Whole Body Color Doppler

A Doppler ultrasound test uses reflected sound waves to see how blood flows through a blood vessel. It helps doctors evaluate blood flow through major arteries and veins, such as those of the arms, legs, and neck. It can show blocked or reduced flow of blood through narrow areas in the major arteries of the neck that could cause a stroke. It also can reveal blood clots in leg veins (deep vein thrombosis, or DVT) that could break loose and block blood flow to the lungs (pulmonary embolism). During pregnancy, Doppler ultrasound may be used to look at blood flow in an unborn baby (fetus) to check the health of the fetus.

During Doppler ultrasound, a handheld instrument (transducer) is passed lightly over the skin above a blood vessel. The transducer sends and receives sound waves that are amplified through a microphone. The sound waves bounce off solid objects, including blood cells. The movement of blood cells causes a change in pitch of the reflected sound waves (called the Doppler effect). If there is no blood flow, the pitch does not change. Information from the reflected sound waves can be processed by a computer to provide graphs or pictures that represent the flow of blood through the blood vessels. These graphs or pictures can be saved for future review or evaluation.

The three basic types of Doppler ultrasound are:

Duplex Doppler.
Duplex Doppler ultrasound uses standard ultrasound methods to produce a picture of a blood vessel and the surrounding organs. Also, a computer converts the Doppler sounds into a graph that gives information about the speed and direction of blood flow through the blood vessel being evaluated.

Color Doppler.
Color Doppler uses standard ultrasound methods to produce a picture of a blood vessel. Also, a computer converts the Doppler sounds into colors that are overlaid on the image of the blood vessel and that represent the speed and direction of blood flow through the vessel.

Power Doppler is a special type of color Doppler. Power Doppler can get some images that are hard or impossible to get using standard color Doppler. Power Doppler is most commonly used to evaluate blood flow through vessels within solid organs.

Common colour Doppler studies

Carotid Doppler

Carotid ultrasound uses sound waves to produce pictures of the carotid arteries in the neck which carry blood from the heart to the brain. A Doppler ultrasound study – a technique that evaluates blood flow through a blood vessel – is usually part of this exam. It’s most frequently used to screen patients for blockage or narrowing of the carotid arteries, a condition called stenosis which may increase the risk of stroke.

Little or no special preparation is required for this procedure. Leave jewelry at home and wear loose, comfortable clothing. A loose-fitting, open necked shirt or blouse is ideal.

• What is Ultrasound Imaging of the Carotid Artery?

• What are some common uses of the procedure?

• How should I prepare?

• What does the equipment look like?

• How does the procedure work?

• How is the procedure performed?
• What will I experience during and after the procedure? 
• What are the benefits vs. risks?

• What are the limitations of Carotid Ultrasound Imaging?

What is Carotid Ultrasound Imaging?

Ultrasound is safe and painless, and produces pictures of the inside of the body using sound waves. Ultrasound imaging, also called ultrasound scanning or sonography, involves the use of a small transducer (probe) and ultrasound gel placed directly on the skin. High-frequency sound waves are transmitted from the probe through the gel into the body. The transducer collects the sounds that bounce back and a computer then uses those sound waves to create an image. Ultrasound examinations do not use ionizing radiation (as used in x-rays), thus there is no radiation exposure to the patient. Because ultrasound images are captured in real-time, they can show the structure and movement of the body’s internal organs, as well as blood flowing through blood vessels.

Ultrasound imaging is a noninvasive medical test that helps physicians diagnose and treat medical conditions.

An ultrasound of the body’s two carotid arteries, which are located on each side of the neck and carry blood from the heart to the brain, provides detailed pictures of these blood vessels and information about the blood flowing through them.

A Doppler ultrasound study is usually an integral part of a carotid ultrasound examination.

Doppler ultrasound, also called color Doppler ultrasonography, is a special ultrasound technique that allows the physician to see and evaluate blood flow through arteries and veins in the abdomen, arms, legs, neck and/or brain (in infants and children) or within various body organs such as the liver or kidneys.

