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SCREENING FOR ATHEROSCLEROSIS

The duration of atherosclerotic disease, from the start of early plaques to arterial blockage, is very long. Patients with the atherosclerotic disease usually do not have symptoms until the lesions advances to serious narrowing or occlusion. This gives the chance to diagnose the disease at an early stage. Early diagnosis and treatment prevent deadly outcomes such as myocardial infarction, stroke, kidney failure or leg amputations.

It is highly recommended that people over 40 years of age with one or more of the following risk factors or associated diseases undergo atherosclerosis screening;

1. Genetic tendency (myocardial infarction, stroke in parents)
2. High cholesterol levels
3. Smoking
4. Hypertension
5. Diabetes  

Blood Tests

LDL (low density cholesterol-bad cholesterol), HDL (high density cholesterol- good cholesterol), triglyceride, blood sugar (HbA1C if necessary), HsCRP (high sensitive CRP), TSH (thyroid stimulating hormone).

Duplex Scanning (Color Flow Ultrasound)

Non-invasive examination of carotid arteries (neck arteries), abdominal aorta, renal arteries (if necessary) and leg arteries are examined for the detection of early atherosclerotic changes, Duplex scanning is an easy method without pain or radiation and very reliable in experienced hands.
The thickness of the inner layer of a carotid artery over 1 mm is the earliest atherosclerotic changes and easily measured with duplex scanning.  
Narrowing of the carotid artery due to a calcified atherosclerotic plaque.   
The aneurysm is the dilatation of the aorta with a maximum diameter over 3 cm. Aortic aneurysm over 5 cm in diameter should be treated electively in order to prevent sudden rupture and death.    

CT-cardiac Calcium Scoring

The majority of atherosclerotic plaques have calcium deposition which can easily be detected by simple CT scanning of the chest without using contrast. Calcium scoring is different than CT angiography with respect to the amount of radiation (much more with CT angiography) and the cost. During a cardiac calcium scoring test, lung and thoracic aortic screening are also made.
Atherosclerotic plaques are detected on CT scanning (right picture- arrow showing white, calcified plaques on coronary arteries).