talk to your healthcare provider before you start a new exercise plan.
- Maintain a Healthy Weight. Maintaining a healthy weight can lower your risk of atherosclerosis. A general goal is a body mass index (BMI) of less than 25. BMI measures your weight in relation to your height and gives an estimate of your total body fat. You can use the NHLBI’s online BMI calculator to figure out your BMI, or your healthcare provider can help you. A BMI between 25 and 29.9 is considered overweight. A BMI of 30 or more is considered obese. A BMI of less than 25 is the goal for preventing and treating atherosclerosis. Your healthcare provider can help you set an appropriate goal.
- Quit Smoking. If you smoke or use tobacco, quit. Smoking can damage and tighten blood vessels, raising the risk of atherosclerosis. Talk to your healthcare provider about programs and products to help you quit.
- Manage Stress. Research shows that the most commonly reported “trigger” for a heart attack is an emotionally upsetting event—particularly one involving anger. Also, drinking, smoking, or overeating to cope with stress is not healthy.
To slow the buildup of plaque, your health professional may prescribe medicines to help lower your cholesterol level or blood pressure or to prevent blood clots from forming.
Medical Procedures and Surgery
In the event of severe atherosclerosis, your doctor may recommend one of several procedures or surgeries.
Angioplasty is a procedure to open blocked or narrowed coronary (heart) arteries. It can improve blood flow, relieve chest pain, and possibly prevent a heart attack. Sometimes a small mesh tube, called a stent, is placed in the artery to keep it open after angioplasty.
Coronary artery bypass grafting (CABG) is a type of surgery that uses arteries or veins from other areas in your body to bypass your narrowed coronary arteries. CABG can improve blood flow to your heart, relieve chest pain, and possibly prevent heart attack.
Bypass grafting also can be used for leg arteries. In this surgery, a healthy blood vessel is used to bypass a narrowed or blocked artery in one of your legs. The healthy blood vessel redirects blood around the artery, improving blood flow to the leg.
Carotid endarterectomy, or carotid artery surgery, removes plaque buildup from the carotid arteries in the neck. This procedure opens the arteries and improves blood flow to the brain, helping prevent a stroke.