What are some common uses of the procedure?

The carotid ultrasound is most frequently performed to detect narrowing, or stenosis, of the carotid artery, a condition that substantially increases the risk of stroke.

The major goal of carotid ultrasound is to screen patients for blockage or narrowing of their carotid arteries, which if present may increase their risk of having a stroke. If a significant narrowing is detected, a comprehensive treatment may be initiated.

It may also be performed if a patient has high blood pressure or a carotid bruit (pronounced brU-E)—an abnormal sound in the neck that is heard with the stethoscope. In some cases, it is also performed in preparation for coronary artery bypass surgery. Other risk factors calling for a carotid ultrasound are:

• diabetes
• elevated blood cholesterol
• a family history of stroke or heart disease

A carotid ultrasound is also performed to:

• locate a hematoma, a collection of clotted blood that may slow and eventually stop blood flow.
• check the state of the carotid artery after surgery to restore normal blood flow.
• verify the position of a metal stent placed to maintain carotid blood flow.

Doppler ultrasound images can help the physician to see and evaluate:

• blockages to blood flow (such as clots)
• narrowing of vessels
• tumors and congenital vascular malformations
• reduced or absent blood flow to various organs
• greater than normal blood flow to different areas, which is sometimes seen in infections

In children, Doppler ultrasound is used to:

• evaluate blood flow.
• predict a higher risk of stroke in children with sickle cell disease.
• detect abnormalities in the blood vessels, lymph nodes and lymphatic vessels.

How should I prepare?

You should wear comfortable, loose-fitting clothing for your ultrasound exam. You may need to remove all clothing and jewelry in the area to be examined.

A loose-fitting, open necked shirt or blouse is ideal.

Ultrasound examinations are very sensitive to motion, and an active or crying child can prolong the examination process. To ensure a smooth experience, it often helps to explain the procedure to the child prior to the exam. Bringing books, small toys, music or games can help to distract the child and make the time pass quickly. The ultrasound exam room may have a television. Feel free to ask for your child’s favorite channel.

No other preparation is required.

What does the equipment look like?

Ultrasound scanners consist of a console containing a computer and electronics, a video display screen and a transducer that is used to do the scanning. The transducer is a small hand-held device that resembles a microphone, attached to the scanner by a cord. Some exams may use different transducers (with different capabilities) during a single exam. The transducer sends out high-frequency sound waves (that the human ear cannot hear) into the body and then listens for the returning echoes from the tissues in the body. The principles are similar to sonar used by boats and submarines.

The ultrasound image is immediately visible on a video display screen that looks like a computer or television monitor. The image is created based on the amplitude (loudness), frequency (pitch) and time it takes for the ultrasound signal to return from the area within the patient that is being examined to the transducer (the device placed on the patient’s skin to send and receive the returning sound waves), as well as the type of body structure and composition of body tissue through which the sound travels. A small amount of gel is put on the skin to allow the sound waves to travel from the transducer to the examined area within the body and then back again. Ultrasound is an excellent modality for some areas of the body while other areas, especially air-filled lungs, are poorly suited for ultrasound.

How does the procedure work?

Ultrasound imaging is based on the same principles involved in the sonar used by bats, ships and fishermen. When a sound wave strikes an object, it bounces back, or echoes. By measuring these echo waves, it is possible to determine how far away the object is as well as the object’s size, shape and consistency (whether the object is solid or filled with fluid).

In medicine, ultrasound is used to detect changes in appearance, size or contour of organs, tissues, and vessels or to detect abnormal masses, such as tumors.

In an ultrasound examination, a transducer both sends the sound waves into the body and receives the echoing waves. When the transducer is pressed against the skin, it directs small pulses of inaudible, high-frequency sound waves into the body. As the sound waves bounce off internal organs, fluids and tissues, the sensitive receiver in the transducer records tiny changes in the sound’s pitch and direction. These signature waves are instantly measured and displayed by a computer, which in turn creates a real-time picture on the monitor. One or more frames of the moving pictures are typically captured as still images. Short video loops of the images may also be saved.

