Atherosclerotic cardiovascular disease; ASCVD; Atherosclerotic heart disease; Arteriosclerotic vascular disease; ASVD; Arteriosclerosis; Hardening of the arteries
Atherosclerosis or arteriosclerosis is hardening and narrowing of the arteries where plaque builds up inside your arteries. It can block blood flow and may lead to heart attack or stroke. The good news is that atherosclerosis is preventable and treatable. Learn about symptoms, causes, prevention strategies, and treatments for atherosclerosis.
atherosclerosis
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Overview
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What Is Atherosclerosis?
Video by TheVisualMD
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What Is Atherosclerosis?
Voyage inside your body to see where cholesterol is made and how plaques form inside your arteries. Witness the inner workings of your own personal cholesterol factory: your liver. Dr. Mehmet Oz, Dr. Peter Fail, and other top experts talk about cholesterol-how it accumulates with other substances in your arteries as plaque, and what happens when plaques rupture. See exactly how tiny stents are inserted in blocked vessels, and view footage of actual bypass surgery. Discover how you can keep your arteries clear and flexible through lifestyle changes and medications.
Video by TheVisualMD
Atherosclerosis
Atherosclerosis is a disease in which plaque builds up inside your arteries. Plaque is a sticky substance made up of fat, cholesterol, calcium, and other substances found in the blood. Over time, plaque hardens and narrows your arteries. That limits the flow of oxygen-rich blood to your body.
Atherosclerosis can lead to serious problems, including
Coronary artery disease. These arteries supply blood to your heart. When they are blocked, you can suffer angina or a heart attack.
Carotid artery disease. These arteries supply blood to your brain. When they are blocked you can suffer a stroke.
Peripheral arterial disease. These arteries are in your arms, legs and pelvis. When they are blocked, you can suffer from numbness, pain and sometimes infections.
Atherosclerosis usually doesn't cause symptoms until it severely narrows or totally blocks an artery. Many people don't know they have it until they have a medical emergency.
A physical exam, imaging, and other diagnostic tests can tell if you have it. Medicines can slow the progress of plaque buildup. Your doctor may also recommend procedures such as angioplasty to open the arteries, or surgery on the coronary or carotid arteries. Lifestyle changes can also help. These include following a healthy diet, getting regular exercise, maintaining a healthy weight, quitting smoking, and managing stress.
Source: National Heart, Lung, and Blood Institute (NHLBI)
Additional Materials (16)
Vessel with Plaque Build Up 1
Vessel with Plaque Build Up 2
Vessel with Plaque Build Up 3
1
2
3
Vessel with Plaque Build Up
A cholesterol-containing fatty substance called plaque can build up and coat the inside of vessels, decreasing their diameter and thus blood flow. Blood clots that build on top of plaque deposits can loosen and break off and then clog smaller blood vessels.
Interactive by TheVisualMD
Atherosclerosis - Part 1
Video by Khan Academy/YouTube
Atherosclerosis Video 1: What Is Atherosclerosis?
Video by YouAsk MDanswers/YouTube
Arteriosclerosis, Arteriolosclerosis, and Atherosclerosis
Video by Khan Academy/YouTube
Atherosclerosis | Circulatory System and Disease | NCLEX-RN | Khan Academy
Video by khanacademymedicine/YouTube
Atherosclerosis
Video by PatientEdChannel/YouTube
Coronary heart disease, clogged arteries and atherosclerosis
Video by British Heart Foundation/YouTube
Heart attack, clogged arteries and atherosclerosis
Atherosclerosis: Definition, Diagnosis & Treatment – Vascular Medicine | Lecturio
Lecturio Medical/YouTube
12:54
Atherosclerosis - part 1 | Circulatory system diseases | Health & Medicine | Khan Academy
khanacademymedicine/YouTube
8:59
Atherosclerosis - part 2 | Circulatory system diseases | Health & Medicine | Khan Academy
khanacademymedicine/YouTube
9:18
Arteriosclerosis, arteriolosclerosis, and atherosclerosis | Health & Medicine | Khan Academy
khanacademymedicine/YouTube
4:38
ATHEROSCLEROSIS and CARDIOVASCULAR DISEASE
biolution/YouTube
What Is Atherosclerosis?
What is Atherosclerosis?
Image by TheVisualMD
What is Atherosclerosis?
Image by TheVisualMD
What Is Atherosclerosis?
Atherosclerosis is a common condition that develops when a sticky substance called plaque builds up inside your arteries. Disease linked to atherosclerosis is the leading cause of death in the United States. About half of Americans between ages 45 and 84 have atherosclerosis and don’t know it.
Atherosclerosis develops slowly as cholesterol, fat, blood cells and other substances in your blood form plaque. When the plaque builds up, it causes your arteries to narrow. This reduces the supply of oxygen-rich blood to tissues of vital organs in the body.
Normal artery and an artery with plaque buildup.
Atherosclerosis can affect most of the arteries in the body, including arteries in the heart, brain, arms, legs, pelvis, and kidneys. It has different names based on which arteries are affected.
Coronary artery disease (CAD) is plaque buildup in the arteries of yourheart.
Peripheral artery disease (PAD) most often is plaque buildup inthearteries of the legs, but it can also build up in your arms or pelvis.
Carotid artery disease is plaque buildup in the neck arteries. It reduces blood flow to the brain.
Renal artery stenosis is plaque buildup in the arteries that supply blood to your kidneys.
Vertebral artery disease is atherosclerosis in the arteries that supply blood to the back of the brain. This area of the brain controls body functions that are needed to keep you alive. Read more about disorders affecting blood supply to the back of the brain.external link
Mesenteric artery Ischemia is plaque buildup in the arteries that supply theintestines with blood. Learn more about plaque buildup in the mesenteric arteriesexternal link.
Reduced blood flow can lead to symptoms such as angina. If a plaque bursts, a Blood clots may form that may block the artery completely or travel to other parts of the body. Blockages, either complete or incomplete, can cause complications, including heart attack, stroke, vascular dementia, erectile dysfunction, or limb loss. Atherosclerosis can cause death and disability.
Confused about terms? Atherosclerosis is not the same as arteriosclerosis, which refers to “hardening of the arteries,” which means the arteries thicken and lose flexibility. Arteriosclerosis has several different causes. Atherosclerosis, which develops from fatty plaque buildup, is a common type of arteriosclerosis.
Plaque often starts to build up during childhood and gets worse with age. Risk factors include unhealthy cholesterol levels, unhealthy lifestyle habits, and your genes.
The good news is that most people can prevent or delay the initiation and progression of atherosclerosis by following steps for heart-healthy living.
Source: National Heart, Lung, and Blood Institute (NHLBI)
Additional Materials (11)
Atherosclerosis may start with your body's own inflammatory (immune system) response
What is Atherosclerosis : Atherosclerosis may start with your body's own inflammatory (immune system) response. When there is long-term injury to the lining of your arteries, like that caused by smoking or high blood pressure, immune system cells and other substances accumulate at the damaged parts of the artery. Over time, the result is clogged, stiffened arteries.
Image by TheVisualMD
This browser does not support the video element.
What Is Atherosclerosis?
Voyage inside your body to see where cholesterol is made and how plaques form inside your arteries. Witness the inner workings of your own personal cholesterol factory: your liver. Dr. Mehmet Oz, Dr. Peter Fail, and other top experts talk about cholesterol-how it accumulates with other substances in your arteries as plaque, and what happens when plaques rupture. See exactly how tiny stents are inserted in blocked vessels, and view footage of actual bypass surgery. Discover how you can keep your arteries clear and flexible through lifestyle changes and medications.
Video by TheVisualMD
What is Atherosclerosis?
Image by TheVisualMD
What is Atherosclerosis?
Image by TheVisualMD
What is Atherosclerosis?
Image by TheVisualMD
What Is Atherosclerosis?
Voyage inside your body to see where cholesterol is made and how plaques form inside your arteries. Witness the inner workings of your own personal cholesterol factory: your liver. Dr. Mehmet Oz, Dr. Peter Fail, and other top experts talk about cholesterol-how it accumulates with other substances in your arteries as plaque, and what happens when plaques rupture. See exactly how tiny stents are inserted in blocked vessels, and view footage of actual bypass surgery. Discover how you can keep your arteries clear and flexible through lifestyle changes and medications.
Image by TheVisualMD
Atherosclerosis - Plaque Animation Model
Video by BD/YouTube
Atherosclerosis Hardening of Arteries | Heart Disease
Video by Howcast/YouTube
Treatment of Atherosclerosis: Therapy Goals & Lifestyle Measures – Vascular Medicine | Lecturio
Video by Lecturio Medical/YouTube
The Role of Angiotensin II in the Process of Atherosclerosis
Video by Mechanisms in Medicine/YouTube
Inflammation and Atherosclerosis
Video by Oxford Academic (Oxford University Press)/YouTube
Atherosclerosis may start with your body's own inflammatory (immune system) response
TheVisualMD
3:10
What Is Atherosclerosis?
TheVisualMD
What is Atherosclerosis?
TheVisualMD
What is Atherosclerosis?
TheVisualMD
What is Atherosclerosis?
TheVisualMD
What Is Atherosclerosis?
TheVisualMD
0:52
Atherosclerosis - Plaque Animation Model
BD/YouTube
1:32
Atherosclerosis Hardening of Arteries | Heart Disease
Howcast/YouTube
4:39
Treatment of Atherosclerosis: Therapy Goals & Lifestyle Measures – Vascular Medicine | Lecturio
Lecturio Medical/YouTube
3:45
The Role of Angiotensin II in the Process of Atherosclerosis
Mechanisms in Medicine/YouTube
10:33
Inflammation and Atherosclerosis
Oxford Academic (Oxford University Press)/YouTube
What Is Cerebral Arteriosclerosis?
Atherosclerosis
Image by TheVisualMD
Atherosclerosis
Blockage of the Carotid Arteries
Image by TheVisualMD
Cerebral Arteriosclerosis Information
What is cerebral arteriosclerosis?
Cerebral arteriosclerosis is the result of thickening and hardening of the walls of the arteries in the brain. Symptoms of cerebral arteriosclerosis include headache, facial pain, and impaired vision.
Cerebral arteriosclerosis can cause serious health problems. If the walls of an artery are too thick, or a blood clot becomes caught in the narrow passage, blood flow to the brain can become blocked and cause an ischemic stroke. When the thickening and hardening is uneven, arterial walls can develop bulges (called aneurysms). If a bulge ruptures, bleeding in the brain can cause a hemorrhagic stroke. Both types of stroke can be fatal.
Cerebral arteriosclerosis is also related to a condition known as vascular dementia, in which small, symptom-free strokes cause cumulative damage and death to neurons (nerve cells) in the brain. Personality changes in the elderly, such as apathy, weeping, transient befuddlement, or irritability, might indicate that cerebral arteriosclerosis is present in the brain. Computer tomography (CT) and magnetic resonance imaging (MRI) of the brain can help reveal the presence of cerebral arteriosclerosis before ischemic strokes, hemorrhagic strokes, or vascular dementia develop.
Is there any treatment?
Treatment for cerebral arteriosclerosis can include medications or surgery. Physicians also may recommend treatments to help people control high blood pressure, quit cigarette smoking, and reduce cholesterol levels, all of which are risk factors for cerebral arteriosclerosis.
What is the prognosis?
Cerebral arteriosclerosis can lead to life threatening health events such as ischemic or hemorrhagic strokes. People who survive stroke may have long-term neurological and motor impairments.
Source: National Institute of Neurological Disorders and Stroke (NINDS)
Additional Materials (23)
Healthy Brain cross section
Brain with Ischemic Stroke cross section
Brain with Hemorrhagic Stroke, cross section
1
2
3
Types of Stroke
Cross Section
1) Healthy Brain - This cross-sectional image through the frontal plane of the head of a healthy individual reveals the temporal and frontal lobes of the brain, along with some major structures visible at this level. The vertebral arteries enter the skull through the foramen magnum. They meet to form the basilar artery, then ultimately branch into the posterior cerebral arteries. The Circle of Willis is a pattern of arteries in the center of the brain, surrounding the pituitary gland. The ventricles are fluid-filled cavities in the brain continuous with the central canal of the spinal cord, housing cells that produce and secrete cerebrospinal fluid. This fluid lubricates and has an immunological function.
2) Ischemic Stroke - This cross-sectional image through the frontal plane of the head of a healthy individual reveals the temporal and frontal lobes of the brain, along with some major structures visible at this level. A portion of dead brain tissue can be seen on the individual's left side of the brain near the surface. The dead tissue is due to an ischemic stroke, most likely a result of blockage in an artery to the brain. The blockage can also occur elsewhere in the body, but break apart and travel through the bloodstream, getting caught in the smaller arteries in the brain. Blood is unable to reach the tissue destination, and therefore that tissue becomes necrotic. The cause of blockage in the first place is likely due to fatty deposits in arterial walls, or atherosclerosis.
3) Hemorrhagic Stroke - This cross-sectional image through the frontal plane of the head of a healthy individual reveals the temporal and frontal lobes of the brain, along with some major structures visible at this level. A hemorrhagic stroke has occurred, as indicated by the area of bleeding on the individual's left side of the brain. A hemorrhagic stroke can occur when a vessel weakened by conditions such as an aneurysm or arteriovenous malformation (AVM) ruptures, allowing blood to leak out into the surrounding tissues. These conditions can be congenital, but risks may increase due to high blood pressure, high cholesterol, smoking, and atherosclerosis.
Interactive by TheVisualMD
Vascular Dementia: Causes & Prevention
Video by Peter M. Lawrence/YouTube
Blockage in Carotid Artery of Head and Neck
An ischemic stroke happens when a blockage occurs in the arteries leading to, and within, the brain. Ischemic strokes are more common than hemorrhagic strokes and fall into different categories. A person suffers a thrombotic stroke if the blockage is a is clot or a narrowing of the artery leading to the brain. An embolic stroke happens when a clot breaks off from its original site and moves through the bloodstream to block one of the smaller arteries in the brain. Embolic strokes tend to occur very suddenly. Thrombotic strokes may occur slowly over a period of time, and may actually be preceded by transient ischemic attacks or mini-strokes.
Image by TheVisualMD
Clogged Carotids
Because your brain needs so much blood, it's well supplied with an abundance of arteries, the blood vessels that carry oxygenated blood from your heart to your body's tissues. There are two pairs of big arteries that carry blood from your heart up to your brain:
Image by TheVisualMD
Blood Vessels of the Head and Neck
Profile of male head, glass skin and vasculature exposed. Magnetic resonance (MR) angiography uses a magnetic field and radio waves to produce pictures of key blood vessels throughout the body. In the vessels of the neck and brain, it can be used to diagnose conditions such as atherosclerosis, aneurysms, and arteriovenous malformations.
Image by TheVisualMD
Carotid Aneurysm cross section
Aneurysms can form in the carotid arteries, which run along the front of the neck. They may cause transient ischemic attacks (TIAs) or stroke, and may also form clots that block blood flow to the brain.
Image by TheVisualMD
Carotid Aneurysm with cross section
Aneurysms can form in the carotid arteries, which run along the front of the neck. They may cause transient ischemic attacks (TIAs) or stroke, and may also form clots that block blood flow to the brain.
Image by TheVisualMD
Carotid stenting
Carotid Artery Stenting: The illustration shows the process of carotid artery stenting. Figure A shows an internal carotid artery that has plaque buildup and reduced blood flow. The inset image shows a cross-section of the narrowed carotid artery. Figure B shows a stent being placed in the carotid artery to support the inner artery wall and keep the artery open. Figure C shows normal blood flow restored in the stent-widened artery. The inset image shows a cross-section of the stent-widened artery.
Image by National Heart Lung and Blood Insitute (NIH)
What Is Carotid Artery Disease?
Carotid Artery: Figure A shows the location of the right carotid artery in the head and neck. Figure B is a cross-section of a normal carotid artery that has normal blood flow. Figure C shows a carotid artery that has plaque buildup and reduced blood flow.
Image by National Heart Lung and Blood Institute (NIH)
What To Expect During Carotid Ultrasound
Carotid ultrasound: Figure A shows how the ultrasound probe (transducer) is placed over the carotid artery. Figure B is a color ultrasound image showing blood flow (the red color in the image) in the carotid artery. Figure C is a waveform image showing the sound of flowing blood in the carotid artery.
Image by National Heart Lung and Blood Institute (NIH)
Internal Carotid Artery
Internal Carotid Artery : The internal carotid arteries branch out of the common carotid arteries, which run up along either side of the front of the neck. The internal carotid arteries are major vessels of the head and neck and help supply blood to the brain.
Image by TheVisualMD
Carotid Arteries Disease
Brain, Viewed from Below, with Carotid Arteries : The heart is not the only organ that can be affected by cardiovascular disease. Ischemic strokes occur when arteries within, or leading to, the brain become blocked. Strokes may cause brain damage, which can result in paralysis as well as loss of language skills, motor control, and vision, among other problems.
Image by TheVisualMD
Carotid arteries with close-up of blocked carotid (left); ischemic stroke (right)
Atherosclerotic plaque from a carotid endarterectomy specimen. This shows the bifurcation of the common into the internal and external carotid arteries.
Image by Ed Uthman, MD.
Who Is at Risk for Carotid Artery Disease?
Angio-MRI (coronal section) of the supra-aortic vessels after injection of 20 cc of gadolinium in a woman aged 24 with EDS type IV, revealing a dissecting haematoma of the left internal carotid (black arrow), a bilateral dissection of the vertebral arteries in their V1 and V2 segments (white arrows) and a dissection of the middle and distal third of the right subclavian artery (head of arrow).
Image by Germain Orphanet Journal of Rare Diseases
Sensitive content
This media may include sensitive content
Carotid Endarterectomy
This surgery aims to reduce the risk of future strokes. An incision is made in the carotid artery, and plaques that have formed there are removed using a dissecting tool. There is a low risk of stroke following the surgery.
Image by TheVisualMD
Who Needs Carotid Endarterectomy?
Carotid Endarterectomy
Image by BruceBlaus
Cross Section of a Carotid Artery Aneurysm
Aneurysms can form in the carotid arteries, which run along the front of the neck. They may cause transient ischemic attacks (TIAs) or stroke, and may also form clots that block blood flow to the brain.
Image by TheVisualMD
Plaque Build Up in Carotid Artery
This 3D visualization reveals plaque buildup and atherosclerosis within the carotid artery.
Image by TheVisualMD
Carotid Aneurysm CrossSection
Image by TheVisualMD
Carotid Arteries of Heart
Major vasculature is revealed in this image looking up at a man's neck and head. Visible are the common carotid arteries, a pair of blood vessels that run along both sides of the neck supplying freshly oxygenated blood to the head and neck. The right common carotid artery is a branch off the brachiocephalic trunk- the first branch of the aorta. The left common carotid artery is the second branch of the aorta. Each common carotid bifurcates in the neck into an internal and external carotid artery. The external carotid artery supplies the tissues of the face and neck, while the internal carotid artery travels straight up into the skull to deliver blood to the brain.
Image by TheVisualMD
Blood Clot in the Carotid Artery
High blood cholesterol levels, together with the presence of inflammatory cells, may lead to the development of hard deposits known as plaque in places such as the carotid arteries. If tiny clots called emboli break off plaques and travel to the smaller blood vessels of the brain, they may block them and cause a stroke.
Image by TheVisualMD
Brain with Ischemic Stroke Caused by Blood Clot
This image shows an ischemic stroke in the right frontal lobe of the brain caused by a blood clot (thrombus) in the internal carotid artery. The cross section of the internal carotid artery shows the cause of the blockage : cholesterol build-up, or atherosclerosis. Ischemic stroke is caused by when an artery to the brain is blocked. If the artery is blocked then the brain cells cannot make energy and may stop working. The most common kind of blockage occurs with atherosclerosis, when cholesterol is gradually deposited in the artery. The internal carotid arteries supply blood to the anterior three-fifths of the cerebrum, except for parts of the temporal and occipital lobes. An Ischemic stroke in the frontal lobes may cause brain impairment that results in numbness, weakness or paralysis on the side of the body opposite the obstruction of the artery.
Image by TheVisualMD
Types of Stroke
TheVisualMD
9:28
Vascular Dementia: Causes & Prevention
Peter M. Lawrence/YouTube
Blockage in Carotid Artery of Head and Neck
TheVisualMD
Clogged Carotids
TheVisualMD
Blood Vessels of the Head and Neck
TheVisualMD
Carotid Aneurysm cross section
TheVisualMD
Carotid Aneurysm with cross section
TheVisualMD
Carotid stenting
National Heart Lung and Blood Insitute (NIH)
What Is Carotid Artery Disease?
