Physical examination involves listening to your heart and blood flow through your arteries. Presence of a whooshing sound called a “bruit” may indicate the presence of plaque. A positive family history and unhealthy lifestyle may also add up to the hypothesis of having atherosclerosis. The following tests may help to detect atherosclerosis:
Blood tests: Blood tests can check blood sugar and cholesterol levels. High levels of blood sugar and cholesterol raise the risk of atherosclerosis. A C-reactive protein (CRP) test also may be done to check for a protein linked to inflammation of the arteries.
Exercise stress test: These tests often involve walking on a treadmill or riding a stationary bike while the heart's activity is watched. Because exercise makes the heart pump harder and faster than it does during most daily activities, an exercise stress test can show heart conditions that might otherwise be missed.
Echocardiogram: This test uses sound waves to show blood flow through the heart. It also shows the size and shape of the structures of the heart. Sometimes an echocardiogram is done during an exercise stress test.
Doppler ultrasound: A healthcare professional may use a special ultrasound device to check blood flow at different points in your body. The test results show the speed of blood flow in the arteries. This can reveal any narrowed areas.
Cardiac catheterization and angiogram: A doctor places a long, thin flexible tube (catheter) in a blood vessel, usually in the groin or wrist, and guides it to the heart. Dye flows through the catheter to the arteries to show up blockage more clearly on images taken during the test.
Coronary calcium scan, also called heart scan: This test uses computerized tomography (CT) imaging to look for calcium deposits in the artery walls. A coronary calcium scan may show coronary artery disease before you have symptoms. Results of the test are given as a score. The higher the calcium score, the higher the risk of heart attacks.
Abdominal ultrasound: This ultrasound takes pictures of your abdominal aorta. It checks for ballooning (abdominal aortic aneurysm) or plaque buildup in your aorta.
Other imaging: Magnetic resonance angiography (MRA) or positron emission tomography (PET) also may be used to study the arteries. These tests can show hardening and narrowing of large arteries, as well as aneurysms.
Ankle-Brachial index (ABI): This test compares the blood pressure in the ankle with that in the arm. It's done to check for atherosclerosis in the arteries in the legs and feet. A difference between the ankle and arm measurements may be due to peripheral artery disease.
Electrocardiogram: This quick and painless test measures the electrical activity of the heart. An ECG can show if there's reduced blood flow to the heart.
What is the treatment for atherosclerosis?
Heart-healthy living is very important for preventing and treating atherosclerotic plaque buildup throughout your lifetime.
Choose heart healthy foods: such as the DASH (Dietary approaches to stop Hypertension) eating plan. A heart-healthy eating plan includes fruits, vegetables, and whole grains and limits saturated fats, sodium (salt), and added sugars.
Be physically active: Regular physical activity can help manage risk factors, such as unhealthy cholesterol levels, high blood pressure, overweight, and obesity. Adults should engage in a total of 150 minutes or more per week of moderate physical activity or 75 minutes per week of vigorous physical activity. Before starting any exercise program, ask your provider what level of physical activity is right for you.
Quit smoking and avoid secondhand smoke: Research shows that nicotine and flavorings found in vaping products can damage your heart and lungs.
Get healthy sleep: The recommended amount for adults is 7 to 9 hours of sleep a day.
Aim for a healthy weight: Losing just 3% to 5% of your current weight can help you manage some coronary heart disease risk factors, such as high blood cholesterol and diabetes. Weight loss can also improve blood pressure readings.
Manage your health factors: Work with your provider to control your blood cholesterol level, blood pressure, and blood sugar. These are all important risk factors for atherosclerosis, but you can work with your provider to treat them with heart-healthy lifestyle changes and medicines.
Limit alcohol intake: Men should limit their intake to two drinks or less in a day. Women should drink one drink or less per day.
Manage stress: Learning how to manage stress, relax, and cope with problems can improve your emotional and physical health.
MEDICATION
Medicines can help manage risk factors and treat atherosclerosis or its complications. Your provider may also prescribe medicines to treat other medical conditions, such as high blood pressure, that can trigger plaque buildup or make it get worse. Following medicines help to mitigate atherosclerosis or related conditions:
ACE inhibitors and beta blockers help lower blood pressure and lower the heart's workload.
Anti-platelet or anti-clotting medicine may help reduce risk of complications for some people who have atherosclerosis.
Aspirin (low dose) is not recommended for most people unless they already have disease caused by atherosclerosis, or they have had a heart attack or stroke. Side effects may include bleeding and anemia, especially for those age 60 and older. Discuss aspirin use with your provider before you start taking it to make sure the benefit will outweigh the risk.
Calcium channel blockers lower blood pressure by relaxing blood vessels.
Medicines to control blood sugar may help lower your risk for complications of atherosclerosis if you have diabetes.
Nitrates, such as nitroglycerin, dilate your coronary arteries and relieve or prevent chest pain from angina.
Ranolazine treats coronary microvascular disease and the chest pain it may cause.
Statins, and other cholesterol medicines treat unhealthy blood cholesterol. Your provider may recommend a statin if you have a higher risk for coronary artery disease or stroke or if you have diabetes and are between ages 40 and 75. Your provider may prescribe another type of medicine if you are unable to take statins or if statins have not worked well enough to manage your blood cholesterol and triglyceride levels. Some non-statin medicines are given as injections or as IV infusions.
Thrombolytic medicine (clot busters) may be used to treat blood clots resulting from atherosclerosis. These medicines can dissolve clots that block arteries, causing a stroke, heart attack, mesenteric ischaemia or other problems. Ideally, the medicine should be given as soon as possible after a clot is discovered.
Weight loss medicine, along with healthy diet and exercise, may help some people with obesity lose weight. Obesity and overweight are risk factors for atherosclerosis. Some medicines are given as injections. Your provider may prescribe a medicine for short-term use, but other medicines may be needed long term. Weight-loss medicines are not safe to use during pregnancy. (https://www.nhlbi.nih.gov/health/atherosclerosis/treatment)
If conservative treatment methods fail to achieve desired treatment outcomes, surgery is considered.