Doppler ultrasound, a special application of ultrasound, measures the direction and speed of blood cells as they move through vessels. The movement of blood cells causes a change in pitch of the reflected sound waves (called the Doppler effect). A computer collects and processes the sounds and creates graphs or color pictures that represent the flow of blood through the blood vessels.

How is the procedure performed?

For most ultrasound exams, you will be positioned lying face-up on an examination table that can be tilted or moved. Patients may be turned to either side to improve the quality of the images.

A clear water-based gel is applied to the area of the body being studied to help the transducer make secure contact with the body and eliminate air pockets between the transducer and the skin that can block the sound waves from passing into your body. The radiologist then places the transducer on the skin in various locations, sweeping over the area of interest or angling the sound beam from a different location to better see an area of concern.

Doppler sonography is performed using the same transducer.

When the examination is complete, you may be asked to dress and wait while the ultrasound images are reviewed.

The branches of the carotid arteries inside the head cannot be seen directly but can be evaluated with Doppler ultrasound in children with sickle cell disease. It is performed by placing the transducer over the child’s temple and recording the blood flow in the center of the skull.

This ultrasound examination is usually completed within 30 to 45 minutes.

What will I experience during and after the procedure?

Ultrasound examinations are painless and easily tolerated by most patients.

After you are positioned on the examination table, the radiologist  will apply some warm water-based gel on your skin and then place the transducer firmly against your body, moving it back and forth over the area of interest until the desired images are captured. There is usually no discomfort from pressure as the transducer is pressed against the area being examined.

If scanning is performed over an area of tenderness, you may feel pressure or minor pain from the transducer.

It may be necessary to tilt or rotate your head for the best exposure, as the transducer is swept over the entire length of your neck on both sides to obtain views of the artery from different perspectives. It also helps to keep your arm and shoulder down. Your head will be supported to keep it still.

If a Doppler ultrasound study is performed, you may actually hear pulse-like sounds that change in pitch as the blood flow is monitored and measured.

Once the imaging is complete, the clear ultrasound gel will be wiped off your skin. Any portions that are not wiped off will dry quickly. The ultrasound gel does not usually stain or discolor clothing.

After an ultrasound examination, you should be able to resume your normal activities immediately.

What are the benefits vs. risks?

Benefits

• Most ultrasound scanning is noninvasive (no needles or injections).
• Occasionally, an ultrasound exam may be temporarily uncomfortable, but it should not be painful.
• Ultrasound is widely available, easy-to-use and less expensive than other imaging methods.
• Ultrasound imaging is extremely safe and does not use any ionizing radiation.
• Ultrasound scanning gives a clear picture of soft tissues that do not show up well on x-ray images.
• If a carotid ultrasound exam shows narrowing of one or both carotid arteries, treatment can be taken to restore the free flow of blood to the brain. Many strokes are prevented as a result.

Risks

• For standard diagnostic ultrasound, there are no known harmful effects on humans.

 

What are the limitations of Carotid Ultrasound Imaging?

• Carotid ultrasound may be difficult or impossible if a patient has a dressing covering a wound or surgical scar in the neck.
• An occasional patient is difficult to examine because of the size or contour of the neck.
• Calcium deposits in the wall of the carotid artery may make it difficult to evaluate the vessel.
• A small amount of soft plaque that produces low-level echoes may go undetected.
• Ultrasound cannot visualize the entire length of the vessel because the last portion of the carotid artery travels though the bone at the base of the skull. For a more complete assessment, patients may need to undergo a CT or MRI of the carotid arteries.