National Heart Lung and Blood Institute (NIH)
What To Expect During Carotid Ultrasound
National Heart Lung and Blood Institute (NIH)
Internal Carotid Artery
TheVisualMD
Carotid Arteries Disease
TheVisualMD
Carotid arteries with close-up of blocked carotid (left); ischemic stroke (right)
Atherosclerosis is a disease in which fatty deposits called plaque build up inside your blood vessel walls. Over time, plaque narrows your blood vessels, which limits the flow of oxygen-rich blood to your body; plaque in coronary arteries restricts blood supply to the heart.
Interactive by TheVisualMD
Atheroma
Atherosclerosis is a disease in which plaque builds up inside your arteries. Plaque is a sticky substance made up of fat, cholesterol, calcium, and other substances found in the blood. Over time, plaque hardens and narrows your arteries. That limits the flow of oxygen-rich blood to your body.
Atherosclerosis can lead to serious problems, including
Coronary artery disease. These arteries supply blood to your heart. When they are blocked, you can suffer angina or a heart attack.
Carotid artery disease. These arteries supply blood to your brain. When they are blocked you can suffer a stroke.
Peripheral arterial disease. These arteries are in your arms, legs, and pelvis. When they are blocked, you can suffer from numbness, pain and sometimes infections.
Atherosclerosis usually doesn't cause symptoms until it severely narrows or totally blocks an artery. Many people don't know they have it until they have a medical emergency.
A physical exam, imaging, and other diagnostic tests can tell if you have it. Medicines can slow the progress of plaque buildup. Your doctor may also recommend procedures such as angioplasty to open the arteries or surgery on the coronary or carotid arteries. Lifestyle changes can also help. These include following a healthy diet, getting regular exercise, maintaining a healthy weight, quitting smoking, and managing stress.
Source: NIH MedlinePlus Magazine
Additional Materials (18)
Atheroma in the artery
Video by Wellcome Trust/YouTube
How is Angina Diagnosed
Video by smallcogbigmachine/YouTube
Atherosclerosis - Part 1
Video by Khan Academy/YouTube
STABLE VS UNSTABLE ANGINA EXPLAINED IN 5 MINUTES | ANGINA PECTORIS | CORONARY ARTERY DISEASE
Video by 5MinuteSchool/YouTube
Blood flow through the Heart
Video by smallcogbigmachine/YouTube
Heart Structure
Video by smallcogbigmachine/YouTube
Consequences of Atherosclerosis: Atheroma & Diseases – Vascular Medicine | Lecturio
Video by Lecturio Medical/YouTube
Narrowed arterial blood vessel.
As atheroma enlarges, the arterial wall ruptures and releases blood clots that lead to narrowing of the artery.
Image by Scientific Animations, Inc.
Plaque Build Up in Carotid Artery
This 3D visualization reveals plaque buildup and atherosclerosis within the carotid artery.
Image by TheVisualMD
Atheroma - Arterial Plaque
Arterial Plaque
Image by TheVisualMD
Atheroma - Plaque Attack
Plaque Attack : Plaques can build up in any of your body's arteries. When they accumulate in your coronary arteries-the vessels that feed your heart-they can reduce blood supply and cause angina (chest pain), or cut supply off completely, producing a heart attack.
Image by TheVisualMD
Atheroma - Forming Plaques
Forming Plaques : Plaques may form in medium-to-large size arteries as a response to injury. Platelets, blood cells that assist in clotting, clump at the damaged site in the vessel lining in an attempt to repair it. Platelets are components of the immune system, and this clumping is part of the inflammatory, or healing, response. Cholesterol and other fats and lipids in the bloodstream adhere to the injured site as part of your body's mistaken attempt at healing the injured vessel. Other substances, such as smooth muscle cells, calcium, and connective tissue, join the mix and add to the size and hardness of the arterial plaque.
Image by TheVisualMD
This browser does not support the video element.
Atheroma
How Do Plaques Form? : Your arteries are flexible and healthy when you’re born. But over the years, bad health habits can cause unhealthy amounts of arterial plaque to build up. Plaques are hard, fatty deposits that form inside the walls of your arteries, narrowing them and making it harder for blood to flow through them.
Video by TheVisualMD
Atheroma
How Do Plaques Form? : Your arteries are flexible and healthy when you’re born. But over the years, bad health habits can cause unhealthy amounts of arterial plaque to build up. Plaques are hard, fatty deposits that form inside the walls of your arteries, narrowing them and making it harder for blood to flow through them.
Image by TheVisualMD
Inflammation In Atherosclerotic Plaque Formation (VIDEO)
Image by TheVisualMD
Atheroma - Forming Plaques
Forming Plaques : Plaques may form in medium-to-large size arteries as a response to injury. Platelets, blood cells that assist in clotting, clump at the damaged site in the vessel lining in an attempt to repair it. Platelets are components of the immune system, and this clumping is part of the inflammatory, or healing, response. Cholesterol and other fats and lipids in the bloodstream adhere to the injured site as part of your body's mistaken attempt at healing the injured vessel. Other substances, such as smooth muscle cells, calcium, and connective tissue, join the mix and add to the size and hardness of the arterial plaque.
Image by TheVisualMD
Atheroma - Forming Plaques
Forming Plaques : Plaques may form in medium-to-large size arteries as a response to injury. Platelets, blood cells that assist in clotting, clump at the damaged site in the vessel lining in an attempt to repair it. Platelets are components of the immune system, and this clumping is part of the inflammatory, or healing, response. Cholesterol and other fats and lipids in the bloodstream adhere to the injured site as part of your body's mistaken attempt at healing the injured vessel. Other substances, such as smooth muscle cells, calcium, and connective tissue, join the mix and add to the size and hardness of the arterial plaque.
Image by TheVisualMD
Atheroma - Forming Plaques
Forming Plaques : Plaques may form in medium-to-large size arteries as a response to injury. Platelets, blood cells that assist in clotting, clump at the damaged site in the vessel lining in an attempt to repair it. Platelets are components of the immune system, and this clumping is part of the inflammatory, or healing, response. Cholesterol and other fats and lipids in the bloodstream adhere to the injured site as part of your body's mistaken attempt at healing the injured vessel. Other substances, such as smooth muscle cells, calcium, and connective tissue, join the mix and add to the size and hardness of the arterial plaque.
Image by TheVisualMD
3:54
Atheroma in the artery
Wellcome Trust/YouTube
1:47
How is Angina Diagnosed
smallcogbigmachine/YouTube
12:54
Atherosclerosis - Part 1
Khan Academy/YouTube
5:41
STABLE VS UNSTABLE ANGINA EXPLAINED IN 5 MINUTES | ANGINA PECTORIS | CORONARY ARTERY DISEASE
5MinuteSchool/YouTube
2:11
Blood flow through the Heart
smallcogbigmachine/YouTube
2:29
Heart Structure
smallcogbigmachine/YouTube
4:32
Consequences of Atherosclerosis: Atheroma & Diseases – Vascular Medicine | Lecturio
Lecturio Medical/YouTube
Narrowed arterial blood vessel.
Scientific Animations, Inc.
Plaque Build Up in Carotid Artery
TheVisualMD
Atheroma - Arterial Plaque
TheVisualMD
Atheroma - Plaque Attack
TheVisualMD
Atheroma - Forming Plaques
TheVisualMD
2:09
Atheroma
TheVisualMD
Atheroma
TheVisualMD
Inflammation In Atherosclerotic Plaque Formation (VIDEO)
TheVisualMD
Atheroma - Forming Plaques
TheVisualMD
Atheroma - Forming Plaques
TheVisualMD
Atheroma - Forming Plaques
TheVisualMD
Fact Sheet
Stiff & Narrow
Image by TheVisualMD
Stiff & Narrow
Image by TheVisualMD
What Is Atherosclerosis?
The coronary arteries can become clogged, or even completely blocked, by atherosclerosis (hardening of the arteries). Atherosclerosis is the main cause of heart disease, which is in turn the leading cause for coronary artery bypass graft (CABG) surgery.
Atherosclerosis occurs when cholesterol, a waxy, fat-like substance, inflammatory cells, and other substances in the blood start to stick to the inner lining of the arteries. If cholesterol levels remain high, this buildup continues over a period of years and develops into hard deposits known as plaque. The ever-growing plaque reduces the diameter of the arteries. This makes it harder for the blood to get through, forces the heart to work harder, and increases the amount of pressure inside the artery (raises blood pressure). In response to inflammation and increased pressure, the arteries start to produce more support cells to form in the blood vessel wall. The arterial walls both weaken and stiffen, resulting in atherosclerosis.
As the coronary arteries become increasingly narrow, blood flow to the heart decreases and the heart muscle doesn't receive the blood supply it requires. It becomes starved of oxygen in a condition called ischemia. The result can be shortness of breath, fatigue, and angina (chest pain).
Atherosclerosis is the main cause of coronary heart disease (CHD), also known as coronary artery disease (CAD). CHD is the leading cause of death in the US. It includes angina, heart attacks, sudden cardiac death syndrome, arrhythmias (abnormal heart rhythms), and heart failure due to a weakened heart. All these conditions are caused by clogged cardiac arteries.
Symptoms
Because atherosclerosis develops slowly, there may be no symptoms until an artery is so clogged that it can't deliver adequate blood and oxygen to the organs or tissues. If atherosclerosis diminishes blood flow to the
coronary arteries, symptoms can include chest pain (angina), shortness of breath, and fatigue.
brain, stroke-like symptoms may occur, such as sudden numbness or weakness in the arms and legs, difficulty speaking, or drooping facial muscles.
arms and legs, walking may become painful.
Causes & Risk Factors
Certain lifestyle habits, traits, and conditions may increase the probability that you'll develop atherosclerosis. These conditions are known as risk factors. The more risk factors a person has, the greater the chance that he or she will develop atherosclerosis. Fortunately, most of the risk factors for atherosclerosis are controllable:
High blood cholesterol, particularly high LDL cholesterol
High blood pressure
Overweight or obesity
Smoking or using tobacco in any form
Diabetes
Lack of exercise
Unmanaged response to stress
Risk factors that can't be controlled include:
Genetics (family history of early heart disease)
Aging
Testing & Diagnosis
Doctors may find evidence of atherosclerosis in the course of a physical exam. Signs may include:
Whooshing sounds (bruits), heard with a stethoscope
Weak or absent pulse in affected regions
Decreased blood pressure in a limb
Poor wound healing in affected regions
Signs of an aneurysm in the abdomen or below the knee
If signs of atherosclerosis are present, diagnostic tests may be performed. Diagnostic tests may include one or more of the following:
Blood tests. Can detect increased levels of cholesterol and blood sugar that can increase risk for atherosclerosis
Electrocardiogram (EKG). Records electrical activity of your heart and may show evidence of a heart attack, either in the past or in progress
Angiogram. Pinpoints blockages in the heart's blood circulation. An X-ray contrast dye is injected into the coronary arteries, and fast-moving X-ray images are monitored on a screen while the dye flows through the arteries.
Other imaging tests. Ultrasound exams, computerized tomography (CT) scans, and magnetic resonance angiograms (MRAs) allow the doctor the study the arteries for signs of atherosclerosis or other problems.
Doppler ultrasound. Measures blood pressure in the limbs and helps determine the amount of blockage in the arteries
Treatments
More aggressive treatment may be necessary if symptoms of atherosclerosis are severe or if a life-threatening blockage is present.
Angioplasty. A catheter (a long, thin hose) is guided into the blocked portion of the artery. A tiny, deflated balloon is passed into the artery via the catheter and inflated, sometimes several times, to open the blocked portion. Then a stent (a small coil of wire mesh, about 3/4" long) is inserted into the artery to keep it from narrowing again. The balloon catheter is removed and the stent remains permanently in place. Angioplasty is a procedure and is considered less risky than surgery, but there are still risks, including bleeding, blockage of blood flow (very rare), infection, damage to a heart valve or blood vessel, kidney failure, arrhythmias, allergic reaction to the X-ray dye, and stroke (rare).
Endarterectomy. Plaques are surgically removed from the walls of the affected artery using a scalpel. There is a low risk of stroke following the surgery. There is also a risk of arterial restenosis (reblockage) and temporary nerve injury, leading to hoarseness, difficulty with swallowing, or numbness.
Thrombolytic therapy. A clot-dissolving drug is inserted into the artery at the point at which it is blocked.
Bypass surgery. The blocked artery is bypassed by creating a new artery, called a graft. The graft may be created either from another blood vessel in the body (usually from the leg) or from a synthetic tube. One end of the graft is attached above the blockage and the other is attached below, creating a new route for the blood to flow. Complications of bypass surgery can include blockage of the graft, bleeding from the incision, infection, heart attack, kidney failure, and stroke.
Prevention
With atherosclerosis, there's good news and there's bad news. The bad news is that atherosclerosis may be slow in developing, but its end results can be debilitating and often fatal. But the good news is that you have the power to prevent and even reverse atherosclerosis by changing the ways in which you live, work, and play. An active, healthy lifestyle is your first line of defense against atherosclerosis.
Healthy lifestyle choices include:
quitting smoking,
losing weight if overweight,
eating a healthy diet with few saturated fats and no trans fats;
more fruits, vegetables, and fiber; and moderate alcohol intake,
exercising regularly (30-45 minutes, 3-5 times per week),
controlling diabetes and high blood pressure,
managing stress.
Your doctor may also prescribe medications, such as:
cholesterol medications,
antiplatelet medications,
anticoagulants (blood thinning medications),
blood pressure medications, and
pain medications.
Actively treating your atherosclerosis will do more than just lower your LDL cholesterol readings or control your blood pressure, as important as those changes are. Living a healthy lifestyle and taking your medications as prescribed is also likely to provide you with increased energy, more restful sleep, a more positive outlook...and a longer, healthier life.
Source: TheVisualMD
Additional Materials (5)
Testing & Diagnosis
Doctors may find evidence of atherosclerosis in the course of a physical exam. Signs may include:
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Testing & Diagnosis
Doctors may find evidence of atherosclerosis in the course of a physical exam. Signs may include:
Image by TheVisualMD
Treatments
More aggressive treatment may be necessary if symptoms of atherosclerosis are severe or if a life-threatening blockage is present.
Image by TheVisualMD
Treatments
More aggressive treatment may be necessary if symptoms of atherosclerosis are severe or if a life-threatening blockage is present.
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Treatments
More aggressive treatment may be necessary if symptoms of atherosclerosis are severe or if a life-threatening blockage is present.
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Testing & Diagnosis
TheVisualMD
Testing & Diagnosis
TheVisualMD
Treatments
TheVisualMD
Treatments
TheVisualMD
Sensitive content
This media may include sensitive content
Treatments
TheVisualMD
Risk Factors
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Atherosclerosis
Video by TheVisualMD
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Atherosclerosis
Obesity and Atherosclerosis : Atherosclerosis is a disease in which hard, fatty deposits called plaque build up inside your arteries. Being obese-defined as having a body mass index over 30--makes it much more likely that you'll develop atherosclerosis.
Video by TheVisualMD
Who Is at Risk for Atherosclerosis?
Risk factors are conditions or habits that make a person more likely to develop a disease. Nearly half of Americans have high blood pressure or unhealthy cholesterol levels, or they smoke. These are key risk factors that can trigger the start of plaque buildup.
What raises the risk of atherosclerosis?
The risk factors for plaque buildup are often linked. For example, smoking and a lack of regular physical activity raises your risk of unhealthy levels of cholesterol, which can lead to plaque buildup.
Other common risk factors for plaque buildup are listed below.
High blood pressure: Over time, high blood pressure can damage artery walls, allowing plaque to build up.
Diabetes: High blood sugar can damage the inner layers of the arteries, causing plaque buildup.
Metabolic syndrome: High levels of cholesterol and triglycerides in your blood increase your risk.
Unhealthy diet: Eating a lot of foods high in saturated fats can increase your cholesterol levels.
Family history: Your genes may increase your risk, especially if you havea common inherited cholesterol disorder called familial hypercholesterolemia.
Inflammatory diseases: When you have conditions such as rheumatoid arthritis and psoriasis, high levels of inflammation can end up irritating your blood vessels, which can lead to plaque buildup.
Older age: For most people, plaque buildup starts in childhood and gets worse as they get older. In men, the risk increases after age 45. In women, the risk increases after age 55. The risk for women is even higher if you have endometriosis or polycystic ovary syndrome, or if you had gestational diabetes or preeclampsia during pregnancy.
What should you do if you have risk factors?
Talk with your healthcare team about your heart health. Together, you can set up a plan to reduce your risk, monitor your health, and manage your risk factors to delay or prevent disease caused by atherosclerosis. Starting treatment early is the key to preventing symptoms.
Source: National Heart, Lung, and Blood Institute (NHLBI)
Additional Materials (3)
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Refined Carbohydrates and Atherosclerosis
Refined Carbohydrates and Atherosclerosis : In atherosclerosis, hard, fatty deposits called plaque build up inside your arteries. For decades it was thought that eating too many fatty foods, especially foods rich in cholesterol, was to blame for plaque accumulation.
Video by TheVisualMD
Risk factors for coronary artery disease | Circulatory System and Disease | NCLEX-RN | Khan Academy
Video by khanacademymedicine/YouTube
Atherosclerosis Video 2: Atherosclerosis risk factors
Video by YouAsk MDanswers/YouTube
2:21
Refined Carbohydrates and Atherosclerosis
TheVisualMD
12:34
Risk factors for coronary artery disease | Circulatory System and Disease | NCLEX-RN | Khan Academy
khanacademymedicine/YouTube
2:47
Atherosclerosis Video 2: Atherosclerosis risk factors
YouAsk MDanswers/YouTube
Atherosclerosis & Cholesterol
Atherosclerosis & Cholesterol
Image by TheVisualMD
Atherosclerosis & Cholesterol
Atherosclerosis & Cholesterol - While the term technically refers to any disease that affects the cardiovascular system (as used in MeSH), it is usually used to refer to those related to atherosclerosis (arterial disease).
Image by TheVisualMD
Atherosclerosis & Cholesterol
The hard, fatty arterial deposits called plaques are composed mostly of cholesterol, a soft, waxy substance that occurs naturally in your body. Cholesterol is necessary for your body's health, because it helps to produce cell membranes and is also necessary for the production of vitamin D and various steroid hormones. Your liver produces about 75% of your body's cholesterol. The rest comes from some of the foods you eat, like meat, egg yolks, and shrimp. There are two forms of cholesterol: low-density lipoprotein (LDL) cholesterol (the "bad" cholesterol) and high-density lipoprotein (HDL) cholesterol (the "good" cholesterol). LDL cholesterol transports cholesterol to the tissues of your body, where it is stored. HDL cholesterol, on the other hand, can actually help your body get rid of excess cholesterol by transporting it to the liver for excretion.
There's always some cholesterol present in your bloodstream. Problems start to happen when there"s too much cholesterol, specifically, too much LDL cholesterol. Over time, LDL cholesterol is deposited in the walls of the arteries and begins to build up. Together with other substances, like calcium, it forms the hard plaques that narrow and stiffen the arteries in a process called atherosclerosis. Atherosclerosis can occur in any of the arteries of the body. When it happens in the coronary arteries, it reduces the blood supply to the heart and causes coronary heart disease (CHD).
Source: TheVisualMD
Additional Materials (3)
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Cholesterol & Atherosclerosis
While the term technically refers to any disease that affects the cardiovascular system (as used in MeSH), it is usually used to refer to those related to atherosclerosis (arterial disease). Everyone talks about high cholesterol and how bad it is for you. But why is it bad for you? Where does it come from? What's the difference between "good" and "bad" cholesterol? Take a journey inside the body and explore its vessels, as world-renowned doctors explain what cholesterol is all about and how it contributes to hardening of the arteries, a dangerous condition also known as atherosclerosis.
Video by TheVisualMD
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What Is HDL and LDL Cholesterol?
This video explains the difference between HDL and LDL cholesterol. It also reveals what may occur when there are high levels of LDL in the body.LDL may stick to an artery's inner wall causing the build up of plaque, affecting blood flow. When an artery stiffens and constricts, aneurysm, heart attack, and stroke can occur.
Video by TheVisualMD
Atherosclerosis
Image by TheVisualMD
3:08
Cholesterol & Atherosclerosis
TheVisualMD
0:45
What Is HDL and LDL Cholesterol?
TheVisualMD
Atherosclerosis
TheVisualMD
Causes
Smoking Assaults the Heart and Arteries
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Smoking Assaults the Heart and Arteries
Smoking Assaults the Heart and Arteries : The interior surface of your blood vessels, called the endothelial lining, starts out smooth. As you age, the lining gets roughed up. The toxins in cigarette smoke cause imperfections in the endothelial lining. Extraneous cells can accumulate around the imperfections to form a plaque. Arterial plaques are the precursor to atherosclerosis, or hardening of the arteries, as well as blood clots and vessel blockages.
Image by TheVisualMD
What Causes Atherosclerosis?
Plaque buildup in the arteries starts with damage to the arteries. Risk factors such as unhealthy lifestyle habits, medical conditions, or your genes, can lead to this damage.
