The so-called “gold standard” of testing for atherosclerosis (hardening of the arteries) in the heart is called a coronary catheterization or coronary angiogram, which is an invasive test that involves injecting dye into the coronary arteries to track the flow of blood.
However, there are noninvasive tests that use sound waves to show whether atherosclerosis is developing.
CAROTID ARTERY ULTRASOUND
The carotids are the two large arteries on either side of the neck, which carry blood to the brain. A carotid artery ultrasound is a noninvasive test that uses probes, passed over the neck, that emit sound waves to create images of any plaque that has built up within the inner layer, or intima, of the arteries.
Significant thickening in the carotid arteries signals the presence of atherosclerosis not only in the heart, but throughout the entire cardiovascular system.
Such a buildup also demonstrates the probability of narrowing in the vessels of the brain, indicating elevated stroke risk.
The carotid artery ultrasound can be done over intervals to demonstrate to patients that such narrowing is receding, which provides them with evidence that lifestyle changes they are making is helping to reduce their heart attack risk.
Consider a carotid artery ultrasound if you have these risk factors:
- Traditional heart disease or stroke risk factors
- A family medical history of stroke or heart attack
- An abnormal sound in your carotid arteries (called “bruit”) while listening to your heart with a stethoscope
- A transient ischemic attack (TIA), which is an episode in which stroke-like symptoms occur, but then disappear. TIAs can be a harbinger of a full-blown stroke.
The test takes only 15 minutes for a qualified technician to perform at a cardiologist’s office. It is sometimes performed in combination with a Doppler echocardiogram to check the blood flow and function of the heart.
The stress echocardiogram, also known as a “stress echo,” is a combination of two standard tests that have long been used in the field of cardiac testing: the treadmill stress test and the echocardiogram.
The treadmill stress test is used to evaluate your heart’s response to exercise. The results of this test can show the presence of atherosclerosis, and whether it has narrowed the coronary arteries.
One of its drawbacks is that this test only zeroes in on the coronary arteries; it does not provide information on the structure of the heart or how well it is functioning, which can also impact blood flow.
For a stress echocardiogram, the patient first undergoes a brief echocardiogram while the heart is at rest. Probes are placed on the surface of the chest, and sound waves are used to create moving images of the heart.
Then, the person performs an exercise treadmill test. After that, another set of images is taken to show how well the blood flowed to the heart during the episodes of peak exercise.
A stress echocardiogram is a very valuable test because it can show:
- How well the blood flows to the heart, an indication of whether atherosclerosis is present
- The condition of the valves, which can indicate problems such as mitral valve regurgitation (a “leaky” valve)
- The presence of aortic stenosis, which is a stiff aortic valve
- Whether valve problems are worsening
- The efficiency of the heart’s pumping action
- Symptoms of congestive heart failure
Doctors have amassed an arsenal of sophisticated diagnostic tests — and even more are on the way. But as valuable as these tests are, they are no substitute for a thorough physical exam and medical history conducted by your physician.
Having an experienced cardiologist who can order the appropriate tests is a first step on the path to victory over heart disease.