Doppler Ultrasound Exam of Arm or Leg

• Purpose
• Preparation
• Procedure
• Results

Your doctor may order a Doppler ultrasound exam if you show signs of:

• deep vein thrombosis (DVT), a condition that occurs when a blood clot forms in a vein deep inside your body (usually in the leg or hip regions)
• superficial thrombophlebitis, an inflammation of the veins due to a blood clot in a vein just below the skin’s surface
• arteriosclerosis, a narrowing and hardening of the arteries that supply blood to the legs and feet
• thromboangiitis obliterans, a rare disease in which the blood vessels of the hands and feet become inflamed and swollen
• vascular tumors in your arms or legs

A Doppler ultrasound can help determine the blood pressure within your arteries. It can also show how much blood is currently flowing through your arteries and veins.

How should I prepare for a Doppler ultrasound?

In general, there’s no preparation required for this test. If you’re a smoker, your doctor may ask you to stop smoking for several hours before the test. Smoking causes your blood vessels to narrow, which can affect the results of your test.

What happens during a Doppler ultrasound?

A Doppler ultrasound is a noninvasive, painless procedure that doesn’t expose you to harmful radiation. There are no risks associated with this test, and most people feel little to no discomfort during the procedure.

The test is usually performed in the radiology department of a hospital, doctor’s office, or peripheral vascular laboratory. The procedure can vary slightly, but in general, you can expect the following:

• You’ll need to remove clothing, jewelry, and any other objects from the area that will be studied. However, there’s no need to remove your glasses, contact lenses, dentures, or hearing aids. You may be asked to wear a hospital gown.
• Before the procedure, you’ll be instructed to lie down on an examination table or bed.
• Your doctor will then place a water-soluble gel on a handheld device called a transducer, which directs high-frequency sound waves into the arteries or veins being studied.
• To examine your arteries, the person administering the test may place blood pressure cuffs around various areas of your body. The cuffs will generally be applied to your thigh, calf, ankle, or different points along your arm. These cuffs help compare the blood pressure in different parts of your leg or arm.
• Images are created as the transducer is pressed against your skin and moved along your arm or leg. The transducer sends sound waves through your skin and other body tissues to the blood vessels. The sound waves echo off your blood vessels and send the information to a computer to be processed and recorded. The computer will produce graphs or pictures that show the flow of the blood through the arteries and veins. The transducer will be moved to different areas for comparison. You may hear a “whooshing” sound as blood flow is detected.

When examining your leg arteries and veins, your doctor will look for narrowing of the blood vessels. This condition may cause skin discoloration, pain when you walk or rest, and ulcers on the foot or ankle.

The test will be completed in about an hour. Depending on your signs and symptoms, you may be asked to perform some mild exercises after the procedure.

After the procedure

In general, there are no special instructions following a Doppler ultrasound. You may resume your usual activities right away, unless your doctor tells you otherwise.

How do I interpret the test results?

Normal test results indicate that you have no narrowing or blockages in your arteries. It also means that the blood pressure in your arteries is normal.Abnormal blood flow patterns, including narrowing or closing of the arteries, can indicate:

• blockage in the arteries, which may be due to a buildup of cholesterol
• blood clots in a vein or artery
• poor circulation, which can be caused by damaged blood vessels
• venous occlusion, or closing of a vein
• spastic arterial disease, a condition in which the arteries contract due to stress or exposure to cold weather
• blockage or clots in an artificial bypass graft

Some factors may compromise your results, which means the test will need to be done again. These factors include:

• smoking less than one hour before the test
• severe obesity
• cardiac dysrhythmias and arrhythmias, or irregular heart rhythms
• cardiovascular disease

The test results will be sent to your referring doctor. If any abnormalities are found, your doctor will explain your results in more detail and inform you about any additional tests or treatments you may need.

 Everything You Want to Know About Deep Vein Thrombosis (DVT)

• Symptoms
• Causes
• Treatment
• Home remedies
• Risk factors
• Prevention
• Diagnosis
• Complications
• In pregnancy
• Flying
• Diet

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Deep vein thrombosis (DVT)

Deep vein thrombosis (DVT) is a serious condition that occurs when a blood clot forms in a vein located deep inside your body. A blood clot is a clump of blood that’s turned to a solid state.