Inflammatory cells travel to the damaged areas of the artery and release chemical signals. The signals cause cholesterol and cell waste to collect at the damaged spots. This buildup attracts white blood cells that eat the cholesterol and clump together, forming plaque. The artery narrows as the plaque grows, reducing the flow of oxygen-rich blood to the limbs and organs. Over time, the plaque can break and flow into the bloodstream. This may lead to formation of blood clots, which can block blood flow. If this happens, nearby tissue can't get enough oxygen and may die.
Source: National Heart, Lung, and Blood Institute (NHLBI)
Additional Materials (15)
The Cardiovascular Continuum
The Cardiovascular Continuum
The Cardiovascular Continuum
The Cardiovascular Continuum
1
2
3
4
Cardiovascular Continuum 1) Childhood and adolescence (0-20 years) 2) Adulthood (21-40) 3) Middle Age (41-60)
1) Childhood and adolescence (0-20 years)
2) Adulthood (21-40)
3) Middle Age (41-60)
4) Old Age (61 and Up)
Interactive by TheVisualMD
Artery with Fatty Deposits Developing Atherosclerosis
Atherosclerosis, or \"hardening of the arteries,\" is the leading cause of heart disease. In this image of an artery, a cross section has been made to reveal yellow fat deposits that have accumulated in the inner wall lining of the artery. This condition will lead to loss of flexibility in the vessel and if the hardening continues, the artery could constrict blood flow and raise blood pressure along with causing many other ailments. This image shows the beginnings of what could be a very serious condition in the body.
Image by TheVisualMD
Causes of Atherosclerosis: Risk Factors – Vascular Medicine | Lecturio
Video by Lecturio Medical/YouTube
Quitting Smoking
Smoking is bad for anyone, of course, but it`s especially bad for people with prediabetes or diabetes. Scientists have known for many years that smokers with diabetes have higher blood sugar levels than nonsmokers with diabetes, but they haven`t understood why. Now, researchers at California State Polytechnic University in Pomona, California, have discovered a “smoking gun” that helps to explain why smoking is especially bad for people with diabetes. They found strong evidence that it`s the nicotine in tobacco that`s the main culprit in making symptoms of diabetes and the risk of developing complications far worse for smokers. Their study showed that nicotine causes blood A1C levels to rise by as much as 34%. And the higher the nicotine levels, the more A1C is produced. Smoking also constricts blood vessels and raises the level of inflammation throughout the body. Smoking is linked with insulin resistance. In fact, cigarette smokers are almost three times as likely to develop diabetes as people who have never smoked.For people who already have diabetes, smoking causes macrovascular complications (like heart attack and stroke) and microvascular complications (such as kidney disease, retinal disease, and foot problems) to occur sooner. Smoking increases risk of death for people with diabetes. Studies show that smoking shortens lives an average of 5-10 years, but there`s evidence that it shortens lifespan even more for people with diabetes. Quitting Smoking • Write down your reasons for quitting. Smoke cessation counselors find this a crucial step in successfully quitting. You must be clear on your goals and reasons for quitting. Writing them down in your own words personalizes and reinforces your objective. • Tell your doctor, friends and family that you want to quit. You will need their support and participation. Ask friends and family not to smoke or keep cigarettes near you. Let them know you may go through some emotional phases that won`t be easy for any of you on the way to a smoke-free life. • Make your home smoke-free. Insist that no one ever smoke inside, for the health of everyone who lives there. Quitters who live in smoke-free homes have fewer episodes of backsliding. It`s important, though, when quitting smoking, to take steps to avoid putting on weight, as weight gain creates health problems as well, especially for people who have diabetes.
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Smoking and Drinking
If you smoke, quit now. Smoking is the single biggest cause of cancer in the world. That smoking causes lung cancer is well known. It’s less well known that tobacco use increases the risk for at least 14 different types of cancer, including cancer of the mouth, throat, esophagus, larynx, cervix, bladder, pancreas, kidney, and stomach. Using tobacco may also promote colon and breast cancer. Smokeless tobacco, touted as a “safer” alternative, is responsible for 400,000 cases of oral cancer worldwide—4% of all cancers. Smoking combined with drinking increases the risk of cancer synergistically. Even if you don’t smoke, you can still be harmed by secondhand smoke, which kills thousands of people every year. Avoid people who smoke and smoke-filled areas. If someone in your home smokes, insist that they smoke outside and encourage them to quit as well. If everyone quit smoking, the number of people who die from cancer would drop by at least one third, and lung cancer would again become the rare disease that it once was.
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Rule 5 Never Smoke, But If You Smoke Now, Quit
A smoker's body shows evidence of the habit's deadly effects from head to toe. The way tobacco smoke ravages lung tissue is well known. The cardiovascular system is also imperiled as smoking damages the cells lining blood vessels and causes arteries to constrict. Smokers' risk of heart disease is 2 to 4 times that of nonsmokers, and their risk of sudden death from a heart attack is twice that of nonsmokers. Smokers also are more likely to suffer vision loss from cataract development or macular degeneration. Expectant mothers who smoke expose the fetus to grievous harm. Smoking causes the uterine blood vessels to narrow. As a result, overall fetal growth is slowed and brain development can be seriously impeded. The likelihood of premature birth and other delivery complications is higher for smokers. The effects of smoking also include slower healing of wounds, muscle fatigue and premature aging. Smoking is an all-out assault on nearly every function of the body. The good news: There are more methods than ever to help smokers quit. In fact, there are slightly more former smokers than there are active smokers in the United States. By calling 1-800-QUIT-NOW (1-800-784-8669), smokers can get started finding the medical help, counseling and support they need to give up the habit for good. Nicotine is highly addictive, and quitting can be difficult, but the benefits are lifesaving. A year after a smoker quits, her risk of coronary heart disease falls to half that of a smoker. Five years on, stroke risk is similar to that of people who have never smoked. Repairing the damage is possible, but it takes time. Smoking is associated with these complications:
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Smoking Assaults the Heart & Arteries
How smoking damages blood vessel linings and raises the risk of heart attacks and strokes
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Hypertension (High Blood Pressure)
Hypertension (High Blood Pressure)
Image by Blausen.com staff (2014). "Medical gallery of Blausen Medical 2014
Artery with Hypertension cross section
Hypertension (high blood pressure). When your blood pressure is chronically high, your arteries protect themselves against the added pressure by thickening and stiffening their walls. You're considered to have high blood pressure if it stays at or above 140/90 mmHg over time (or 130/80 mmHg, if you have diabetes or chronic kidney disease).
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Control Blood Pressure
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What Are the Signs and Symptoms of Angina?
Diagram of discomfort caused by coronary artery disease. Pressure, fullness, squeezing or pain in the center of the chest. Can also feel discomfort in the neck, jaw, shoulder, back or arm.
Image by BruceBlaus
Diabetes-Related Atherosclerosis
Video by 3FXanimation/YouTube
Stroke, clogged arteries and atherosclerosis
Video by British Heart Foundation/YouTube
Inflammation and Atherosclerosis
Video by Oxford Academic (Oxford University Press)/YouTube
Atherosclerosis - Plaque Animation Model
Video by BD/YouTube
Cardiovascular Continuum 1) Childhood and adolescence (0-20 years) 2) Adulthood (21-40) 3) Middle Age (41-60)
TheVisualMD
Artery with Fatty Deposits Developing Atherosclerosis
TheVisualMD
5:07
Causes of Atherosclerosis: Risk Factors – Vascular Medicine | Lecturio
Lecturio Medical/YouTube
Quitting Smoking
TheVisualMD
Smoking and Drinking
TheVisualMD
Rule 5 Never Smoke, But If You Smoke Now, Quit
TheVisualMD
Smoking Assaults the Heart & Arteries
TheVisualMD
Hypertension (High Blood Pressure)
Blausen.com staff (2014). "Medical gallery of Blausen Medical 2014
Artery with Hypertension cross section
TheVisualMD
Control Blood Pressure
TheVisualMD
What Are the Signs and Symptoms of Angina?
BruceBlaus
1:26
Diabetes-Related Atherosclerosis
3FXanimation/YouTube
1:20
Stroke, clogged arteries and atherosclerosis
British Heart Foundation/YouTube
10:33
Inflammation and Atherosclerosis
Oxford Academic (Oxford University Press)/YouTube
0:52
Atherosclerosis - Plaque Animation Model
BD/YouTube
How Does Atherosclerosis Occur?
What is Atherosclerosis?
Image by TheVisualMD
What is Atherosclerosis?
Image by TheVisualMD
How Does Atherosclerosis Occur?
Atherosclerosis is thought to be a chronic inflammatory (immune system) response in the walls of the arteries, leading to arterial blockage, ischemia (lack of oxygenated blood), and coronary and peripheral artery disease. The inflammatory response is the body's attempt to "heal" the inner linings of arteries that have been injured.
Arteries may be damaged by irritating substances carried in the bloodstream, like alcohol and nicotine, or by high blood pressure, high cholesterol, or certain diseases, like diabetes. Free radicals play a major role in this damage.
Free Radicals
Free radicals are highly reactive atoms formed when oxygen interacts with certain molecules. They try to "steal" electrons from atoms in body tissues, and in doing so can damage cellular components such as cell membranes and DNA, and lead to heart disease, cancer, and other diseases.
Free radicals are formed in the normal processes of energy metabolism, but they are also created by environmental pollution, cigarette smoke, and toxic chemicals. Hypertension, smoking, and diabetes are all associated with damage to the vascular wall due to excess free radical activity. In addition, free radicals increase the tendency of LDL-cholesterol to adhere to the interior of the blood vessel.
To prevent free radical damage, your body has several enzyme systems that scavenge free radicals. However, the body can be inundated by so many free radicals that it can't cope with them all.
The Inflammatory Response
The body attempts to repair chronic injury to the blood vessels with an inflammatory response. Macrophage white blood cells and other inflammatory cells are recruited and accumulate at the site of injury. When levels of LDL cholesterol and triglyceride blood levels in the blood are high, fats and lipids can build up to create plaques, hard, fatty deposits, in medium-to-large size arteries.
Source: TheVisualMD
Additional Materials (6)
What is Atherosclerosis?
Image by TheVisualMD
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What Happens When Plaques Rupture?
Plaques are hard, fatty deposits that can build up inside the walls of your arteries. Plaque buildup thickens and narrows arteries, making it harder for blood to flow through them. This process is called atherosclerosis.
Video by TheVisualMD
What is Atherosclerosis?
Image by TheVisualMD
What is Atherosclerosis?
Image by TheVisualMD
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Cardiovascular Inflammation
Heart disease is the number one killer of men and women in the U.S. The most common cause of heart attack, stroke, and cardiovascular death is atherosclerosis. Atherosclerosis is a chronic inflammatory response in the walls of arteries that leads to the hardening of arterial walls and the buildup of fatty deposits called plaques, or atheromas. Although the process of inflammation can be beneficial in other parts of the body, chronic inflammation within arterial walls is problematic as it seems to promote this underlying growth of plaque. The combination of arterial inflammation and the growth of plaque can lead to the rupture of the plaque, and result in a blood clot. Blood clots can lead to dangerous conditions such as heart attack or stroke.
Video by TheVisualMD
How coronary heart disease (atherosclerosis) develops
Video by Bupa Health UK/YouTube
What is Atherosclerosis?
TheVisualMD
2:25
What Happens When Plaques Rupture?
TheVisualMD
What is Atherosclerosis?
TheVisualMD
What is Atherosclerosis?
TheVisualMD
4:26
Cardiovascular Inflammation
TheVisualMD
1:37
How coronary heart disease (atherosclerosis) develops
Bupa Health UK/YouTube
Atherosclerosis & Your Heart
Atherosclerosis & Your Heart
Image by TheVisualMD
Atherosclerosis & Your Heart
Atherosclerosis, also known as hardening of the arteries and coronary heart disease, is largely caused by having an unhealthy lifestyle. It develops when we eat too many high-carb and fatty foods, smoke, are overweight, don't get enough exercise, or don't control diabetes and high blood pressure.
Image by TheVisualMD
Atherosclerosis & Your Heart
Atherosclerosis, also known as hardening of the arteries and coronary heart disease, is largely caused by having an unhealthy lifestyle. It develops when we eat too many high-carb and fatty foods, smoke, are overweight, don't get enough exercise, or don't control diabetes and high blood pressure.
Atherosclerosis begins when cholesterol, a waxy, fat-like substance, and other molecules in your blood stick to the inner lining of the arteries. From there, they are transported into the middle layer of the arterial wall. If your cholesterol levels remain high, this buildup continues over a period of years and develops into hard deposits known as plaque. The ever-growing plaque reduces the diameter of your arteries, decreasing blood flow and increasing the amount of pressure your blood exerts against the arterial wall. To defend against the increased pressure, your arteries start to produce more support cells to strengthen the blood vessel. The arterial walls begin to stiffen, resulting in atherosclerosis.
Your heart has to work harder to push blood through the clogged vessels. As the coronary arteries become increasingly blocked, the heart muscle becomes starved of oxygen in a condition called ischemia. The result can be shortness of breath, fatigue, and chest pains, or angina. If the plaque ruptures, a blood clot can break away and travel to your brain, causing a stroke. When a coronary artery becomes totally blocked, the lack of blood causes the heart tissue to actually die. This is called myocardial infarction: a heart attack. One third of all heart attacks are fatal. Even if the heart attack victim survives, the heart is permanently damaged because the heart's dead tissue is replaced by scar tissue, which can't pulsate the way healthy heart tissue does. The heart can no longer beat efficiently. Now it has to work harder to pump blood throughout the body, stressing the weakened heart even more.
Source: TheVisualMD
Symptoms
Low Density Lipoprotein: Clogged Arteries (Atherosclerosis) / Plaque in Coronary Artery, close up
Plaque in Coronary Artery / Leading to a Heart Attack
Interactive by TheVisualMD
Low Density Lipoprotein: Clogged Arteries (Atherosclerosis) / Plaque in Coronary Artery, close up
Plaque in Coronary Artery / Leading to a Heart Attack
1) Plaque in Coronary Artery - In this image, a tiny coronary artery has been cross-sectioned to reveal a stenosis, or narrowing, caused by fatty deposits in the blood stream. Plaque in a coronary artery may break apart, and the resulting release of platelet adhesion-enhancing substances encourages clots to form on the plaque surface. The clot may then block the flow of blood through the already narrowed artery. Having this condition present in the coronary arteries is particularly dangerous because these are the arteries that wrap around the surface of the heart and supply the organ itself with oxygen and nutrients needed to pump blood to the entire body.
2) Leading to a Heart Attack - In this image, a tiny coronary artery has been cross-sectioned to reveal a stenosis, or narrowing, caused by fatty deposits in the blood stream. It is evident that this stenosis has advanced such that tissue necrosis, or death, has occurred in the area upstream from the blockage. Plaque in a coronary artery may break apart, and the resulting release of platelet adhesion-enhancing substances encourages clots to form on the plaque surface. The clot may then block the flow of blood through the already narrowed artery. Having this condition present in the coronary arteries is particularly dangerous because these are the arteries that wrap around the surface of the heart and supply the organ itself with oxygen and nutrients needed to pump blood to the entire body. This heart has been severely injured and the individual is at a high risk for heart attack.
Interactive by TheVisualMD
What Are the Signs and Symptoms of Atherosclerosis?
If you think that you or someone else has symptoms of heart attack or stroke, call 9-1-1 immediately. Every minute matters. Read more about the symptoms of heart attack and stroke.
Early stages of atherosclerosis often do not develop with symptoms. Symptoms may first appear when you’re under physical or emotional stress — times when the body needs more oxygen.
What symptoms does atherosclerosis cause?
Atherosclerosis leads to poor oxygen-rich blood supply, as well as symptoms that can affect your quality of life. Symptoms depend on which arteries are affected and how much blood flow is blocked.
Chest pain (angina), cold sweats, dizziness, extreme tiredness, heart palpitations (feeling that your heart is racing), shortness of breath, nausea and weakness are all symptoms of coronary heart disease.
Pain, aching, heaviness, or cramping in the legs when walking or climbing stairs are the main symptoms of peripheral artery disease. The symptoms also go away after rest.
Problems with thinking and memory, weakness or numbness on one side of the body or face, and vision trouble are all early symptoms of vertebral artery disease. Transient ischemic attack (TIA), commonly called a mini-stroke, is a more serious symptom.
Severe pain following meals, weight loss, and diarrhea are symptoms of mesenteric artery Ischemia of the intestines.
Erectile dysfunction (ED) is an early warning sign that a man may be at higher risk for atherosclerosis and its complications. If you have ED, talk with your healthcare team about your risk of plaque buildup.
You may not notice other symptoms until plaque buildup causes serious problems. Seeing your doctor regularly is important, as they may be able to find plaque buildup before it gets serious. For example:
Plaque buildup in the arteries of the neck (carotid artery disease) can cause a bruit. This is a whooshing sound that your doctor hears when using a stethoscope. Severe symptoms of a bruit include a transient ischemic attack (TIA).
Using a stethoscope, doctors may hear a bruit in your belly, which is an early sign of plaque buildup in the arteries that deliver blood to the kidneys (renal artery stenosis). As the disease worsens, it can cause high blood pressure, extreme tiredness, loss of appetite, nausea (feeling sick to the stomach), swelling in the hands or feet, and itchiness or numbness.
Talk to your doctor about your symptoms and whether you have risk factors of atherosclerosis.
Source: National Heart, Lung, and Blood Institute (NHLBI)
Additional Materials (22)
The illustration shows the major signs and symptoms of coronary heart disease
The illustration shows the major signs and symptoms of coronary heart disease.
Image by National Heart Lung and Blood Institute (NIH)
Figure A shows the location of the heart and coronary arteries. Figure B shows a deflated balloon catheter inserted into a coronary artery narrowed by plaque. The inset image shows a cross-section of the artery with the inserted balloon catheter. In figure C, the balloon is inflated, compressing the plaque against the artery wall. Figure D shows the widened artery with increased blood flow. The inset image shows a cross-section of the widened artery and compressed plaque.
Image by National Heart, Lung, and Blood Institute
Coronary Arteries
Aorta and Coronary Arteries : The aorta is the largest blood vessel in the body. The right and left coronary arteries branch off of the aorta to encircle the heart like a crown, and still smaller arteries branch off of the coronary arteries. Coronary arteries are vessels that deliver oxygen-rich blood to the myocardium ( heart muscle. )
Image by TheVisualMD
Women experiencing symptoms due to blockage of coronary arteries
Image by TheVisualMD
Heart and Coronary Arteries
Our heart gets its own blood supply through the coronary arteries, which encircle the heart like a crown. (Hence the term "coronary," from the Latin word for crown.) There are two main coronary arteries, which branch out of the aorta. These large coronary arteries are about the width of a drinking straw and gradually taper as they descend on the heart. The left main coronary artery divides into two branches called the left anterior descending artery and the circumflex artery. The right coronary artery branches into the posterior descending artery and the marginal artery. These arteries branch into smaller and smaller arteries, some of which penetrate inside the heart. They eventually branch into capillaries, some so fine that it would take ten of them lying side by side to form the thickness of a human hair. Your capillaries deliver oxygen and nutrients and remove waste from your heart's cells. If one or more of the coronary arteries becomes narrowed or completely blocked, blood supply to the heart may be decreased or cut off altogether. The results can be painful and even deadly, including angina (chest pain), tissue death, and myocardial infarction, in other words, a heart attack.
Image by TheVisualMD
Coronary arteries
Coronary circulation in anterior view, with coronary arteries labeled in red text and other landmarks in blue text.
Image by Patrick J. Lynch, medical illustrator
Coronary arteries
Heart with coronary arteries: LCA: Left Coronary Artery, RCA: Right Coronary Artery (=MARG: Marginal branch), CB: Circumflex branch, LAD: Left Anterior Descending (=AIB:Anterior interventricular branch), DIAG: Diagonal interventricular branch of anterior interventricular artery, RCA: Right coronary artery, AB: (Right) Atrial branch, SANB: Sinuatrial nodal branch, RMA: Right marginal branch, LMA: Left marginal branch, ACV: Anterior cardiac vein SCV: Small cardiac vein, GCV: Great cardiac vein (=AIV: Anterior interventricular vein), MCV: Middle cardiac vein, SCV: Small cardiac vein, PIA: Posterior interventricular branch (=PDA: Posterior descending artery), AVN: Atrioventricular nodal (branch), CS: Coronary sinus, IVC: Inferior venacava
Image by Patrick J. Lynch (1999), modified by Christian 2003
Heart and Coronary Arteries
Heart and Coronary Arteries
Image by TheVisualMD
Coronary Artery Disease (CAD)
Coronary artery disease is caused by plaque buildup in the wall of the arteries that supply blood to the heart (called coronary arteries). Plaque is made up of cholesterol deposits. Plaque buildup causes the inside of the arteries to narrow over time. This process is called atherosclerosis.
Image by Centers for Disease Control and Prevention (CDC)
How Are Stents Used?
Figure A shows the location of the heart and coronary arteries. Figure B shows the deflated balloon catheter and closed stent inserted into the narrow coronary artery. The inset image shows a cross-section of the artery with the inserted balloon catheter and closed stent. In figure C, the balloon is inflated, expanding the stent and compressing the plaque against the artery wall. Figure D shows the stent-widened artery. The inset image shows a cross-section of the compressed plaque and stent-widened artery.
Image by National Heart, Lung, and Blood Institute
Coronary Artery Blockage
This video shows blockage that can occur within coronary arteries of the heart. Coronary arteries is a network of blood vessels that delivers the heart its own supply of blood. Here, the video reveals an angiogram of a patient showing blockages in the 4 coronary arteries.
Image by TheVisualMD
Angiogram Imaging of the Coronary Arteries
Angiogram Imaging of the Coronary Arteries
Image by TheVisualMD
Coronary Arteries
The aorta is the largest blood vessel in the body and ascends out of the heart's left ventricle. The two main coronary arteries branch out of the aorta: the left main coronary artery and the right coronary artery. These arteries provide the heart muscle tissue with its own oxygen-rich blood supply.
Image by TheVisualMD
Coronary CT angiography of coronary arteries
Researchers have found that anti-inflammatory biologic therapies used to treat moderate to severe psoriasis can significantly reduce coronary inflammation in patients with the chronic skin condition. Scientists said the findings are particularly notable because of the use of a novel imaging biomarker, the perivascular fat attenuation index (FAI), that was able to measure the effect of the therapy in reducing the inflammation.
The study published online in JAMA Cardiology, has implications not just for people with psoriasis, but for those with other chronic inflammatory diseases, such as lupus and rheumatoid arthritis. These conditions are known to increase the risk for heart attacks and strokes. The study was funded by the National Heart, Lung, and Blood Institute (NHLBI), part of the National Institutes of Health.
In this image: Coronary CT angiography image of the coronary arteries depicting the perivascular fat attenuation index before and after biologic therapy at one-year follow-up for patients with excellent response to biologic therapy.
Image by Oxford Academic Cardiovascular CT Core Lab and Lab of Inflammation and Cardiometabolic Diseases at NHLBI
Stent in Left Coronary Artery
The heart shown in this image has had a stent placed in the left coronary artery. Stents are tiny coils of wire mesh used to open up blocked arteries in a medical procedure called an angioplasty. They are often inserted laparoscopically, feeding wires up to the coronary arteries through arteries elsewhere in the body that are more accessible, without having to open the patient's chest. Stents are specially engineered to fit various diameters of arteries, allowing an individualized fit. Once in place, the previously blocked artery is now equipped with a miniature scaffolding to hold it open and allow blood to easily flow through.
Image by TheVisualMD
Plaque in Coronary Artery, close up
In this image, a tiny coronary artery has been cross-sectioned to reveal a stenosis, or narrowing, caused by fatty deposits in the blood stream. It is evident that this stenosis has advanced such that tissue necrosis, or death, has occurred in the area upstream from the blockage. Plaque in a coronary artery may break apart, and the resulting release of platelet adhesion-enhancing substances encourages clots to form on the plaque surface. The clot may then block the flow of blood through the already narrowed artery. Having this condition present in the coronary arteries is particularly dangerous because these are the arteries that wrap around the surface of the heart and supply the organ itself with oxygen and nutrients needed to pump blood to the entire body. This heart has been severely injured and the individual is at a high risk for heart attack.
Image by TheVisualMD
Plaque in Coronary Artery
In this image, a tiny coronary artery has been cross-sectioned to reveal a stenosis, or narrowing, caused by fatty deposits in the blood stream. Plaque in a coronary artery may break apart, and the resulting release of platelet adhesion-enhancing substances encourages clots to form on the plaque surface. The clot may then block the flow of blood through the already narrowed artery. Having this condition present in the coronary arteries is particularly dangerous because these are the arteries that wrap around the surface of the heart and supply the organ itself with oxygen and nutrients needed to pump blood to the entire body.
Image by TheVisualMD
Heart and Coronary Arteries
Coronary Arteries
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Coronary arteries
Our heart gets its own blood supply through the coronary arteries, which encircle the heart like a crown. (Hence the term "coronary," from the Latin word for crown.) There are two main coronary arteries, which branch out of the aorta. These large coronary arteries are about the width of a drinking straw and gradually taper as they descend on the heart. The left main coronary artery divides into two branches called the left anterior descending artery and the circumflex artery. The right coronary artery branches into the posterior descending artery and the marginal artery. These arteries branch into smaller and smaller arteries, some of which penetrate inside the heart. They eventually branch into capillaries, some so fine that it would take ten of them lying side by side to form the thickness of a human hair. Your capillaries deliver oxygen and nutrients and remove waste from your heart's cells. If one or more of the coronary arteries becomes narrowed or completely blocked, blood supply to the heart may be decreased or cut off altogether. The results can be painful and even deadly, including angina (chest pain), tissue death, and myocardial infarction, in other words, a heart attack.
Interactive by TheVisualMD
9 Years - Aging Vessel
25 Years - Aging Vessel
50 Years - Aging Vessel
75 Years - Aging Vessel
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Women's Aging Arteries
Top half of artery reflect aging well / Bottom half reflects poor life-style and accelerated plaque build-up leading to chronic diseases and early death - Image 1) 9 Years, Image 2) 25 Years, Image 3) 50 Years, Image 4) 75 Years
Over the years, if we don't take care of our bodies, our blood vessels can start to lose their resiliency and plaque can start to build up in our arteries. Plaque is composed of cholesterol, inflammatory (immune) cells, calcium, and other substances that flow through our bloodstreams. Plaque buildup occurs if we eat high-fat diets, don't get enough exercise, are overweight, smoke, or have other unhealthy habits.
Interactive by TheVisualMD
Atheroma - Blocked Artery Due to Plaque
What To Expect Before a Stent Procedure
Angioplasty Balloon in External Iliac Artery
What To Expect After a Stent Procedure
Completed Angioplasty of External Iliac Artery
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Blocked Artery / Balloon Angioplasty / Insertion of Stent
1) Blocked Artery
2) Pre Expansion of balloon
3) Balloon Angioplasty
4) Insertion of Stent
5) With-drawl of Catheter
Interactive by TheVisualMD
Wall of Artery / Wall of Vein
Wall of Artery / Wall of Vein
Wall of Artery - Your arteries are made up of three layers of cells: the tunica intima, the tunica media, and the tunica adventitia. The tunica intima is actually a single layer of endothelial cells. These cells are used as lining in many parts of your body. They provide a smooth surface for the blood to flow on. In addition, the endothelial layer is a functioning system that secretes different products and responds to different stimuli from the blood vessels and tissues. The tunica media or middle layer of the artery contains the muscle cells and other structural and elastic fibers that contract and dilate the artery. One of the signs of arterial aging is a loss of the pliability of the muscle cells in the tunica media and a loss of ability to distend. The tunica adventitia, the outer layer, contains the artery's support system - tiny blood vessels that feed the artery and nerves that respond to signals and control the artery's contraction and dilation.
Wall of Vein - Like arteries, veins are also made of three layers. However, veins do not contract like arteries. Veins in the lower part of your body have one-way valves to counteract the effects of gravity and prevent blood from flowing back into the feet. Veins in the upper part of the body have no valves because gravity itself brings the blood back \"down\" to the heart. Unfortunately, valves can be damaged and weakened over time. Varicose veins are caused by leaky valves that allow blood to pool and bulge in the veins of the legs.
Interactive by TheVisualMD
The illustration shows the major signs and symptoms of coronary heart disease
Women experiencing symptoms due to blockage of coronary arteries
TheVisualMD
Heart and Coronary Arteries
TheVisualMD
Coronary arteries
Patrick J. Lynch, medical illustrator
Coronary arteries
Patrick J. Lynch (1999), modified by Christian 2003
Heart and Coronary Arteries
TheVisualMD
Coronary Artery Disease (CAD)
Centers for Disease Control and Prevention (CDC)
How Are Stents Used?
National Heart, Lung, and Blood Institute
Coronary Artery Blockage
TheVisualMD
Angiogram Imaging of the Coronary Arteries
TheVisualMD
Coronary Arteries
TheVisualMD
Coronary CT angiography of coronary arteries
Oxford Academic Cardiovascular CT Core Lab and Lab of Inflammation and Cardiometabolic Diseases at NHLBI
Stent in Left Coronary Artery
TheVisualMD
Plaque in Coronary Artery, close up
TheVisualMD
Plaque in Coronary Artery
TheVisualMD
Coronary arteries
TheVisualMD
Women's Aging Arteries
TheVisualMD
Blocked Artery / Balloon Angioplasty / Insertion of Stent
TheVisualMD
Wall of Artery / Wall of Vein
TheVisualMD
Diagnosis
Diagnosing Atherosclerosis
Image by TheVisualMD
Diagnosing Atherosclerosis
Doctors may find evidence of atherosclerosis during a physical exam, such as sounds (bruits) heard through a stethoscope, weak pulse, or poor wound healing. If signs of atherosclerosis are present, diagnostic tests may be performed. These can include blood tests, electrocardiograms (EKGs), angiograms or other imaging tests, and Doppler ultrasounds. If signs of atherosclerosis are present, diagnostic tests may be performed. Diagnostic tests may include one or more of the following:
Image by TheVisualMD
How Is Atherosclerosis Diagnosed?
To diagnose atherosclerosis, your doctor will check the results of blood tests, imaging procedures, and other tests and also ask about your medical and family history. A physical exam helps detect symptoms.
Screening tests
Beginning at age 20, your doctor will regularly check to see if you have risk factors for plaque buildup in the arteries. Your doctor may:
Check your blood pressure.
Calculate your body mass index and measure your waist to see whether you have an unhealthy weight.
Orderblood tests to see whether you have unhealthy blood cholesterol or triglycerides levels, or diabetes.
Estimating your risk
Talk with your healthcare provider about risk factors:
Lifestyle habits such as smoking or vaping, physical activity, andeating habits
Your personal health history of medical conditions that may affect your risk, including diabetes and Inflammatory conditions, such as rheumatoid arthritis and psoriasis
Your family history if you have blood relatives who had heart attacks or died suddenly before they were 55 years old
A risk estimator app can help assess the risk that you’ll have a major complication, such as a heart attack, from atherosclerosis. The app estimates your risk over the next 10 years or throughout your lifetime based on your data. If you have all the information, you can use the app yourself. The app shows risk levels as low, borderline, intermediate, or high.
Diagnostic tests
To diagnose atherosclerosis, your doctor may order tests. Your doctor may recommend tests even if you do not have symptoms. The type of test depends on which arteries are affected by plaque buildup.
Blood tests
Blood tests check the levels of cholesterol, triglycerides, blood sugar, lipoproteins, or proteins that are signs of inflammation, such as C-reactive protein.
Electrocardiogram
An electrocardiogram, also called an ECG or EKG, is a simple, painless test that detects and records your heart’s electrical activity. An EKG can show how fast your heart is beating, whether the rhythm of your heartbeats is steady or irregular, and the strength and timing of the electrical impulses passing through each part of your heart. You may have an EKG as part of a routine exam to screen for heart disease.
An EKG may be recorded in a doctor’s office, an outpatient facility, in a hospital before major surgery, or as part of stress testing. For the test, you will lie still on a table. A nurse or technician will attach up to 12 electrodes to the skin on your chest, arms, and legs. Your skin may need to be shaved to help the electrodes stick. The electrodes are connected by wires to a machine that records your heart’s electrical activity on graph paper or on a computer. After the test, the electrodes will be removed.
An EKG has no serious risks. EKGs don’t give off electrical charges such as shocks. You may develop a slight rash where the electrodes were attached to your skin. This rash usually goes away on its own without treatment.
Heart imaging tests
Your doctor may order a heart imaging test to take pictures of your heart and find problems in blood flow in the heart or coronary arteries.
Examples of heart imaging tests used to diagnose atherosclerosis appear below.
Angiography is a special type of X-ray using a dye. This procedure can be used to check the arteries in the heart, neck, brain, or other areas of the body.
Cardiac MRI(magnetic resonance imaging) detects tissue damage or problems with blood flow in the heart or coronary arteries. Cardiac MRI can help explain results from other imaging tests such as chest X-rays and CT scans.
Cardiac positron emission tomography (PET) scanning assesses blood flow through the small blood vessels of the heart. This is a type of nuclear heart scan that can diagnose coronary microvascular disease.
Coronary computed tomographic (CT) angiographyshows the insides of your coronary arteries rather than an invasive cardiac catheterization. It is a noninvasive imaging test using CT scanning.
Coronary calcium scan
A coronary calcium scan is a CT scan of your heart that measures the amount of calcium in the walls of your coronary arteries. Buildup of calcium, or calcifications, are a sign of atherosclerosis or coronary heart disease.
A coronary calcium scan may be done in a medical imaging facility or hospital. The test does not use contrast dye and will take about 10 to 15 minutes to complete. A coronary calcium scan uses a special scanner such as an electron beam CT or a multidetector CT (MDCT) machine. An MDCT machine is a much faster CT scanner that makes high-quality pictures of the beating heart. A coronary calcium scan will determine an Agatston score that reflects the amount of calcium found in your coronary arteries. A score of zero is normal. In general, the higher your score, the more likely you are to have heart disease. If your score is high, your doctor may recommend more tests.
A coronary calcium scan has few risks. There is a slight risk of cancer, particularly in people younger than 40 years old. However, the amount of radiation from one test is similar to the amount of radiation you are naturally exposed to over one year. Talk to your doctor and the technicians performing the test about whether you are or could be pregnant.
Stress tests
A stress test measures how healthy your heart is and how well it works during physical stress. Some heart problems are easier to identify when your heart is working hard to pump blood throughout your body, such as when you exercise.
You may do a stress test in your doctor’s office or a hospital. The test usually involves physical exercise such as walking on a treadmill or riding a stationary bicycle. If you are not able to exercise, your doctor will give you medicine that will make your heart work hard and beat faster, as if you were exercising. Your doctor may ask you not to take some of your prescription medicines or to avoid coffee, tea, or any drinks with caffeine on the day of your test, because these may affect your results. Your doctor will ask you to wear comfortable clothes and shoes for the test.
Ankle-brachial index (ABI) test
Ankle-brachial index (ABI) testsare used to diagnose peripheral artery disease. This painless test compares the blood pressures in your ankle and your arm using a blood pressure cuff and ultrasound device.
The illustration shows the ankle-brachial index test. The test compares blood pressure in the ankle with blood pressure in the arm. As the blood pressure cuff deflates, the blood pressure in the arteries is recorded.
Source: National Heart, Lung, and Blood Institute (NHLBI)
Additional Materials (5)
Diagnosis of Atherosclerosis: Ankle-Brachial Index – Vascular Medicine | Lecturio
Video by Lecturio Medical/YouTube
Atherosclerosis Hardening of Arteries | Heart Disease
Video by Howcast/YouTube
Testing & Diagnosis
Doctors may find evidence of atherosclerosis in the course of a physical exam. Signs may include:
Image by TheVisualMD
Angiogram of the Coronary Vessels
An angiogram is a type of medical imaging that allows a physician to see someone's arteries. In angiogram imaging, an X-ray contrast dye is injected into the arteries of interest, and fast-moving X-ray images, known as fluoroscopy, are monitored on a screen while the dye flows through the arteries. The series of images produced will reveal the flow of blood in the region, including any blockages or vessel abnormalities. Angiograms are commonly done with the arteries that supply the heart itself with blood, known as the coronary arteries. If blockage exists within these arteries, the patient may be at serious risk because if the heart itself does not have a supply of blood to function, it will not be able to effectively perform the job of pumping blood to the entire body.
Image by TheVisualMD
Angiogram Revealing Coronary Blockage
Doctors use angiograms as an effective imaging tool for visualizing and locating blockages or inconsistencies in blood flow. Contrast dye is used to illuminate the interior of the coronary arteries as blood passes through them. This angiogram reveals blockage in the left main coronary artery, supplying the left side of the heart. The left ventricle of the heart is responsible for exerting a powerful force pushing blood out from the heart, through the aorta, to be delivered throughout the entire body. The patient may be at serious risk of heart disease, including heart attack. If the heart does not have the blood supply it needs to perform its job of pumping volumes of blood to the entire body, organ systems will not be able to function.
Image by TheVisualMD
4:52
Diagnosis of Atherosclerosis: Ankle-Brachial Index – Vascular Medicine | Lecturio
Lecturio Medical/YouTube
1:32
Atherosclerosis Hardening of Arteries | Heart Disease
Howcast/YouTube
Testing & Diagnosis
TheVisualMD
Angiogram of the Coronary Vessels
TheVisualMD
Angiogram Revealing Coronary Blockage
TheVisualMD
Heart Health
Cardiac Profile
Also called: Heart Health Profile, Heart Profile, Cardiac Risk Assessment, Heart Health Tests, Cardiovascular Health
Heart diseases are the number one killer in the U.S. They are also a major cause of disability. If you do have a heart disease, it is important to find it early, when it is easier to treat. Blood tests and heart health tests can help find heart diseases or identify problems that can lead to heart diseases.
Cardiac Profile
Also called: Heart Health Profile, Heart Profile, Cardiac Risk Assessment, Heart Health Tests, Cardiovascular Health
Heart diseases are the number one killer in the U.S. They are also a major cause of disability. If you do have a heart disease, it is important to find it early, when it is easier to treat. Blood tests and heart health tests can help find heart diseases or identify problems that can lead to heart diseases.
Mayo Clinic: Blood tests for heart disease [accessed on Aug 17, 2018]
Cleveland Clinic: Blood Tests to Determine Risk of Coronary Artery Disease [accessed on Aug 17, 2018]
The high-sensitivity c-reactive protein (hs-CRP) test is used to measure your heart disease risk even if you seem healthy. It can find much smaller changes in CRP levels than the regular CRP test.
The high-sensitivity c-reactive protein (hs-CRP) test is used to measure your heart disease risk even if you seem healthy. It can find much smaller changes in CRP levels than the regular CRP test.
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Use the slider below to see how your results affect your
health.
mg/L
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Your result is Low.
You have a low risk of developing heart disease.
Related conditions
C-reactive protein (CRP) is produced in the liver in case of trauma or inflammation. It can also be produced in the case fever or some asymptomatic chronic disease.
The main function of CRP is to aid the people’s immune system. It notifies other protective cells (e.g., white blood cells) to take action against foreign bodies (bacteria, viruses, cancer cells) that may cause harm to your body.
In the hs-CRP test, the sensitivity to detect low-grade inflammation has been improved, which can aid in the detection of acute inflammation (injury, infection).
The hs-CRP test is most commonly used to assess the risk of heart disease. Heart and vascular diseases are often caused by the chronic inflammation of arteries.
Your doctor may want to order this test if you have a suspected heart disease, or if you have risk factors for cardiovascular disease. This includes:
Unbalanced diet
Physical inactivity (sedentarism)
Being overweight or obese
More than 50 years of age in women
More than 45 years of age in men
Cigarette smoking
Diabetes
High blood pressure
Family history of early heart disease
Previously diagnosed heart disease
Your doctor may also want to order this test in case that your blood analysis tests have shown increased levels of cholesterol, triglycerides, and LDL cholesterol, or decreased levels of HDL cholesterol.
A small amount of blood will be drawn from a vein in your arm by using a needle.
Usually, no fasting or other special preparations are needed.
Only the risks related to blood extraction, which are temporary discomfort, bruising, little bleeding, and risk of infection in the place where the needle was inserted.
The levels of hs-CRP test are related to the risk of heart disease, its results indicate:
Low risk: 1.00 mg/L
Average risk: 1.00 - 3.00 mg/L
High risk: >3.00 mg/L
The levels of hs-CRP rise rapidly in the case of acute inflammation and decrease as the inflammation subsides.
You should inform your doctor about any medications that you are taking because some drugs (e.g. aspirin, ibuprofen or hormonal replacement therapy) may affect your tests results.
As your hs-CRP levels may vary over time, this test should be taken twice within a period frame of two weeks to properly assess the risk of coronary artery disease.