Deep vein blood clots typically form in your thigh or lower leg, but they can also develop in other areas of your body. Other names associated with this condition may include thromboembolism, post-thrombotic syndrome, and postphlebitic syndrome.

DVT symptoms

According to the Centers for Disease Control and Prevention (CDC), symptoms of DVT only occur in about half of the people who have this condition. Common symptoms include:

• swelling in your foot, ankle, or leg, usually on one side
• cramping pain in your affected leg that usually begins in your calf
• severe, unexplained pain in your foot and ankle
• an area of skin that feels warmer than the skin on the surrounding areas
• skin over the affected area turning pale or a reddish or bluish color

People with an upper extremity DVT, or a blood clot in the arm, may also not experience symptoms. If they do, common symptoms include:

• neck pain
• shoulder pain
• swelling in the arm or hand
• blue-tinted skin color
• pain that moves from the arm to the forearm
• weakness in the hand

People may not find out that they have deep vein thrombosis until they’ve gone through emergency treatment for a pulmonary embolism (blood clot in the lung).

A pulmonary embolism can happen when a DVT clot has moved from the arm or leg into the lung. When an artery in the lung becomes blocked, it’s a life-threatening condition and requires emergency care.

DVT causes

DVT is caused by a blood clot. The clot blocks a vein, preventing blood from properly circulating in your body. Clotting may occur for several reasons. These include:

• Injury. Damage to a blood vessel’s wall can narrow or block blood flow. A blood clot may form as a result.
• Surgery. Blood vessels can be damaged during surgery, which can lead to the development of a blood clot. Bed rest with little to no movement after surgery may also increase your risk for developing a blood clot.
• Reduced mobility or inactivity. When you sit frequently, blood can collect in your legs, especially the lower parts. If you’re unable to move for extended periods of time, the blood flow in your legs can slow down. This can cause a clot to develop.
• Certain medications. Some medications increase the chances your blood will form a clot.

DVT treatment

DVT is a serious medical condition. Tell your doctor right away if you think you’re experiencing symptoms of DVT or go to the closest emergency room. A healthcare provider can check out your symptoms.

DVT treatments focus on keeping the clot from growing. In addition, treatment may help prevent a pulmonary embolism and lower your risk of having more clots.

Medication

Your doctor might prescribe medications that thin your blood,  This makes it harder for your blood to clot. It also keeps existing clots as small as possible and decreases the chance that you’ll develop more clots.

Compression stockings

Wearing compression stockings can prevent swelling and might lower your chance of developing clots.

Compression stockings reach just below your knee or right above it. Your doctor may recommend you wear these every day.

Filters

You might need to have a filter put inside the large abdominal vein called the vena cava if you aren’t able to take blood thinners. This form of treatment helps prevent pulmonary embolisms by stopping clots from entering your lungs.

But filters do have risks. If they’re left in for too long, they can actually cause DVT. Filters should be used for a short-term period, until the risk of thromboembolism is reduced and blood thinning medications can be used.

DVT home remedies

Once a DVT blood clot is diagnosed, your doctor will likely prescribe a medication to help thin the blood or break up the clot. You can combine the prescribed medication with the following home remedies to prevent other complications and reduce the risk of future blood clots.

Move more

Take walks daily to improve blood flow. Shorter, frequent walks are better than one longer walk.

Keep your leg or arm elevated

This is especially important for legs. Blood can pool if your feet are on the ground all day. Use a stool or chair to keep your legs elevated and close to level with your hips.

Wear compression stockings

These specially designed stockings fit tightly around your feet and become gradually looser as they move up your leg to your knee.

The compression helps prevent pooling and swelling, and it increases blood flow. Compression stockings are also recommended when traveling. Read more about how they help.