MedicineNet. C-Reactive Protein CRP Test, Ranges, Symptoms, and Treatment. Melissa Conrad Stöppler. [accessed on Aug 14, 2018]
Kiran Musunuru et al. The use of high-sensitive protein in clinical practice. Published online 2008 Aug 19. [accessed on Aug 14, 2018]
Cleveland Clinic. Blood Tests to Determine Risk of Coronary Artery Disease: C-Reactive Protein. Reviewed by Dr. Leslie Cho. [accessed on Aug 14, 2018]
Mayo Clinic Mayo Medical Laboratories. Test ID: HSCRP CReactive Protein, High Sensitivity, Serum. [accessed on Aug 14, 2018]
LabTests Online. High-sensitivity C-Reactive Protein (hs-CRP). [accessed on Aug 14, 2018]
Pritikin Longevity Centre. What is high-sensitivity C-reactive protein? Can you lower it with food? [accessed on Aug 14, 2018]
Doc’s opinion. Blog About Heart Disease, Nutrition, Healthy Lifestyle and Prevention of Disease. Hs-CRP. [accessed on Aug 14, 2018]
120766: C-Reactive Protein (CRP), High Sensitivity ... | LabCorp [accessed on Oct 11, 2018]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (17)
CRP And Homocysteine Inflammation Markers, How Do They Relate To Coronary Artery Disease? - Dr. Lyel
Video by EmpowHER/YouTube
Chronic Inflammation: The Root Cause of a Multitude of Diseases
Video by Criticalbench/YouTube
Inflammation and Type 2 Diabetes
Video by WEHImovies/YouTube
Part I - Inflammation
Video by Armando Hasudungan/YouTube
Part II - Inflammation
Video by Armando Hasudungan/YouTube
This browser does not support the video element.
What Is Inflammation?
Inflammation is the body's response to damage. It takes many forms. Chronic inflammation is common in overweight and obese people, because their fat cells manufacture damaging substances that trigger a reaction from the immune system's white blood cells. Keeping track of a key biomarker for inflammation, C-reactive Protein or CRP, helps doctors determine whether an overweight patient is at risk for such conditions as heart disease, dementia, diabetes, cancers, and more.
Video by TheVisualMD
C Reactive Protein: Liver and Heart
C-Reactive protein is synthesized by the liver in response to either signals from fat cells (adipocytes) or when there is inflammation throughout the body.
Image by TheVisualMD
C Reactive Protein: Fat cells
Researchers have found that fat cells trigger the production of C-reactive protein (CRP), which is why individuals who are overweight or obese tend to have chronically higher levels of CRP. High levels of CRP are sometimes treated with aspirin or statins.
Image by TheVisualMD
C-Reactive Protein (CRP) Molecule
C-reactive protein (CRP) is a substance made by the liver; infection and inflammation can trigger the release of CRP within hours. Elevated CRP levels are also seen after a heart attack or surgery. Levels can jump 1000-fold in response to acute inflammation, often rising before the appearance of pain, fever or other clinical symptoms. The high sensitivity version of the test (hs-CRP) measures the same molecule, but in very small amounts, and is used to assess the risk of heart disease in otherwise healthy people. The C-reactive protein (CRP) test is a general test for inflammation in the body; it can indicate that inflammation is present, but cannot determine the location or cause. The test is sometimes used to monitor flare-ups of inflammatory diseases such as rheumatoid arthritis or lupus. A version of the test called high-sensitivity C-reactive protein (hs-CRP) is used to evaluate a person's risk for heart disease.
Image by TheVisualMD
C-reactive Protein, Atherosclerosis and Heart Disease
C-reactive protein (CRP) is a substance made by the liver that is released into the bloodstream by inflammation. CRP levels also seem to be associated with an increased risk of heart disease and atherosclerosis, in which fatty deposits called plaque build up inside the arteries. For this reason, a high sensitivity C-reactive protein test (hs-CRP) is increasingly ordered along with other tests as part of a cardiovascular risk profile (other components of the profile include cholesterol, triglycerides, blood pressure, glucose levels, lifestyle and family history).
Image by TheVisualMD
Phagocytosis - C-reactive protein (CRP) is a substance made by the liver that is released into the bloodstream by inflammation and infection as part of the body's immune response.
C-reactive protein (CRP) is a substance made by the liver that is released into the bloodstream by inflammation and infection as part of the body's immune response. White blood cells are also mobilized by the immune system and CRP is believed to enhance the activity of the white blood cells called macrophages. Each type of white blood cell has its own specialized immune functions; macrophages, for example, basically engulf and \"eat\" foreign invaders such as bacteria, viruses and fungi. Macrophages in the spleen and the liver weed out old and defective red blood cells and break them into recyclables (iron, heme, and some globin) and wastes (such as bilirubin). The bilirubin is then used by the liver to produce bile, which is stored in the gallbladder and released into the small intestine to aid digestion.
Image by TheVisualMD
CRP High Sensitivity Cardiac Risk Assessment from Walk-in Lab
Video by Walk-In Lab LLC/YouTube
C-reactive Protein, Fat cells
C-reactive protein (CRP) is a substance made by the liver that is released into the bloodstream by inflammation and infection as part of the body's immune response. Researchers have found, however, that fat cells also seem to trigger the production of C-reactive protein (CRP), which is why individuals who are overweight or obese tend to have chronically higher levels of CRP.
Image by TheVisualMD
What Can Give False Readings on an hs-CRP Test? : Health Tips
Video by ehowhealth/YouTube
CRP Indicates Heart Disease Risk Video - Brigham and Women's Hospital
Video by Brigham And Women's Hospital/YouTube
This browser does not support the video element.
Cardiovascular Inflammation
Heart disease is the number one killer of men and women in the U.S. The most common cause of heart attack, stroke, and cardiovascular death is atherosclerosis. Atherosclerosis is a chronic inflammatory response in the walls of arteries that leads to the hardening of arterial walls and the buildup of fatty deposits called plaques, or atheromas. Although the process of inflammation can be beneficial in other parts of the body, chronic inflammation within arterial walls is problematic as it seems to promote this underlying growth of plaque. The combination of arterial inflammation and the growth of plaque can lead to the rupture of the plaque, and result in a blood clot. Blood clots can lead to dangerous conditions such as heart attack or stroke.
Video by TheVisualMD
Inflammation In Atherosclerotic Plaque Formation (VIDEO)
Image by TheVisualMD
2:12
CRP And Homocysteine Inflammation Markers, How Do They Relate To Coronary Artery Disease? - Dr. Lyel
EmpowHER/YouTube
1:35
Chronic Inflammation: The Root Cause of a Multitude of Diseases
Criticalbench/YouTube
5:09
Inflammation and Type 2 Diabetes
WEHImovies/YouTube
8:27
Part I - Inflammation
Armando Hasudungan/YouTube
7:54
Part II - Inflammation
Armando Hasudungan/YouTube
1:57
What Is Inflammation?
TheVisualMD
C Reactive Protein: Liver and Heart
TheVisualMD
C Reactive Protein: Fat cells
TheVisualMD
C-Reactive Protein (CRP) Molecule
TheVisualMD
C-reactive Protein, Atherosclerosis and Heart Disease
TheVisualMD
Phagocytosis - C-reactive protein (CRP) is a substance made by the liver that is released into the bloodstream by inflammation and infection as part of the body's immune response.
TheVisualMD
1:51
CRP High Sensitivity Cardiac Risk Assessment from Walk-in Lab
Walk-In Lab LLC/YouTube
C-reactive Protein, Fat cells
TheVisualMD
2:25
What Can Give False Readings on an hs-CRP Test? : Health Tips
ehowhealth/YouTube
3:37
CRP Indicates Heart Disease Risk Video - Brigham and Women's Hospital
Brigham And Women's Hospital/YouTube
4:26
Cardiovascular Inflammation
TheVisualMD
Inflammation In Atherosclerotic Plaque Formation (VIDEO)
TheVisualMD
Homocysteine Test
Homocysteine Test
Also called: Homocyst(e)ine, Homocysteine Cardiac Risk
A homocysteine test measures the level of homocysteine in your blood. High levels may mean a vitamin deficiency, heart disease, or an inherited disorder.
Homocysteine Test
Also called: Homocyst(e)ine, Homocysteine Cardiac Risk
A homocysteine test measures the level of homocysteine in your blood. High levels may mean a vitamin deficiency, heart disease, or an inherited disorder.
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Use the slider below to see how your results affect your
health.
mg/L
0.68
2.02
Your result is Normal.
Homocysteine is an amino acid found in most cells of the body, in trace amounts. Normally, homocysteine levels are low, because it is constantly turned into other substances your body needs.
Related conditions
A homocysteine test measures the amount of homocysteine in a sample of your blood. Homocysteine is an amino acid. Amino acids are molecules that your body uses to make proteins.
Normally, your homocysteine levels are low. That's because your body uses vitamin B12, vitamin B6, and folic acid (also called folate or vitamin B9) to quickly break down homocysteine and change it into other substances that your body needs. High levels of homocysteine in your blood may be a sign that this process isn't working properly or that you're lacking certain B vitamins.
High levels of homocysteine can damage the inside of your arteries and increase your risk of forming blood clots. This may increase your risk for heart attack, stroke, and other heart diseases and blood vessel disorders.
A homocysteine test may be used to:
Find out if you're lacking vitamin B6, B12, or folic acid. These vitamins break down homocysteine. So if you don't have enough of them, your homocysteine levels will increase. A homocysteine test may be done with a blood test to measure your vitamin B levels.
Help diagnose homocystinuria. Homocystinuria is a rare, genetic disease that prevents your body from using a certain amino acid to make important proteins. Symptoms usually show up in the first year of life, but they may not appear until childhood or later. Common symptoms include problems with eyesight, blood clots, and weak bones. In the U.S., most newborns have a routine screening test to check for homocystinuria.
Better understand your risk for heart attack or stroke if you already have an increased risk. Your health care provider may order a homocysteine test if you have been diagnosed with heart or blood vessel disease or if you have conditions that increase your risk for heart and blood vessel disease, such as:
High blood pressure
High cholesterol
Diabetes
Medical experts don't recommend routine homocysteine testing to screen for heart disease risk in everyone. That's because researchers aren't sure how much homocysteine levels affect heart and blood vessel diseases. And so far, studies have shown that lowering homocysteine levels doesn't reduce the risk of heart attack or stroke.
You may need this test if you have symptoms that suggest you lack vitamin B12 or folic acid. The symptoms may be very mild to severe and may include:
Dizziness
Fatigue and/or weakness
Headache
Heart palpitations (racing or pounding heart)
Changes in the color of your skin or fingernails
Sores on your tongue or in your mouth
Tingling or numbness in your hands, feet, arms, and/or legs
Your provider may order this test if you have a high risk for low levels of vitamin B12 or folic acid because you:
Have malnutrition.
Are an older adult. Older people often can't absorb enough vitamin B12 from food.
Have alcohol use disorder or a drug addiction.
Your provider may recommend this test if you:
Have had a heart attack or stroke
Have one or more conditions that increase your risk for heart attack or stroke, such as high LDL "bad" cholesterol or high blood pressure
A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.
You may need to fast (not eat or drink) for 8–12 hours before a homocysteine test. Some medicines and supplements may affect your test results. So, tell your provider about all medicines and supplements you take, especially vitamin B. But never stop taking any medicines unless your provider tells you to.
There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.
A high homocysteine level may be a sign that:
You are not getting enough vitamin B12 or folic acid in your diet.
You (or your child) have homocystinuria. You will probably need more testing to rule out or confirm a diagnosis of homocystinuria.
You may have a higher risk of heart disease, stroke, or other blood vessel disorders.
Higher than normal homocysteine levels may also happen with other conditions, such as osteoporosis, chronic kidney disease, hypothyroidism, or Alzheimer's disease or other types of dementia.
If your homocysteine levels are high, it doesn't always mean you have a medical condition that needs treatment. Your results may be affected by:
Your age. Homocysteine levels may get higher as you get older.
Your sex. Males usually have higher homocysteine levels than females, but levels in females increase after menopause.
Smoking
If you have questions about your results, talk with your provider.
If you have high homocysteine levels, your provider may suggest that you make changes in the foods you eat. Eating a balanced diet can help you get the right amount of vitamins. If you're considering taking vitamin supplements, talk with your provider first. Research has not shown that reducing homocysteine levels can reduce your risk of heart attack or stroke.
Homocysteine Test: MedlinePlus Lab Test Information [accessed on Sep 30, 2018]
Homocysteine [accessed on Sep 30, 2018]
706994: Homocyst(e)ine | LabCorp [accessed on Sep 30, 2018]
Homocysteine Blood Test [accessed on Sep 30, 2018]
Fontanarosa, P., & Christiansen, S. (2009, April 01). Laboratory Values. AMA Manual of Style. Ed. [accessed on Sep 30, 2018]
https://www.drkarafitzgerald.com/2017/04/04/low-homocysteine-concern/ [accessed on Sep 30, 2018]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (8)
CRP And Homocysteine Inflammation Markers, How Do They Relate To Coronary Artery Disease? - Dr. Lyel
Video by EmpowHER/YouTube
This browser does not support the video element.
What Is Inflammation?
Inflammation is the body's response to damage. It takes many forms. Chronic inflammation is common in overweight and obese people, because their fat cells manufacture damaging substances that trigger a reaction from the immune system's white blood cells. Keeping track of a key biomarker for inflammation, C-reactive Protein or CRP, helps doctors determine whether an overweight patient is at risk for such conditions as heart disease, dementia, diabetes, cancers, and more.
Video by TheVisualMD
Homocystinuria Infographic
Video by HCU Network/YouTube
The Homocysteine Factor
Video by hcyfactor/YouTube
Homocysteine
homocysteine molecule (L-isomer).
Image by Ben Mills and Jynto
Homocysteine
Homocysteine is a non-proteinogenic amino acid. It is a homologue of the amino acid cysteine, differing by an additional methylene (-CH2-) group. It is biosynthesized from methionine, and can be recycled into methionine or converted into cysteine with the aid of B-vitamins. While detection of high levels of homocysteine has been linked to cardiovascular disease, lowering homocysteine levels may not improve outcomes.
Image by TheVisualMD
Fasting for a Blood Test | WebMD
Video by WebMD/YouTube
Fasting Plasma Glucose
Fasting Plasma Glucose - The fasting plasma glucose (FPG) test, also known as the fasting blood sugar test, measures blood sugar levels and is used to diagnose diabetes.
Image by TheVisualMD
2:12
CRP And Homocysteine Inflammation Markers, How Do They Relate To Coronary Artery Disease? - Dr. Lyel
EmpowHER/YouTube
1:57
What Is Inflammation?
TheVisualMD
3:57
Homocystinuria Infographic
HCU Network/YouTube
3:23
The Homocysteine Factor
hcyfactor/YouTube
Homocysteine
Ben Mills and Jynto
Homocysteine
TheVisualMD
0:50
Fasting for a Blood Test | WebMD
WebMD/YouTube
Fasting Plasma Glucose
TheVisualMD
Brain Natriuretic Peptide Tests
Brain Natriuretic Peptide Tests
Also called: BNP, NT-proBNP, Natriuretic Peptide Test, N-Terminal Pro B-Type Natriuretic Peptide Test
Natriuretic peptide tests measure levels of BNP or NT-proBNP in a sample of your blood. Natriuretic peptides are proteins that your heart and blood vessels make. High levels of either substance in the blood can be a sign of heart failure.
Brain Natriuretic Peptide Tests
Also called: BNP, NT-proBNP, Natriuretic Peptide Test, N-Terminal Pro B-Type Natriuretic Peptide Test
Natriuretic peptide tests measure levels of BNP or NT-proBNP in a sample of your blood. Natriuretic peptides are proteins that your heart and blood vessels make. High levels of either substance in the blood can be a sign of heart failure.
{"label":"BNP reference range","scale":"lin","step":0.1,"hideunits":false,"items":[{"flag":"normal","label":{"short":"Normal","long":"Normal","orientation":"horizontal"},"values":{"min":0,"max":100},"text":"B-type natriuretic peptide test reference values can widely vary according to a person\u2019s sex and age.","conditions":[]},{"flag":"abnormal","label":{"short":"High","long":"High","orientation":"horizontal"},"values":{"min":100,"max":500},"text":"High levels of BNP indicate heart failure.","conditions":["Congestive heart failure","Left ventricular hypertrophy","Acute myocardial infarction","Coronary angioplasty","Hypertension","Kidney disease"]}],"units":[{"printSymbol":"pg\/mL","code":"pg\/mL","name":"picogram per milliliter"}],"value":50}[{"normal":0},{"abnormal":0}]
Use the slider below to see how your results affect your
health.
pg/mL
100
Your result is Normal.
B-type natriuretic peptide test reference values can widely vary according to a person’s sex and age.
Related conditions
{"label":"NT-proBNP reference range","scale":"lin","step":0.1,"hideunits":false,"items":[{"flag":"normal","label":{"short":"Normal","long":"Normal","orientation":"horizontal"},"values":{"min":0,"max":100},"text":"NT-proBNP test reference values can widely vary according to a person\u2019s sex and age.","conditions":[]},{"flag":"abnormal","label":{"short":"High","long":"High","orientation":"horizontal"},"values":{"min":100,"max":500},"text":"High levels of NT-proBNP indicate heart failure.","conditions":["Congestive heart failure","Left ventricular hypertrophy","Acute myocardial infarction","Coronary angioplasty","Hypertension","Kidney disease"]}],"units":[{"printSymbol":"pg\/mL","code":"pg\/mL","name":"picogram per milliliter"}],"value":50}[{"normal":0},{"abnormal":0}]
Use the slider below to see how your results affect your
health.
pg/mL
100
Your result is Normal.
NT-proBNP test reference values can widely vary according to a person’s sex and age.
Related conditions
Natriuretic peptides are proteins that your heart and blood vessels make. Natriuretic peptide tests measure the amount of these proteins in a sample of your blood. They are mainly used to help confirm or rule out heart failure in people who have symptoms.
Heart failure is also called congestive heart failure. If you have this condition, your heart has trouble pumping enough oxygen-rich blood to meet your body's needs.
Two types of natriuretic peptides can be measured to check for possible heart failure. Your health care provider will decide which of these peptides to test:
Brain natriuretic peptide (BNP) is a protein that's a type of hormone. A hormone is a chemical messenger in your bloodstream that controls the actions of certain cells or organs. BNP has "brain" in its name because that's where researchers first discovered it. Your heart makes and releases BNP into your bloodstream when it's working harder than normal to pump blood.
The BNP tells your blood vessels to open wider and your kidneys to get rid of water and salt through urine (pee). This helps reduce the workload on your heart by lowering blood pressure and reducing the amount of blood your heart has to pump.
N-terminal pro b-type natriuretic peptide (NT-proBNP) is a protein that's an "ingredient" for making the BNP hormone. Like BNP, your heart makes larger amounts of NT-proBNP when it has to work harder to pump blood.
It's normal to have some BNP and NT-proBNP in your bloodstream. But higher than normal levels for your age and sex may be a sign of heart failure.
Other names: brain natriuretic peptide, NT-pro B-type natriuretic peptide test, B-type natriuretic peptide, N terminal proBNP
A BNP test or an NT-proBNP test is mainly used to help diagnose or rule out heart failure in a person who is having symptoms. Shortness of breath is the most common symptom of heart failure, but other conditions can cause the same type of breathing problems.
If a person with shortness of breath has normal BNP or NT-proBNP levels, heart failure can usually be ruled out. If high BNP or NT-proBNP levels are found, other tests will usually be done to confirm that heart failure is causing the symptoms.
For people who have already been diagnosed with heart failure, the test may be used to:
Find out how serious their heart condition is
Predict the chances that their condition will get worse
Check if an increase in symptoms means that heart failure has gotten worse
In certain cases, the test may also be used to monitor the heart health of people who:
Have had a heart attack
Have a heart condition that suddenly reduces the flow of blood to the heart, such as unstable angina
You may need a BNP test or an NT-proBNP test if you have symptoms that could mean you have heart failure. These include:
Feeling short of breath
Swelling in your abdomen (belly), feet, legs, and/or veins in your neck
Fatigue and/or general weakness
Coughing
Inability to sleep lying flat
Needing to urinate (pee) a lot, especially at night
Loss of appetite and nausea
If you have already been diagnosed with heart failure, your provider may order one of these tests to learn more about your condition.
For a BNP test or an NT-proBNP test, a health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.
If you're being tested in a hospital, you may have a fingerstick test. Your finger will be pricked with a small needle and a few drops of blood will be gathered for testing. This method provides quicker results than using blood from a vein.
You don't need any special preparations for a BNP test or an NT-proBNP test.
There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.
The meaning of your test results will depend on your age, sex, medical history, family history, and the results of other tests. Ask your provider to explain what the results of your BNP or NT-proBNP test say about your health and how this information may affect your treatment.
A BNP or NT-proBNP test alone can't diagnose the cause of your symptoms. But in general, if you have symptoms that could be caused by heart failure:
Normal results on a BNP or NT-proBNP usually mean that you're unlikely to have heart failure. Your provider may order other tests to find out what's causing your symptoms.
If you have obesity, your weight may affect the accuracy of your test results, making your levels lower than they really are. If your provider suspects heart failure, you may have other heart health tests even if your BNP or NT-proBNP levels are normal.
Higher than normal levels of BNP or NT-proBNP mean that you could have heart failure. Your provider will probably order other heart health tests to help make a final diagnosis.
In most cases, the higher the level of your test results, the more serious your heart failure may be. But other health conditions can increase BNP and NT-proBNP levels. That's why your medical history is important for understanding whether high test results mean you have heart failure.
Other conditions that can cause high levels of BNP and NT-proBNP include:
Kidney failure
Other types of heart disease, including conditions that affect your heart valves or heart muscle
Certain lung disorders, including a blood clot in your lung (pulmonary embolism) and high blood pressure in your lungs (pulmonary hypertension)
If you have questions about your results, talk with your provider.
Natriuretic Peptide Tests (BNP, NT-proBNP): MedlinePlus Medical Test [accessed on Jan 19, 2024]
Brain natriuretic peptide test: MedlinePlus Medical Encyclopedia [accessed on Jan 19, 2024]
Brain Natriuretic Peptide Test (BNP and NT-proBNP) - Testing.com. Jan 21, 2022 [accessed on Jan 19, 2024]
Additional Materials (2)
Heart Revealing Blood in Left Ventricle
3d visualization based on scanned human data of the anterior view of a heart. The anterior wall of the epicardium is transparent to reveal the blood in the left ventricle as it is being pumped into the aorta.
Image by TheVisualMD
Human Heart with Enlarged Left Ventricle
3D visualization based on scanned human data of an enlarge heart. The coronal cut reveals the right ventricle and the enlarged left ventricle. The muscular wall of the left ventricle is thicker and larger to do the increase force required to push blood into the systemic system.
Image by TheVisualMD
Heart Revealing Blood in Left Ventricle
TheVisualMD
Human Heart with Enlarged Left Ventricle
TheVisualMD
Lipoprotein (A) Test
Lipoprotein (A) Test
Also called: Cholesterol Lp(a), Lp(a), Lp "Little a", lipoprotein (a) blood test
Lipoprotein(a) is a particle that carries cholesterol, proteins and fats in blood vessels. The level of Lp(a) is genetically inherited and not affected by lifestyle or treatment. Lp(a) test allows to assess the risk of heart disease.
Lipoprotein (A) Test
Also called: Cholesterol Lp(a), Lp(a), Lp "Little a", lipoprotein (a) blood test
Lipoprotein(a) is a particle that carries cholesterol, proteins and fats in blood vessels. The level of Lp(a) is genetically inherited and not affected by lifestyle or treatment. Lp(a) test allows to assess the risk of heart disease.
{"label":"Lipoprotein (A) Reference Range","scale":"lin","step":0.1,"hideunits":false,"units":[{"printSymbol":"mg\/dL","code":"mg\/dL","name":"milligram per deciliter"}],"items":[{"flag":"normal","label":{"short":"Normal","long":"Normal","orientation":"horizontal"},"values":{"min":0,"max":30},"text":"Some cholesterol and Lp(a) in your blood is normal.","conditions":[]},{"flag":"abnormal","label":{"short":"High","long":"High","orientation":"horizontal"},"values":{"min":30,"max":100},"text":"High levels of Lp(a) in blood are associated with an increased risk of heart attack, stroke, or narrowed arteries supplying blood to vital organs.","conditions":["Atherosclerosis","Coronary artery disease","Heart attack","Peripheral vascular disease","Aortic stenosis","Thrombosis","Stroke"]}],"value":15}[{"normal":0},{"abnormal":0}]
Use the slider below to see how your results affect your
health.
mg/dL
30
Your result is Normal.
Some cholesterol and Lp(a) in your blood is normal.
Related conditions
A lipoprotein (a) test measures the level of lipoprotein (a) in your blood. Lipoproteins are substances made of protein and fat that carry cholesterol through your bloodstream. There are two main types of cholesterol:
High-density lipoprotein (HDL), or "good" cholesterol
Low-density lipoprotein (LDL), or "bad" cholesterol.
Lipoprotein (a) is a type of LDL (bad) cholesterol. A high level of lipoprotein (a) may mean you are at risk for heart disease.
A lipoprotein (a) test is used to check for risk of stroke, heart attack, or other heart diseases. It is not a routine test. It is usually only given to people who have certain risk factors, such as a family history of heart disease.
You may need this test if you have:
Heart disease, despite normal results on other lipid tests
High cholesterol, despite maintaining a healthy diet
A family history of heart disease, especially heart disease that has occurred at an early age and/or sudden deaths from heart disease
A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.
You don't need any special preparations for a lipoprotein (a) test. If your health care provider has ordered other tests, such as a cholesterol test, you may need to fast (not eat or drink) for 9 to 12 hours before your blood is drawn. Your health care provider will let you know if there are any special instructions to follow.
There is very little risk to having a blood test. You may experience slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.
A high lipoprotein (a) level may mean you are at risk for heart disease. There are no specific treatments to lower lipoprotein (a). Your level of lipoprotein (a) is determined by your genes and is not affected by your lifestyle or by most medicines. But if your test results show a high level of lipoprotein (a), your health care provider may make recommendations to reduce other risk factors that can lead to heart disease. These may include medicines or lifestyle changes such as:
Eating a healthy diet
Weight Control
Quitting smoking
Getting regular exercise
Reducing stress
Lowering blood pressure
Reducing LDL cholesterol
Certain situations and factors can affect your test results. You should not get a lipoprotein (a) test if you have any of these conditions:
Fever
Infection
Recent and considerable weight loss
Pregnancy
Lipoprotein (a) Blood Test: MedlinePlus Lab Test Information [accessed on Sep 09, 2018]
120188: Lipoprotein(a) | LabCorp [accessed on Sep 09, 2018]
https://www.labcorp.com/tests/related-documents/L15045 [accessed on Sep 09, 2018]
Understand Inherited Lipoprotein(a) - Lipoprotein(a) Foundation [accessed on Sep 09, 2018]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (10)
Lipids and Lipoproteins
Lipids and Lipoproteins
Image by TheVisualMD
Lipoprotein Associated Phospholipase: Macrophage
Lp-PLA2 (or lipoprotein-associated phospholipase A2) is an enzyme produced by specialized immune cells called macrophages that engulf and destroy pathogens, foreign particles, aging cells and biological debris.
Image by TheVisualMD
Lp-PLA2, Coronary heart disease
Coronary heart disease is the leading cause of death for both men and women. There is no single biomarker that can perfectly predict a person's risk of heart disease; half of all people who suffer heart attacks have normal cholesterol. This is why researchers have developed additional biomarkers for heart disease, such as Lp-PLA2 (or lipoprotein-associated phospholipase A2), an enzyme linked to the inflammation of blood vessels. Individuals with high levels of Lp-PLA2 are at much higher risk of heart attack and stroke even if their cholesterol levels are normal.
Image by TheVisualMD
Lipoproteins
Lipid logistics: transport of triglycerides and cholesterol in organisms in form of lipoproteins as chylomicrons, VLDL, LDL, IDL, HDL.
Image by Peter Forster
Lipoprotein(a) (Lp(a)) and Stroke
Video by Children's Stroke Foundation/YouTube
Lipoprotein(a) Foundation Thanks Bob Harper ...
Video by BusinessWire/YouTube
What Is Lipoprotein(a)?
Video by Rush University System for Health/YouTube
High Cholesterol Medical Animation (Hyperlipidemia)
Video by Silverback Video/YouTube
What is FH?
Video by NationalLipid/YouTube
Jeanine's Story
Video by Rush University System for Health/YouTube
Lipids and Lipoproteins
TheVisualMD
Lipoprotein Associated Phospholipase: Macrophage
TheVisualMD
Lp-PLA2, Coronary heart disease
TheVisualMD
Lipoproteins
Peter Forster
4:09
Lipoprotein(a) (Lp(a)) and Stroke
Children's Stroke Foundation/YouTube
2:20
Lipoprotein(a) Foundation Thanks Bob Harper ...
BusinessWire/YouTube
3:47
What Is Lipoprotein(a)?
Rush University System for Health/YouTube
1:19
High Cholesterol Medical Animation (Hyperlipidemia)
Silverback Video/YouTube
1:54
What is FH?
NationalLipid/YouTube
2:48
Jeanine's Story
Rush University System for Health/YouTube
Cholesterol Test
Cholesterol Test
Also called: Cholesterol Levels, Blood Cholesterol, Total Cholesterol
A cholesterol test is a blood test that measures the amount of each type of cholesterol and certain fats in your blood. Cholesterol is needed to carry out functions such as hormone and vitamin production. High cholesterol can put you at risk for heart disease.
Cholesterol Test
Also called: Cholesterol Levels, Blood Cholesterol, Total Cholesterol
A cholesterol test is a blood test that measures the amount of each type of cholesterol and certain fats in your blood. Cholesterol is needed to carry out functions such as hormone and vitamin production. High cholesterol can put you at risk for heart disease.
{"label":"Cholesterol reference range","scale":"lin","step":0.1,"hideunits":false,"items":[{"flag":"normal","label":{"short":"Desirable","long":"Desirable","orientation":"horizontal"},"values":{"min":125,"max":200},"text":"While cholesterol levels can vary widely among healthy individuals, total cholesterol levels below 200 milligrams per deciliter (mg\/dL) are considered most desirable.","conditions":[]},{"flag":"borderline","label":{"short":"Borderline high","long":"Borderline high","orientation":"horizontal"},"values":{"min":200,"max":240},"text":"High cholesterol generally means your total cholesterol is 200 mg\/dL or higher.","conditions":[]},{"flag":"abnormal","label":{"short":"High","long":"High","orientation":"horizontal"},"values":{"min":240,"max":400},"text":"Total cholesterol levels of 240 mg\/dL and higher may put people at high risk for cardiovascular disease.","conditions":["Hypercholesterolemia","Cardiovascular disease","Diabetes","Biliary cirrhosis","High-fat diet","Familial hyperlipidemia"]}],"units":[{"printSymbol":"mg\/dL","code":"mg\/dL","name":"milligram per deciliter"}],"value":162.5}[{"normal":0},{"borderline":0},{"abnormal":0}]
Use the slider below to see how your results affect your
health.
mg/dL
200
240
Your result is Desirable.
While cholesterol levels can vary widely among healthy individuals, total cholesterol levels below 200 milligrams per deciliter (mg/dL) are considered most desirable.
Related conditions
{"label":"HDL reference range","scale":"lin","step":0.1,"hideunits":false,"items":[{"flag":"abnormal","label":{"short":"Low","long":"Low","orientation":"horizontal"},"values":{"min":1,"max":40},"text":"HDL levels less than 40 mg\/dL for men and less than 50 mg\/dL for women are associated with an increased risk of heart disease.","conditions":["Cardiovascular disease","Atherosclerosis"]},{"flag":"normal","label":{"short":"Desirable","long":"Desirable","orientation":"horizontal"},"values":{"min":40,"max":60},"text":"HDL levels between 40-50 mg\/dL for men, and 50-60 mg\/dl for women, are associated with average risk of heart disease. The higher HDL levels, the better.","conditions":[]},{"flag":"normal","label":{"short":"Optimal","long":"Optimal","orientation":"horizontal"},"values":{"min":60,"max":160},"text":"HDL levels of 60 mg\/dL (milligrams per deciliter) or higher are associated with a less-than-average risk of heart disease.","conditions":[]}],"units":[{"printSymbol":"mg\/dL","code":"mg\/dL","name":"milligram per deciliter"}],"value":50}[{"abnormal":0},{"normal":0},{"normal":1}]
Use the slider below to see how your results affect your
health.
mg/dL
40
60
Your result is Desirable.
HDL levels between 40-50 mg/dL for men, and 50-60 mg/dl for women, are associated with average risk of heart disease. The higher HDL levels, the better.
Related conditions
{"label":"LDL reference range","scale":"lin","step":0.1,"hideunits":false,"items":[{"flag":"normal","label":{"short":"O","long":"Optimal","orientation":"horizontal"},"values":{"min":20,"max":100},"text":"The optimal level of LDL has changed over time and depends on the number of risk factors you have for heart disease and stroke. Generally, you want your LDL to be low. It's possible to have extremely low levels of LDL, but this is rare.","conditions":[]},{"flag":"normal","label":{"short":"NO","long":"Near optimal","orientation":"horizontal"},"values":{"min":100,"max":130},"text":"The optimal level of LDL has changed over time and depends on the number of risk factors you have for heart disease and stroke. You want your LDL to be low. Too much LDL is linked to heart disease and stroke.","conditions":[]},{"flag":"borderline","label":{"short":"BH","long":"Borderline high","orientation":"horizontal"},"values":{"min":130,"max":160},"text":"Borderline LDL represents the at-risk stage of developing high LDL. High LDL contributes to cardiovascular disease, which can cause a heart attack or stroke.","conditions":["Dyslipidemia"]},{"flag":"abnormal","label":{"short":"H","long":"High","orientation":"horizontal"},"values":{"min":160,"max":190},"text":"If you have a high LDL level, this means that you have too much LDL cholesterol in your blood. High LDL contributes to cardiovascular disease, which can cause a heart attack or stroke.","conditions":["Angina","Atherosclerosis","Dyslipidemia","Familial hypercholesterolemia","Heart attack","Metabolic syndrome","Peripheral artery disease","Stroke"]},{"flag":"abnormal","label":{"short":"VH","long":"Very high","orientation":"horizontal"},"values":{"min":190,"max":300},"text":"If you have a high LDL level, this means that you have too much LDL cholesterol in your blood. High LDL contributes to cardiovascular disease, which can cause a heart attack or stroke.","conditions":["Angina","Atherosclerosis","Dyslipidemia","Familial hypercholesterolemia","Heart attack","Metabolic syndrome","Peripheral artery disease","Stroke"]}],"units":[{"printSymbol":"mg\/dL","code":"mg\/dL","name":"milligram per deciliter"}],"value":60}[{"normal":1},{"normal":0},{"borderline":0},{"abnormal":0},{"abnormal":1}]
Use the slider below to see how your results affect your
health.
mg/dL
100
130
160
190
Your result is Optimal.
The optimal level of LDL has changed over time and depends on the number of risk factors you have for heart disease and stroke. Generally, you want your LDL to be low. It's possible to have extremely low levels of LDL, but this is rare.
Related conditions
A cholesterol test is a blood test that measures the amount of cholesterol and certain fats in your blood. Cholesterol is a waxy, fat-like substance that's found in your blood and every cell of your body. You need some cholesterol to keep your cells and organs healthy.
Your liver makes all the cholesterol your body needs. But you can also get cholesterol from the foods you eat, especially meat, eggs, poultry, and dairy products. Foods that are high in dietary fat can also make your liver produce more cholesterol.
There are two main types of cholesterol: low-density lipoprotein (LDL), or "bad" cholesterol, and high-density lipoprotein (HDL), or "good" cholesterol.
Too much LDL cholesterol in your blood increases your risk for coronary artery disease and other heart diseases. High LDL levels can cause the buildup of a sticky substance called plaque in your arteries. Over time, plaque can narrow your arteries or fully block them. When this happens, parts of your body don't get enough blood:
If the blood flow to the heart is blocked, it can cause a heart attack.
If the blood flow to the brain is blocked, it can cause a stroke.
If the blood flow to the arms or legs is blocked, it can cause peripheral artery disease.
Other names for a cholesterol test: Lipid profile, Lipid panel
A cholesterol test gives you and your health care provider important information about your risk of developing heart disease. If your test shows you have high cholesterol, you can take steps to lower it. This may decrease your risk of developing heart problems in the future. A cholesterol test measures:
LDL levels. Also known as the "bad" cholesterol, LDL is the main source of blockages in the arteries.
HDL levels. Considered the "good" cholesterol, HDL helps get rid of "bad" LDL cholesterol.
Total cholesterol. The combined amount of LDL cholesterol and HDL cholesterol in your blood.
Triglyceride levels. Triglycerides are a type of fat found in your blood. Some studies show that high levels of triglycerides may increase the risk of heart disease, especially in women.
VLDL levels. Very low-density lipoprotein (VLDL) is another type of "bad" cholesterol. High VLDL levels have been linked to plaque buildup in the arteries. VLDL isn't usually included in routine cholesterol tests because it's difficult to measure. About half of VLDL is triglycerides, so your VLDL level can be estimated as a percentage of your triglyceride level.
Your provider may order a cholesterol test as part of a routine exam. You may also have a cholesterol test if you have a family history of heart disease or if your risk for heart problems is high because of:
High blood pressure
Type 2 diabetes
Smoking
Excess weight or obesity
Lack of physical activity
A diet high in saturated fat
Your age may also be a factor, because your risk for heart disease increases as you get older.
A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.
You may be able to use an at-home kit to check your cholesterol levels. Your kit will include a device to prick your finger to collect a drop of blood for testing. Be sure to follow the kit instructions carefully. Also, be sure to tell your provider if your at-home test shows that your total cholesterol level is higher than 200 mg/dl.
You may need to fast (not eat or drink) for 9 to 12 hours before your blood cholesterol test. That's why the tests are often done in the morning. Your provider will let you know if you need to fast and if there are any other special instructions.
There is very little risk to having a blood test. You may experience slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.
Cholesterol is usually measured in milligrams (mg) of cholesterol per deciliter (dL) of blood. The information below will help you understand what your test results mean. In general, low LDL levels and high HDL cholesterol levels are good for heart health.
Total cholesterol
Total Cholesterol Level
Category
Less than 200mg/dL
Desirable
200-239 mg/dL
Borderline high
240mg/dL and above
High
LDL (bad) cholesterol
LDL (Bad) Cholesterol Level
LDL Cholesterol Category
Less than 100mg/dL
Optimal (best for your health)
100-129mg/dL
Near optimal
130-159 mg/dL
Borderline high
160-189 mg/dL
High
190 mg/dL and above
Very High
HDL (good) cholesterol
HDL (Good) Cholesterol Level
HDL Cholesterol Category
60 mg/dL and higher
Considered protective against heart disease
40-59 mg/dL
The higher, the better
Less than 40 mg/dL
A major risk factor for heart disease
The LDL listed on your results may say "calculated." This means that your LDL level is an estimate based on your total cholesterol, HDL, and triglycerides. Your LDL level may also be measured "directly" from your blood sample. Either way, you want your LDL number to be low.
A healthy cholesterol level for you may depend on your age, family history, lifestyle, and other risk factors for heart disease, such as high triglyceride levels. Your provider can explain what's right for you.
High cholesterol can lead to heart disease, the number one cause of death in the United States. You can't change some risk factors for high cholesterol, such as age and your genes. But there are actions you can take to lower your LDL levels and reduce your risk, including:
Eating a healthy diet. Reducing or avoiding foods high in saturated fat and cholesterol can help reduce the cholesterol levels in your blood.
Losing weight. Being overweight can increase your cholesterol and risk for heart disease.
Staying active. Regular exercise may help lower your LDL (bad) cholesterol levels and raise your HDL (good) cholesterol levels. It may also help you lose weight.
Talk to your provider before making any major change in your diet or exercise routine.
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (12)
Total Cholesterol: Heart
The heart beats about 100,000 times a day, pumping blood through a vast system of arteries, veins and microscopic capillaries. While many risk factors for cardiovascular disease, including cholesterol levels, are related to lifestyle, others are largely genetic.
Image by TheVisualMD
Total Cholesterol: Heart and Liver
The liver produces most of the body's cholesterol in order to package fats in the form of lipoproteins. HDL is referred to as \"good\" cholesterol because it picks up excess cholesterol in the bloodstream and carries it back to the liver for disposal.
Image by TheVisualMD
Total Cholesterol: Thrombus
Thrombosis is the formation of a blood clot (thrombus) inside a blood vessel. If the clot is large or persistent enough, it can obstruct blood flow, which can starve tissue of oxygen-carrying blood. Most strokes are the result of thrombosis.
Image by TheVisualMD
This browser does not support the video element.
Lipids, Heart Health and Baselining Your Health
Your blood "knows" what you eat, meaning that the cardiovascular system is a sensitive barometer of a person's health, including diet. What individuals eat is reflected in their blood chemistry and the health of their heart, arteries and vessels. Fats (also known as lipids), for example, are vital to health and wellbeing throughout our lives and yet they are mostly associated with obesity and cardiovascular disease. The problem is that not all fats (or cholesterol) are equal. They share basic chemical similarities, but they also have important differences, which, in turn, result in different roles and effects in the body. Tests that offer information on diet and heart health include total cholesterol, low-density lipoprotein (LDL or "bad" cholesterol), high-density lipoprotein (HDL or "good" cholesterol), and triglycerides.
Video by TheVisualMD
This browser does not support the video element.
What Is Atherosclerosis?
Voyage inside your body to see where cholesterol is made and how plaques form inside your arteries. Witness the inner workings of your own personal cholesterol factory: your liver. Dr. Mehmet Oz, Dr. Peter Fail, and other top experts talk about cholesterol-how it accumulates with other substances in your arteries as plaque, and what happens when plaques rupture. See exactly how tiny stents are inserted in blocked vessels, and view footage of actual bypass surgery. Discover how you can keep your arteries clear and flexible through lifestyle changes and medications.
Video by TheVisualMD
What cholesterol is and what cholesterol blood tests show
Video by Bupa Health UK/YouTube
Cholesterol Blood Test
Video by Baptist Health Physician Partners/YouTube
Cholesterol - what is it and how can you prevent high cholesterol?