DVT risk factors

DVT occurs most commonly in people who are over 50 years of age. But they can still happen at any age. Certain conditions that alter how your blood moves through your veins can raise your risk of developing clots. These include:

• having an injury that damages your veins, like a bone fracture
• being overweight, which puts more pressure on the veins in your legs and pelvis
• having a family history of DVT
• having a catheter placed in a vein
• taking birth control pills or undergoing hormone therapy
• smoking (especially heavily)
• staying seated for a long time while you’re in a car or on a plane, especially if you already have at least one other risk factor

Some conditions can increase your risk of having blood clots. These include hereditary blood clotting disorders, especially when you have at least one other risk factor. Cancer and inflammatory bowel disease can also increase the risk of developing a blood clot.

Heart failure, a condition that makes it more difficult for your heart to pump blood, also causes an increased risk of clots.

DVT is a major risk associated with surgery. This is especially true if you’re having a surgery in the lower extremities, like joint replacement surgery.

DVT prevention

You can lower your risk of having DVT by making a few lifestyle changes. These include keeping your blood pressure under control, giving up smoking, and losing weight if you’re overweight.

Moving your legs around when you’ve been sitting for a while also helps keep your blood flowing. Walking around after being on bed rest can prevent clots from forming.

Take any blood thinners your doctor prescribes if you’re having surgery, as this can lower your chance of developing clots afterward.

The risk of developing DVT during travel becomes higher if you’re sitting for more than four hours. Lower your risk by moving around every so often. Get out of your car and stretch at intervals during long drives. Walk in the aisles if you’re flying, taking a train, or riding a bus.

Stretch your legs and feet while you’re sitting — this keeps your blood moving steadily in your calves. Don’t wear tight clothes that can restrict blood flow. 

DVT test

Your doctor will use your medical history, a thorough physical exam, as well as one or more diagnostic tests to find or rule out DVT. These tests include:

Ultrasound

This is the most commonly used test for diagnosing DVT. Ultrasound uses sound waves to create a picture of your arteries and veins in order to see how blood flows through them.

If a clot is present, your doctor will be able to see the interrupted blood flow and make the diagnosis.

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DVT complications

A major complication of DVT is a pulmonary embolism. You can develop a pulmonary embolism if a blood clot moves to your lungs and blocks a blood vessel.

This can cause serious damage to your lungs and other parts of your body. Get immediate medical help if you have signs of a pulmonary embolism. These signs include:

• dizziness
• sweating
• chest pain that gets worse with coughing or inhaling deeply
• rapid breathing
• coughing up blood
• rapid heart rate

Many complications of DVT can be prevented. 

DVT in pregnancy

Being pregnant increases your risk of DVT. In fact, pregnant women are 5 to 10 times more likely to develop DVT than women who aren’t pregnant.

While pregnant, the level of blood-clotting proteins increases, and the level of anticlotting proteins falls. Plus, increased hormone levels, and a slower blood flow as your uterus expands and restricts blood flowing back from your lower extremities, contribute to this risk.

The elevated risk continues until about six weeks after giving birth. Being on bed rest or having a cesarean delivery also increases your risk of having DVT.

Remain watchful for symptoms of DVT while you’re pregnant. 

DVT and flying

Your risk of developing blood clots is higher when flying because sitting for long periods of time increases the chances of DVT.

The longer the flight, the greater the risk. It’s especially significant for people taking flights that last more than eight hours. Your risk also increases if you’re flying and already have other risk factors for DVT.

These measures can help you reduce your risk for a blood clot while flying:

• Sit in an exit row or bulkhead seat so you have more room to stretch and move your legs.
• Wear compression stockings, which reduce blood pooling and help maintain blood flow.
• Take any prescription blood thinners or aspirin as prescribed by your doctor.
• Do exercises with your feet and legs to keep blood flowing.
• Get up and walk around the cabin during the flight.

DVT and diet

A healthy lifestyle is important for preventing DVT and helping to avoid life-threatening complications. Plus, a healthy lifestyle incorporates many of the changes that are necessary to prevent blood clots. This includes moving more, quitting smoking, and losing weight.

You can lower your risk for DVT and blood clots with a healthy diet. Fruits, vegetables, and whole grains deliver essential vitamins and minerals.

A vegan, vegetarian, or Mediterranean diet may be best for people at risk of DVT or people who’ve had DVT before, but research is needed to support this. Eating these herbs in small amounts may help you reduce your risk of DVT, too.

But some vitamins and minerals can interfere with DVT medications. For example, too much vitamin K can bypass warfarin’s ability to thin your blood and prevent a clot.

Review any vitamins or supplements you take with your doctor and ask about possible interactions with medications. It’s also important you talk with your doctor about any foods or nutrients you should avoid.

Atherosclerosis

• Types
• Causes
• Risk factors
• Symptoms
• Diagnosis
• Treatment
• Outlook
• Prevention

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What is atherosclerosis?

Atherosclerosis is a narrowing of the arteries caused by a buildup of plaque. It’s also called arteriosclerosis or hardening of the arteries. Arteries are the blood vessels that carry oxygen and nutrients from your heart to the rest of your body.

As you get older, fat and cholesterol can collect in your arteries and form plaque. The buildup of plaque makes it difficult for blood to flow through your arteries. This buildup may occur in any artery in your body and can result in a shortage of blood and oxygen in various tissues of your body. Pieces of plaque can also break off, causing a blood clot. Atherosclerosis can lead to heart attack, stroke, or heart failure if left untreated.

Atherosclerosis is a fairly common problem associated with aging. This condition can be prevented, and many successful treatment options exist.

What are the types of atherosclerosis?

Atherosclerosis occurs when fat, cholesterol, and calcium harden in your arteries. Atherosclerosis can occur in an artery located anywhere in your body, including your heart, legs, and kidneys.

Atherosclerosis can cause the following diseases:

Coronary artery disease

Coronary artery disease occurs when the coronary arteries of your heart become hard. The coronary arteries are blood vessels that provide your heart’s muscle tissue with oxygen and blood. Plaque prevents blood flow to the heart.

Carotid artery disease

The carotid arteries are found in your neck and supply blood to your brain. These arteries may be compromised if plaque builds up in their walls. The lack of circulation may reduce how much blood and oxygen reaches your brain’s tissue and cells.

Peripheral artery disease

Your legs, arms, and lower body depend on your arteries to supply blood and oxygen to their tissues. Hardened arteries can cause circulation problems in these areas of the body.

Kidney disease

The renal arteries supply blood to your kidneys. Kidneys filter waste products and extra water from your blood. Atherosclerosis of these arteries may lead to kidney failure.

What causes atherosclerosis?

Plaque buildup and subsequent hardening of the arteries restricts blood flow in the arteries, preventing your organs and tissues from getting the oxygenated blood they need to function.

The following are common causes of hardening of the arteries:

High cholesterol

Cholesterol is a waxy, yellow substance that’s found naturally in your body and also in certain foods you eat. If the levels of this substance in your blood are too high, it can clog your arteries. It becomes a hard plaque that restricts or blocks blood circulation to your heart and other organs.

Diet

It’s important to eat a healthy diet.

• Avoid foods with added sugar, such as sugar-sweetened beverages, candy, and desserts. The American Heart Association recommends no more than 6 teaspoons or 100 calories of sugar a day for most women, and no more than 9 teaspoons or 150 calories a day for most men.
• Avoid foods high in salt; aim to eat no more than 2,400 milligrams of sodium per day.
• Avoid foods high in fat; replace them with the better fats, monounsaturated and polyunsaturated. If you need to lower your blood cholesterol, reduce saturated fat to no more than 5 to 6 percent of total calories. For someone eating 2,000 calories a day, that’s about 13 grams of saturated fat.
• The American Heart Association recommends you eat an overall healthy dietary patternthat emphasizes:
  • a variety of fruits and vegetables
  • whole grains
  • low-fat dairy products
  • skinless poultry and fish
  • nuts and legumes
  • non-tropical vegetable oils
  • Eating foods high in fat may also lead to plaque buildup.