Video by Healthchanneltv / cherishyourhealthtv/YouTube
Cholesterol Good and Bad
Video by The National Library of Medicine/YouTube
This browser does not support the video element.
What Is HDL and LDL Cholesterol?
This video explains the difference between HDL and LDL cholesterol. It also reveals what may occur when there are high levels of LDL in the body.LDL may stick to an artery's inner wall causing the build up of plaque, affecting blood flow. When an artery stiffens and constricts, aneurysm, heart attack, and stroke can occur.
Video by TheVisualMD
This browser does not support the video element.
Refined Carbohydrates and Atherosclerosis
Refined Carbohydrates and Atherosclerosis : In atherosclerosis, hard, fatty deposits called plaque build up inside your arteries. For decades it was thought that eating too many fatty foods, especially foods rich in cholesterol, was to blame for plaque accumulation.
Video by TheVisualMD
This browser does not support the video element.
Cardiovascular Inflammation
Heart disease is the number one killer of men and women in the U.S. The most common cause of heart attack, stroke, and cardiovascular death is atherosclerosis. Atherosclerosis is a chronic inflammatory response in the walls of arteries that leads to the hardening of arterial walls and the buildup of fatty deposits called plaques, or atheromas. Although the process of inflammation can be beneficial in other parts of the body, chronic inflammation within arterial walls is problematic as it seems to promote this underlying growth of plaque. The combination of arterial inflammation and the growth of plaque can lead to the rupture of the plaque, and result in a blood clot. Blood clots can lead to dangerous conditions such as heart attack or stroke.
Video by TheVisualMD
Total Cholesterol: Heart
TheVisualMD
Total Cholesterol: Heart and Liver
TheVisualMD
Total Cholesterol: Thrombus
TheVisualMD
2:46
Lipids, Heart Health and Baselining Your Health
TheVisualMD
3:10
What Is Atherosclerosis?
TheVisualMD
3:53
What cholesterol is and what cholesterol blood tests show
Bupa Health UK/YouTube
3:06
Cholesterol Blood Test
Baptist Health Physician Partners/YouTube
2:42
Cholesterol - what is it and how can you prevent high cholesterol?
Healthchanneltv / cherishyourhealthtv/YouTube
3:01
Cholesterol Good and Bad
The National Library of Medicine/YouTube
0:45
What Is HDL and LDL Cholesterol?
TheVisualMD
2:21
Refined Carbohydrates and Atherosclerosis
TheVisualMD
4:26
Cardiovascular Inflammation
TheVisualMD
High-Density Lipoprotein Test
High-Density Lipoprotein Test
Also called: HDL, HDL-C, HDL Cholesterol, High-Density Lipoprotein Cholesterol
HDL, or high-density lipoprotein, is the "good" cholesterol. It helps to remove bad cholesterol from your arteries, so a higher HDL level is better.
High-Density Lipoprotein Test
Also called: HDL, HDL-C, HDL Cholesterol, High-Density Lipoprotein Cholesterol
HDL, or high-density lipoprotein, is the "good" cholesterol. It helps to remove bad cholesterol from your arteries, so a higher HDL level is better.
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Use the slider below to see how your results affect your
health.
mg/dL
40
60
Your result is Desirable.
HDL levels between 40-50 mg/dL for men, and 50-60 mg/dl for women, are associated with average risk of heart disease. The higher HDL levels, the better.
Related conditions
Cholesterol is a waxy, fat-like substance that's found in all the cells in your body. Your liver makes cholesterol, and it is also in some foods, such as meat and dairy products. Your body needs some cholesterol to work properly. But having too much cholesterol in your blood raises your risk of coronary artery disease.
HDL and LDL are two types of lipoproteins.They are a combination of fat (lipid) and protein. The lipids need to be attached to the proteins so they can move through the blood. HDL and LDL have different purposes:
HDL stands for high-density lipoproteins. It is sometimes called the "good" cholesterol because it carries cholesterol from other parts of your body back to your liver. Your liver then removes the cholesterol from your body.
LDL stands for low-density lipoproteins. It is sometimes called the "bad" cholesterol because a high LDL level leads to a buildup of cholesterol in your arteries.
A blood test can measure your cholesterol levels, including HDL. When and how often you should get this test depends on your age, risk factors, and family history. The general recommendations are:
For people who are age 19 or younger:
The first test should be between ages 9 to 11
Children should have the test again every 5 years
Some children may have this test starting at age 2 if there is a family history of high blood cholesterol, heart attack, or stroke
For people who are age 20 or older:
Younger adults should have the test every 5 years
Men ages 45 to 65 and women ages 55 to 65 should have it every 1 to 2 years
With HDL cholesterol, higher numbers are better, because a high HDL level can lower your risk for coronary artery disease and stroke. How high your HDL should be depends on your age and sex:
Group
Healthy HDL Level
Age 19 or younger
More than 45mg/dl
Men age 20 or older
More than 40mg/dl
Women age 20 or older
More than 50mg/dl
If your HDL level is too low, lifestyle changes may help. These changes may also help prevent other diseases, and make you feel better overall:
Eat a healthy diet. To raise your HDL level, you need to eat good fats instead of bad fats. This means limiting saturated fats, which include full-fat milk and cheese, high-fat meats like sausage and bacon, and foods made with butter, lard, and shortening. You should also avoid trans fats, which may be in some margarines, fried foods, and processed foods like baked goods. Instead, eat unsaturated fats, which are found in avocado, vegetable oils like olive oil, and nuts. Limit carbohydrates, especially sugar. Also try to eat more foods naturally high in fiber, such as oatmeal and beans.
Stay at a healthy weight. You can boost your HDL level by losing weight, especially if you have lots of fat around your waist.
Exercise. Getting regular exercise can raise your HDL level, as well as lower your LDL. You should try to do 30 minutes of moderate to vigorous aerobic exercise on most, if not all, days.
Avoid cigarettes. Smoking and exposure to secondhand smoke can lower your HDL level. If you are a smoker, ask your health care provider for help in finding the best way for you to quit. You should also try to avoid secondhand smoke.
Limit alcohol. Moderate alcohol may lower your HDL level, although more studies are needed to confirm that. What we do know is that too much alcohol can make you gain weight, and that lowers your HDL level.
Some cholesterol medicines, including certain statins, can raise your HDL level, in addition to lowering your LDL level. Health care providers don't usually prescribe medicines only to raise HDL. But if you have a low HDL and high LDL level, you might need medicine.
Taking certain medicines can lower HDL levels in some people. They include
Beta blockers, a type of blood pressure medicine
Anabolic steroids, including testosterone, a male hormone
Progestins, which are female hormones that are in some birth control pills and hormone replacement therapy
Benzodiazepines, sedatives that are often used for anxiety and insomnia
If you are taking one of these and you have a very low HDL level, ask your provider if you should continue to take them.
Diabetes can also lower your HDL level, so that gives you another reason to manage your diabetes.
HDL: The "Good" Cholesterol: MedlinePlus [accessed on Oct 08, 2018]
Cholesterol Levels: What You Need to Know: MedlinePlus [accessed on Oct 08, 2018]
High blood cholesterol levels: MedlinePlus Medical Encyclopedia [accessed on Oct 08, 2018]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (21)
HDL and LDL Molecules Subfractionization
The standard lipid profile, which measures the quantity of LDL and HDL cholesterol in the blood stream, has proven itself to be very useful in identifying many people who are risk for heart disease. But it doesn't catch everyone at risk. A more detailed lipid profile, called lipoprotein subfraction testing, divides the basic cholesterol groups into finer categories, which makes possible more accurate risk assessment. This interactive features all of the different tests involved in a lipid panel- HDL, LDL and VLDL, and the different subclasses for each.
Image by TheVisualMD
LDL particle
LDL (low-density lipoprotein or \"bad cholesterol\") along with HDL (high-density lipoprotein or \"good cholesterol\") are the two main types of cholesterol particles in the bloodstream. LDL is referred to as \"bad\" cholesterol because it forms deposits (plaque) in the lining of blood vessels. The size and density of the lipoprotein determines whether its cholesterol is classified as \"good: or \"bad\". Low-density lipoproteins (LDL) are larger, lighter, and fluffier; high-density lipoproteins (HDL) are small and dense. An LDL test is part of a lipid panel that measures total cholesterol, LDL, HDL, and triglycerides. Cholesterol tests do not diagnose heart disease; instead, they are used to estimate risk. And while cholesterol levels can vary widely among healthy individuals, the evidence suggests that low levels of LDL cholesterol decrease the risk of heart disease and stroke, while high levels of LDL increase that risk.
Image by TheVisualMD
Cholesterol, Healthy Heart
A heart-healthy lifestyle includes a diet based on the principles of balance, variety and moderation in the consumption of fats. Fats are essential nutrients and critical building blocks. The type of fat in a diet, however, turns out to be even more important than the total amount; there are \"good\" fats and \"bad\" dietary fats, just as there are \"good\" and \"bad\" types of cholesterol in our bloodstream. Other keys to cardiovascular health and wellbeing: get aerobic exercise, don't smoke, and drink alcohol only in moderation.
Image by TheVisualMD
Aerobic athletes in general, particularly lean ones, have lower LDL (or "bad" cholesterol) levels
There are many factors that can potentially influence cholesterol levels. Exercise may be an important one, though evidence is not definitive; studies have shown that endurance athletes have higher HDL (or \"good\" cholesterol) levels, and aerobic athletes in general, particularly lean ones, have lower LDL (or \"bad\" cholesterol) levels.
Image by TheVisualMD
Cross-Section View of HDL Lipoprotein
This image shows a cross-section of a globule of High Density-Lipoprotein (HDL). HDL has a large amount of protein, which makes it denser than other lipoproteins. The purple area shows protein content (33-57%), the off-white shell shows phospholipids (26-43%), and the yellow and red interior shows cholesterol (17-40%) and triglycerides (3-15%). HDL supplies two other lipoproteins-chylomicrons and VLDLs-with proteins that signal the liver to trap and extract their fat. HDL also sponges up excess cholesterol from blood vessel linings and carries it to the liver for removal. This reduces the risk of plaque build-up in the arteries and gives HDL its nickname \"good\" cholesterol.
Image by TheVisualMD
Cholesterol, Atherosclerotic Heart Disease
Atherosclerosis is a disease in which fatty deposits called plaque build up inside arteries; one of the components of plaque is LDL or \"bad\" cholesterol. Over time, plaque narrows the arteries, which limits the flow of oxygen-rich blood to the body; plaque in coronary arteries restricts blood supply to the heart. Plaque also makes the arterial walls stiff and less elastic, which is why a common term for artherosclerosis is \"hardening\" of the arteries. To try to clean up the mess, the endothelial cells that make up the inner lining send out chemical signals that summon inflammatory cells. These cells invade the area and engulf the fatty molecules, leaving behind the fatty streaks. If the levels of cholesterol don't drop, the buildup continues. The fats start to accumulate faster than the cleanup process can remove them and develop into noticeable deposits known as plaque. As the plaques grow, so do the problems. The bulging plaque reduces the diameter of the arteries, which decreases blood flow and increases blood pressure. As a defense, the arteries start shoring up, making more support cells to cope with the rising blood pressure. The arteries become less flexible; hence the description of the condition as hardening of the arteries.
Image by TheVisualMD
Cholesterol pathway
Cholesterol is essential for the maintenance of cell membranes, production of sex hormones, and absorption of key vitamins. We get cholesterol from the foods we eat (particularly red meat, dairy and eggs), but our livers produce most of it in a multi-step process (drugs like statins interrupt this process). Cholesterol is carried in the bloodstream in specialized packages called lipoproteins.
Image by TheVisualMD
Cholesterol Traveling Through Cell Membrane to HDL
This image shows the healthy membrane of an endothelial cell in a blood vessel wall. You can see the semi-permeable double layer of phospholipids that allows lipids to move across the membrane. The cholesterol molecules (yellow) maintain permeability by keeping the phospholipid tails from sticking together. Excess cholesterol molecules are passing through the phospholipid bilayer through passive, aqueous diffusion to a mature high-denisty lipoprotein (HDL) molecule. HDL is considered \"good\" cholesterol. The cell membrane benefits from this interaction with HDL and now has less cholesterol in the membrane. The HDL molecule carries the cholesterol away and back to the liver for recycling or degradation.
Image by TheVisualMD
High-Density Lipoprotein (HDL) Molecule
High-density lipoproteins, abbreviated HDL, are small and dense protein spheres that transport cholesterol, triglyceride, and other lipids through the bloodstream. Because the density of a protein bundle is associated with its ability to gather cholesterol from cells and transport it to the liver for eventual elimination, high-density lipoproteins are commonly referred to as the \"good\" cholesterol. A heart-healthy diet is rich in HDL sources. Wholesome foods that deliver Omega-3 fatty acids, antioxidants, and soluble fibers can raise HDL levels and provide numerous health benefits, including the warding off of life-threatening diseases.
Image by TheVisualMD
This browser does not support the video element.
What Is HDL and LDL Cholesterol?
This video explains the difference between HDL and LDL cholesterol. It also reveals what may occur when there are high levels of LDL in the body.LDL may stick to an artery's inner wall causing the build up of plaque, affecting blood flow. When an artery stiffens and constricts, aneurysm, heart attack, and stroke can occur.
Video by TheVisualMD
This browser does not support the video element.
Cardiovascular Inflammation
Heart disease is the number one killer of men and women in the U.S. The most common cause of heart attack, stroke, and cardiovascular death is atherosclerosis. Atherosclerosis is a chronic inflammatory response in the walls of arteries that leads to the hardening of arterial walls and the buildup of fatty deposits called plaques, or atheromas. Although the process of inflammation can be beneficial in other parts of the body, chronic inflammation within arterial walls is problematic as it seems to promote this underlying growth of plaque. The combination of arterial inflammation and the growth of plaque can lead to the rupture of the plaque, and result in a blood clot. Blood clots can lead to dangerous conditions such as heart attack or stroke.
Video by TheVisualMD
This browser does not support the video element.
Lipids, Heart Health and Baselining Your Health
Your blood "knows" what you eat, meaning that the cardiovascular system is a sensitive barometer of a person's health, including diet. What individuals eat is reflected in their blood chemistry and the health of their heart, arteries and vessels. Fats (also known as lipids), for example, are vital to health and wellbeing throughout our lives and yet they are mostly associated with obesity and cardiovascular disease. The problem is that not all fats (or cholesterol) are equal. They share basic chemical similarities, but they also have important differences, which, in turn, result in different roles and effects in the body. Tests that offer information on diet and heart health include total cholesterol, low-density lipoprotein (LDL or "bad" cholesterol), high-density lipoprotein (HDL or "good" cholesterol), and triglycerides.
Video by TheVisualMD
The 5 Most Important Molecules in Your Body
Video by SciShow/YouTube
Cholesterol Blood Test
Video by Baptist Health Physician Partners/YouTube
High Cholesterol Medical Animation (Hyperlipidemia)
Video by Silverback Video/YouTube
British Heart Foundation - Cholesterol and heart disease
Video by British Heart Foundation/YouTube
HDL: When Good Cholesterol Goes Bad
Video by UW Video/YouTube
Lipid Panel Interpretation
Video by FatIsNotYourFault/YouTube
Triglycerides and HDL
Video by Joslin Diabetes Center/YouTube
Tri HDL
Video by ACAP Health/YouTube
HDL Molecule
HDL Molecule
Image by TheVisualMD
HDL and LDL Molecules Subfractionization
TheVisualMD
LDL particle
TheVisualMD
Cholesterol, Healthy Heart
TheVisualMD
Aerobic athletes in general, particularly lean ones, have lower LDL (or "bad" cholesterol) levels
TheVisualMD
Cross-Section View of HDL Lipoprotein
TheVisualMD
Cholesterol, Atherosclerotic Heart Disease
TheVisualMD
Cholesterol pathway
TheVisualMD
Cholesterol Traveling Through Cell Membrane to HDL
TheVisualMD
High-Density Lipoprotein (HDL) Molecule
TheVisualMD
0:45
What Is HDL and LDL Cholesterol?
TheVisualMD
4:26
Cardiovascular Inflammation
TheVisualMD
2:46
Lipids, Heart Health and Baselining Your Health
TheVisualMD
7:55
The 5 Most Important Molecules in Your Body
SciShow/YouTube
3:06
Cholesterol Blood Test
Baptist Health Physician Partners/YouTube
1:19
High Cholesterol Medical Animation (Hyperlipidemia)
Silverback Video/YouTube
6:23
British Heart Foundation - Cholesterol and heart disease
British Heart Foundation/YouTube
54:59
HDL: When Good Cholesterol Goes Bad
UW Video/YouTube
1:16:38
Lipid Panel Interpretation
FatIsNotYourFault/YouTube
3:25
Triglycerides and HDL
Joslin Diabetes Center/YouTube
2:17
Tri HDL
ACAP Health/YouTube
HDL Molecule
TheVisualMD
Low Density Lipoprotein Test
Low Density Lipoprotein Test
Also called: LDL, LDL-C, LDL Cholesterol, Low-Density Lipoprotein Cholesterol
LDL, or low-density lipoprotein, is the "bad" cholesterol. A high LDL level can lead to a buildup of cholesterol in your arteries. Too much LDL is linked to heart disease and stroke.
Low Density Lipoprotein Test
Also called: LDL, LDL-C, LDL Cholesterol, Low-Density Lipoprotein Cholesterol
LDL, or low-density lipoprotein, is the "bad" cholesterol. A high LDL level can lead to a buildup of cholesterol in your arteries. Too much LDL is linked to heart disease and stroke.
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Use the slider below to see how your results affect your
health.
mg/dL
100
130
160
190
Your result is Optimal.
The optimal level of LDL has changed over time and depends on the number of risk factors you have for heart disease and stroke. Generally, you want your LDL to be low. It's possible to have extremely low levels of LDL, but this is rare.
Related conditions
Cholesterol is a waxy, fat-like substance that's found in all the cells in your body. Your liver makes cholesterol, and it is also in some foods, such as meat and dairy products. Your body needs some cholesterol to work properly. But having too much cholesterol in your blood raises your risk of coronary artery disease.
LDL and HDL are two types of lipoproteins. They are a combination of fat (lipid) and protein. The lipids need to be attached to the proteins so they can move through the blood. LDL and HDL have different purposes:
LDL stands for low-density lipoproteins. It is sometimes called the "bad" cholesterol because a high LDL level leads to a buildup of cholesterol in your arteries.
HDL stands for high-density lipoproteins. It is sometimes called the "good" cholesterol because it carries cholesterol from other parts of your body back to your liver. Your liver then removes the cholesterol from your body.
If you have a high LDL level, this means that you have too much LDL cholesterol in your blood. This extra LDL, along with other substances, forms plaque. The plaque builds up in your arteries; this is a condition called atherosclerosis.
Coronary artery disease happens when the plaque buildup is in the arteries of your heart. It causes the arteries to become hardened and narrowed, which slows down or blocks the blood flow to your heart. Since your blood carries oxygen to your heart, this means that your heart may not be able to get enough oxygen. This can cause angina (chest pain), or if the blood flow is completely blocked, a heart attack.
A blood test can measure your cholesterol levels, including LDL. When and how often you should get this test depends on your age, risk factors, and family history. The general recommendations are:
For people who are age 19 or younger:
The first test should be between ages 9 to 11
Children should have the test again every 5 years
Some children may have this test starting at age 2 if there is a family history of high blood cholesterol, heart attack, or stroke
For people who are age 20 or older:
Younger adults should have the test every 5 years
Men ages 45 to 65 and women ages 55 to 65 should have it every 1 to 2 years
Things that can affect your LDL level include
Diet. Saturated fat and cholesterol in the food you eat make your blood cholesterol level rise
Weight. Being overweight tends to raise your LDL level, lower your HDL level, and increase your total cholesterol level
Physical Activity. A lack of physical activity can lead to weight gain, which can raise your LDL level
Smoking. Cigarette smoking lowers your HDL cholesterol. Since HDL helps to remove LDL from your arteries, if you have less HDL, that can contribute to you having a higher LDL level.
Age and Gender. As women and men get older, their cholesterol levels rise. Before the age of menopause, women have lower total cholesterol levels than men of the same age. After the age of menopause, women's LDL levels tend to rise.
Genetics. Your genes partly determine how much cholesterol your body makes. High cholesterol can run in families. For example, familial hypercholesterolemia (FH) is an inherited form of high blood cholesterol.
Medicines. Certain medicines, including steroids, some blood pressure medicines, and HIV/AIDS medicines, can raise your LDL level.
Other medical conditions. Diseases such as chronic kidney disease, diabetes, and HIV/AIDS can cause a higher LDL level.
Race. Certain races may have an increased risk of high blood cholesterol. For example, African Americans typically have higher HDL and LDL cholesterol levels than whites.