Aging

As you age, your heart and blood vessels work harder to pump and receive blood. Your arteries may weaken and become less elastic, making them more susceptible to plaque buildup.

Who is at risk for atherosclerosis?

Many factors place you at risk for atherosclerosis. Some risks can be prevented, while others cannot.

Family history

If atherosclerosis runs in your family, you may be at risk for hardening of the arteries. This condition as well as other heart-related problems may be inherited.

Lack of exercise

Regular exercise is good for your heart. It keeps your heart muscle strong and encourages oxygen and blood flow throughout your body. Living a sedentary lifestyle increases your risk for a host of medical conditions, including heart disease.

High blood pressure

High blood pressure can damage your blood vessels by making them weak in some areas. Cholesterol and other substances in your blood may reduce the flexibility of your arteries over time.

Smoking

Smoking tobacco products can damage your blood vessels and heart.

Diabetes

People with diabetes have a much higher incidence of coronary artery disease.

What are the symptoms of atherosclerosis?

Most symptoms of atherosclerosis don’t show until a blockage occurs. Common symptoms include:

• chest pain or angina
• pain in your leg, arm, and anywhere else that has a blocked artery
• shortness of breath
• fatigue
• confusion, which occurs if the blockage affects circulation to your brain
• muscle weakness in your legs from lack of circulation

It’s also important to know the symptoms of heart attack and stroke. Both of these problems can be caused by atherosclerosis and require immediate medical attention. The symptoms of a heart attack include:

• chest pain or discomfort
• pain in the shoulders, back, neck, arms, and jaw
• abdominal pain
• shortness of breath
• perspiration
• lightheadedness
• nausea or vomiting
• a sense of impending doom

The symptoms of stroke include:

• weakness or numbness in the face or limbs
• trouble speaking
• trouble understanding speech
• vision problems
• loss of balance
• sudden, severe headache

Call 911 and get to a hospital’s emergency room as soon as possible if you experience symptoms of a heart attack or stroke.

How is atherosclerosis diagnosed?

Your doctor will perform a physical exam if you have symptoms of atherosclerosis. They’ll check for:

• a weakened pulse
• an aneurysm, which is an abnormal bulging or widening of an artery due to weakness of the arterial wall
• slow wound healing, which indicates a restricted blood flow

A heart specialist called a cardiologist may listen to your heart to see if you have any abnormal sounds. They’ll be listening for a whooshing noise, which indicates that an artery is blocked. Your doctor will order more tests if they think you may have atherosclerosis. These tests can include:

• a blood test to check your cholesterol levels
• a Doppler ultrasound, which uses sound waves to create a picture of the artery that shows if there’s a blockage
• ankle-brachial index test, which looks for a blockage in your arms or legs by comparing the blood pressure in each limb
• a stress test, or exercise tolerance test, which monitors your heart rate and blood pressure while you exercise on a treadmill or stationary bicycle

How is atherosclerosis treated?

Treatment involves changing your current lifestyle to one that limits the amount of fat and cholesterol you consume. You may need to exercise more to improve the health of your heart and blood vessels.

You may also need additional medical treatments, such as:

Medications

Medications can help prevent atherosclerosis from worsening. Medications include:

Surgery

In some cases, surgery may be necessary if symptoms are especially severe, or if muscle or skin tissue are endangered.

Nonmedical treatment and prevention

Lifestyle changes can help to prevent as well as treat atherosclerosis. Unless your atherosclerosis is severe, your doctor may recommend lifestyle changes as the first line of treatment. Lifestyle changes include:

• eating a healthy diet that’s low in saturated fat and cholesterol
• avoiding fatty foods
• adding fish to your diet twice per week
• exercising for 30 to 60 minutes per day, six days per week
• quitting smoking if you’re a smoker
• losing weight if you’re overweight or obese
• managing stress
• treating conditions associated with atherosclerosis, such as hypertension, high cholesterol, and diabetes