With LDL cholesterol, lower numbers are better, because a high LDL level can raise your risk for coronary artery disease and related problems:
LDL (Bad) Cholesterol Level
LDL Cholesterol Category
Less than 100mg/dL
Optimal
100-129mg/dL
Near optimal/above optimal
130-159 mg/dL
Borderline high
160-189 mg/dL
High
190 mg/dL and above
Very High
There are two main ways to lower your LDL cholesterol:
Therapeutic lifestyle changes (TLC). TLC includes three parts:
Heart-healthy eating. A heart-healthy eating plan limits the amount of saturated and trans fats that you eat. Examples of eating plans that can lower your cholesterol include the Therapeutic Lifestyle Changes diet and the DASH eating plan.
Weight Management. If you are overweight, losing weight can help lower your LDL cholesterol.
Physical Activity. Everyone should get regular physical activity (30 minutes on most, if not all, days).
Drug Treatment. If lifestyle changes alone do not lower your cholesterol enough, you may also need to take medicines. There are several types of cholesterol-lowering drugs available, including statins. The medicines work in different ways and can have different side effects. Talk to your health care provider about which one is right for you. While you are taking medicines to lower your cholesterol, you still should continue with the lifestyle changes.
Some people with familial hypercholesterolemia (FH) may receive a treatment called lipoprotein apheresis. This treatment uses a filtering machine to remove LDL cholesterol from the blood. Then the machine returns the rest of the blood back to the person.
https://medlineplus.gov/ldlthebadcholesterol.html [accessed on Mar 01, 2019]
https://medlineplus.gov/ency/patientinstructions/000386.htm [accessed on Mar 01, 2019]
https://labtestsonline.org/tests/ldl-cholesterol [accessed on Mar 01, 2019]
https://my.clevelandclinic.org/health/articles/11920-cholesterol-numbers-what-do-they-mean [accessed on Mar 01, 2019]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (18)
Lipids and Lipoproteins
Lipids and Lipoproteins
Image by TheVisualMD
Lipid Absorption
Lipid Absorption
Image by OpenStax College
Cholesterol
Cholesterol is a soft, waxy, fatty substance that's found naturally in every cell in your body. It's categorized as a lipid-that is, a fat, oil, or wax that won't dissolve in water. Cholesterol is necessary for your body's health because it helps to make cell membranes, digest fats, and produce vitamin D and various steroid hormones. Your bloodstream transports cholesterol throughout your body bound to water-soluble particles called lipoproteins.
Image by TheVisualMD
Lipids & Fats
Image by TheVisualMD
Lipids & Fats
Lipids & Fats
Image by TheVisualMD
Anatomy of a Lipoprotein
Lipoproteins transport cholesterol, triglycerides, or other lipids through the bloodstream. Lipoproteins are protein spheres that consist of a core of triglycerides and cholesterol esters, surrounded by a shell made up of water-soluble phospholipids with embedded proteins and cholesterol. The lipid-laden core of the lipoprotein is insoluble in aqueous (water-based) blood, so the phospholipid-protein shell is necessary to allow the lipoprotein to float freely in the bloodstream.
Image by TheVisualMD
Anatomy of a Lipoprotein
Lipoproteins transport cholesterol, triglycerides, or other lipids through the bloodstream. Lipoproteins are protein spheres that consist of a core of triglycerides and cholesterol esters, surrounded by a shell made up of water-soluble phospholipids with embedded proteins and cholesterol. The lipid-laden core of the lipoprotein is insoluble in aqueous (water-based) blood, so the phospholipid-protein shell is necessary to allow the lipoprotein to float freely in the bloodstream.
Image by TheVisualMD
Dr. Tara Dall discusses LDL, LDL Cholesterol (LDL-C) & LDL Particles (LDL-P)
Video by AdvLip/YouTube
What Is HDL and LDL Cholesterol?
This video explains the difference between HDL and LDL cholesterol. It also reveals what may occur when there are high levels of LDL in the body.LDL may stick to an artery's inner wall causing the build up of plaque, affecting blood flow. When an artery stiffens and constricts, aneurysm, heart attack, and stroke can occur.
Image by TheVisualMD
The New Marker for Heart Disease that is BETTER than LDL Cholesterol
Video by Dr. Adrian Chavez/YouTube
% Small Dense LDL Cholesterol
The predominance of small, dense low-density lipoprotein (LDL) is now recognized as a serious cardiovascular risk factor by the National Cholesterol Education Program Adult Treatment Panel. Research showed that the predominance of small, dense LDL is associated with an increased risk of coronary artery disease (CAD).
Image by TheVisualMD
This browser does not support the video element.
What Is HDL and LDL Cholesterol?
This video explains the difference between HDL and LDL cholesterol. It also reveals what may occur when there are high levels of LDL in the body.LDL may stick to an artery's inner wall causing the build up of plaque, affecting blood flow. When an artery stiffens and constricts, aneurysm, heart attack, and stroke can occur.
Video by TheVisualMD
HDL and LDL Cholesterol Sub-fraction, Heart Disease
The standard lipid profile, which measures the quantity of LDL (\"bad\") and HDL (\"good\") cholesterol in the bloodstream, has proven itself to be useful in identifying many people who are at risk for heart disease. But it doesn't catch everyone at risk. A more detailed lipid profile, called lipoprotein sub-fraction testing, categorizes cholesterol particles according to their size and density. Such testing is more sensitive and is especially useful for people who have a strong family history of heart disease. Heart attack (myocardial infarction) is a condition when blood flow to the heart is reduced or blocked. Heart cells die when the blood supply is cut off; the longer the blood supply is cut off, the greater the area of heart damage.
Image by TheVisualMD
Low Density Lipoprotein: Arterial Wall
It's estimated that there are nearly 100,000 miles of arteries in an adult body. The walls of these arteries are composed of fibroblasts, smooth muscle cells, elastica interna, and an endothelial cell layer.
Image by TheVisualMD
Low Density Lipoprotein: Clogged Arteries (Atherosclerosis) / Plaque in Coronary Artery, close up
Plaque in Coronary Artery / Leading to a Heart Attack
1) Plaque in Coronary Artery - In this image, a tiny coronary artery has been cross-sectioned to reveal a stenosis, or narrowing, caused by fatty deposits in the blood stream. Plaque in a coronary artery may break apart, and the resulting release of platelet adhesion-enhancing substances encourages clots to form on the plaque surface. The clot may then block the flow of blood through the already narrowed artery. Having this condition present in the coronary arteries is particularly dangerous because these are the arteries that wrap around the surface of the heart and supply the organ itself with oxygen and nutrients needed to pump blood to the entire body.
2) Leading to a Heart Attack - In this image, a tiny coronary artery has been cross-sectioned to reveal a stenosis, or narrowing, caused by fatty deposits in the blood stream. It is evident that this stenosis has advanced such that tissue necrosis, or death, has occurred in the area upstream from the blockage. Plaque in a coronary artery may break apart, and the resulting release of platelet adhesion-enhancing substances encourages clots to form on the plaque surface. The clot may then block the flow of blood through the already narrowed artery. Having this condition present in the coronary arteries is particularly dangerous because these are the arteries that wrap around the surface of the heart and supply the organ itself with oxygen and nutrients needed to pump blood to the entire body. This heart has been severely injured and the individual is at a high risk for heart attack.
Lp-PLA2 (or lipoprotein-associated phospholipase A2) is an enzyme produced by specialized immune cells called macrophages that engulf and destroy pathogens, foreign particles, aging cells and biological debris. Most of the Lp-PLA2 in the body is bound to LDL (or `bad` cholesterol) and the enzyme, like LDL, is linked to inflammation and the formation of plaques on blood vessel walls. Because Lp-PLA2 is very specifically linked to inflammation of blood vessels rather than inflammation that is systemic (throughout the body), it is a particularly good biomarker for vessel health.
Image by TheVisualMD
Oleic Acid Molecule
Oleic acid is a monounsaturated Omega-9 fatty acid found in animal and vegetable fats. Monounsaturated fats have one double bond between carbon atoms in the chain and polyunsaturated fats have more than one double bond. These fats lower the risk of heart disease by reducing levels of low-density lipoprotein (LDL, or "bad" cholesterol) in the blood. In this model, carbon atoms are dark gray, hydrogen atoms are white, and oxygen atoms are red. Interactive also available on white background.
Image by TheVisualMD
Lipoprotein(a) Molecule
The test for Lipoprotein(a) is used to help assess an individual's risk of developing cardiovascular disease. Unlike other risk factors for heart disease, however, Lp(a) levels are largely genetically determined and remain fairly stable over a person's life; they are also relatively resistant to treatment by either lifestyle changes or drugs. So why test for it? Because it is additional risk factor that can flag patients and their doctors to take an aggressive approach towards other, more treatable risk factors.
Image by TheVisualMD
Lipids and Lipoproteins
TheVisualMD
Lipid Absorption
OpenStax College
Cholesterol
TheVisualMD
Lipids & Fats
TheVisualMD
Lipids & Fats
TheVisualMD
Anatomy of a Lipoprotein
TheVisualMD
Anatomy of a Lipoprotein
TheVisualMD
8:37
Dr. Tara Dall discusses LDL, LDL Cholesterol (LDL-C) & LDL Particles (LDL-P)
AdvLip/YouTube
What Is HDL and LDL Cholesterol?
TheVisualMD
5:19
The New Marker for Heart Disease that is BETTER than LDL Cholesterol
Dr. Adrian Chavez/YouTube
% Small Dense LDL Cholesterol
TheVisualMD
0:45
What Is HDL and LDL Cholesterol?
TheVisualMD
HDL and LDL Cholesterol Sub-fraction, Heart Disease
TheVisualMD
Low Density Lipoprotein: Arterial Wall
TheVisualMD
Plaque in Coronary Artery / Leading to a Heart Attack
A triglycerides test measures the amount of triglycerides in your blood. High triglyceride levels may put you at risk for heart disease. The test is usually part of a lipid profile.
Triglycerides Test
Also called: TRIG
A triglycerides test measures the amount of triglycerides in your blood. High triglyceride levels may put you at risk for heart disease. The test is usually part of a lipid profile.
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Use the slider below to see how your results affect your
health.
mg/dL
150
200
500
Your result is Optimal.
For adults, triglyceride levels less than 150 mg/dL (milligrams per deciliter) are considered optimal.
Related conditions
A triglycerides test measures the amount of triglycerides in your blood. Triglycerides are a type of fat in your body. If you eat more calories than you need, the extra calories are changed into triglycerides. These triglycerides are stored in your fat cells for later use. When your body needs energy, triglycerides are released into your bloodstream to provide fuel for your muscles to work. If you eat more calories than you burn off, especially calories from carbohydrates and fats, you may get high triglyceride levels in your blood. High triglycerides may put you at greater risk for a heart attack or stroke.
A triglycerides test is usually part of a lipid profile. Lipid is another word for fat. A lipid profile is a test that measures the level of fats in your blood, including triglycerides and cholesterol, a waxy, fatty substance found in every cell of your body. If you have high levels of both LDL (bad) cholesterol and triglycerides, you may be at an increased risk for a heart attack or stroke.
Your health care provider may order a lipid profile as part of a routine exam or to diagnose or monitor heart conditions.
Healthy adults should get a lipid profile, which includes a triglycerides test, every four to six years. You may need to be tested more often if you have certain risk factors for heart disease. These include:
Family history of heart disease
Smoking
Being overweight
Unhealthy eating habits
Lack of exercise
Diabetes
High blood pressure
Age. Men 45 years or older and women 50 years or older are at a higher risk for heart disease
A triglycerides test is a blood test. During the test, a health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.
You may need to fast (not food or drink) for 9 to 12 hours before your blood is drawn. Your health care provider will let you know if you need to fast and if there are any special instructions to follow.
There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.
Triglycerides are usually measured in milligrams (mg) of triglycerides per deciliter (dL) of blood. For adults, results are usually categorized as:
Normal/desirable triglyceride range: less than 150mg/dL
Borderline high triglyceride range: 150 to 199 mg/dL
High triglyceride range: 200 to 499 mg/dL
Very high triglyceride range: 500 mg/dL and above
Higher than normal triglyceride levels may put you at risk for heart disease. To reduce your levels and lower your risk, your health care provider may recommend lifestyle changes and/or prescribe medicines.
If your results were borderline high, your provider may recommend that you:
Lose weight
Eat a healthier diet
Get more exercise
Reduce alcohol intake
Take a cholesterol lowering medicine
If your results were high or very high, your provider may recommend the same lifestyle changes as above and also that you:
Follow a very low-fat diet
Lose a significant amount of weight
Take medicine or medicines designed to lower triglycerides
Be sure to talk to your health care provider before making any major changes to your diet or exercise routine.
Triglycerides Test: MedlinePlus Medical Test [accessed on May 17, 2022]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (39)
Triglycerides
A Triglyceride model showing the positions of Sn1, Sn2 and Sn3, fatty acids, and the glycerol backbone
Image by Roger Daniels, Bunge Oils Director of Research & Development
Excess fat cells growing on top of the muscle tissue
Triglycerides are a large and varied category of fats found in both plants and animals. Because fats and blood, like oil and water, do not mix, triglycerides (as well as cholesterol) circulate through the body in special parcels called lipoproteins, which are fat-and-protein packages that enable fats to move freely within the bloodstream. Proteins and other components make up the outer shell; fats, in the form of triglycerides and cholesterol, are packed together inside.
Image by TheVisualMD
Lipids and Lipoproteins
Lipids and Lipoproteins
Image by TheVisualMD
This browser does not support the video element.
Lipids, Heart Health and Baselining Your Health
Your blood "knows" what you eat, meaning that the cardiovascular system is a sensitive barometer of a person's health, including diet. What individuals eat is reflected in their blood chemistry and the health of their heart, arteries and vessels. Fats (also known as lipids), for example, are vital to health and wellbeing throughout our lives and yet they are mostly associated with obesity and cardiovascular disease. The problem is that not all fats (or cholesterol) are equal. They share basic chemical similarities, but they also have important differences, which, in turn, result in different roles and effects in the body. Tests that offer information on diet and heart health include total cholesterol, low-density lipoprotein (LDL or "bad" cholesterol), high-density lipoprotein (HDL or "good" cholesterol), and triglycerides.
Video by TheVisualMD
Thoracic Duct
The lymphatic system consists of a network of vessels and nodes that collect and carry a clear fluid called lymph that plays roles in immune function as well as the transport of nutrients. The thoracic duct, which is the largest vessel in the lymphatic system, delivers lymph into the bloodstream, including lymph from the intestinal system, called chyle, which is milky rich in fats.
Image by TheVisualMD
Triglyceride Molecule
Triglycerides are the body's primary form of stored fat. When you consume excess calories, your body converts them right away into triglycerides. In the liver, triglycerides are packaged up with cholesterol and with proteins in carriers called lipoproteins, which are transported through the blood to various sites of the body to be stored in fat cells. Luckily for anyone with a high triglyceride reading in their lipid profile, levels can often be lowered by making smart changes to the diet. Even if you are prescribed medication to lower triglyceride levels, your physician will also recommend improving food choices. In this model, carbon atoms are dark gray, hydrogen atoms are white, and oxygen atoms are red.
Image by TheVisualMD
Triglyceride Molecule
Triglycerides are the body's primary form of stored fat. When you consume excess calories, your body converts them right away into triglycerides. In the liver, triglycerides are packaged up with cholesterol and with proteins in carriers called lipoproteins, which are transported through the blood to various sites of the body to be stored in fat cells. Luckily for anyone with a high triglyceride reading in their lipid profile, levels can often be lowered by making smart changes to the diet. Even if you are prescribed medication to lower triglyceride levels, your physician will also recommend improving food choices. In this model, carbon atoms are dark gray, hydrogen atoms are white, and oxygen atoms are red.
Image by TheVisualMD
Lowering Triglycerides - Mayo Clinic
Video by Mayo Clinic/YouTube
Tri HDL
Video by ACAP Health/YouTube
Triglycerides: Liver and Intestines
The liver is the body's central chemical plant, removing toxins, storing sugars and lipids and producing a wide range of proteins that play key roles as enzymes. The liver also produces packages cholesterol and triglycerides, along with special proteins, into lipoproteins.
Image by TheVisualMD
Triglycerides: Triglyceride
Triglycerides are a large and varied category of fats found in both plants and animals. When we eat our bodies convert excess calories into triglycerides, which can be stored in fat cells and then released as needed into the bloodstream for energy between meals.
Image by TheVisualMD
LDL-Particles: Triglycerides
One factor that may contribute to a high LDL particle count is raised levels of triglycerides. Elevated triglyceride levels in the blood start a chain of biochemical reactions that eventually leads to a reduction in the size of LDL particles. The smaller LDL particles can't carry as much cholesterol as larger LDL particles, so a greater number of them is needed to carry a given amount of cholesterol.
Image by TheVisualMD
Triglycerides and HDL
Video by Joslin Diabetes Center/YouTube
Asian Heart Hospital - What is Triglycerides?
Video by Asian Heart Institute/YouTube
What is Plaque?
Video by CardioTabs/YouTube
Lipid Absorption
Lipid Absorption
Image by OpenStax College
lipid vesicles in these adipocytes
The preadipocyte cell line PA6 fully differentiated into adipocytes. The lipid vesicles in these adipocytes are stained using oil-red-O staining.
Image by M. Oktar Guloglu
Anatomy of a Lipoprotein
Lipoproteins transport cholesterol, triglycerides, or other lipids through the bloodstream. Lipoproteins are protein spheres that consist of a core of triglycerides and cholesterol esters, surrounded by a shell made up of water-soluble phospholipids with embedded proteins and cholesterol. The lipid-laden core of the lipoprotein is insoluble in aqueous (water-based) blood, so the phospholipid-protein shell is necessary to allow the lipoprotein to float freely in the bloodstream.
Image by TheVisualMD
Anatomy of a Lipoprotein
Lipoproteins transport cholesterol, triglycerides, or other lipids through the bloodstream. Lipoproteins are protein spheres that consist of a core of triglycerides and cholesterol esters, surrounded by a shell made up of water-soluble phospholipids with embedded proteins and cholesterol. The lipid-laden core of the lipoprotein is insoluble in aqueous (water-based) blood, so the phospholipid-protein shell is necessary to allow the lipoprotein to float freely in the bloodstream.
Image by TheVisualMD
Anatomy of a Lipoprotein
Lipoproteins transport cholesterol, triglycerides, or other lipids through the bloodstream. Lipoproteins are protein spheres that consist of a core of triglycerides and cholesterol esters, surrounded by a shell made up of water-soluble phospholipids with embedded proteins and cholesterol. The lipid-laden core of the lipoprotein is insoluble in aqueous (water-based) blood, so the phospholipid-protein shell is necessary to allow the lipoprotein to float freely in the bloodstream.
Image by TheVisualMD
Anatomy of a Lipoprotein
Lipoproteins transport cholesterol, triglycerides, or other lipids through the bloodstream. Lipoproteins are protein spheres that consist of a core of triglycerides and cholesterol esters, surrounded by a shell made up of water-soluble phospholipids with embedded proteins and cholesterol. The lipid-laden core of the lipoprotein is insoluble in aqueous (water-based) blood, so the phospholipid-protein shell is necessary to allow the lipoprotein to float freely in the bloodstream.
Image by TheVisualMD
Breast Milk Component Pathway
The components of breast milk are brought together in the alveoli via different routes. Breast milk constituents are either absorbed from the bloodstream from nutrients in the mother's diet or synthesized in special milk-producing cells called lactocytes. These constituents are brought together in the alveoli via different routes. Some components pass through or between the lactocytes, while others are assembled within the lactocytes.
Image by TheVisualMD
Maintaining Cardiovascular Health
This series of images illustrates diet and lifestyle changes that help maintain cardiovascular health, and which may actually help improve existing damage. From left to right: 1) A woman eats an apple, with visible cardiovascular system and digestive system. 2) Fresh vegetables, including tomatoes, peppers, broccoli, cauliflower and carrots, are high in fiber which helps keep blood lipid levels healthy. 3) Monounsaturated and polyunsaturated fats are better for heart health than trans fats and saturated fats. Good sources include those shown: nuts, seeds, olive oil and omega-3 fatty acids like those found in salmon. 4) A woman takes a vigorous walk with muscles, skeletal bones and heart visible. Regular exercise in combination with a heart-healthy diet helps keep your heart and blood vessels in top condition.
Image by TheVisualMD
Fat Cells Growing on the Surface of a Blood Vessel
This image shows mature fat cells growing on the surface of a blood vessel. The image is from an animation that shows how fat cells, or adipocytes, expand and contribute to obesity. Some tissue is also visible in the image.
Image by TheVisualMD
Healthy Cell Membrane
This image shows the healthy membrane of an endothelial cell in a blood vessel wall. You can see the semi-permeable double layer of phospholipids that allows lipids to move across the membrane. The cholesterol molecules (yellow) maintain permeability by keeping the phospholipid tails from sticking together.
Managing Atherosclerosis Risk : Certain lifestyle habits, traits, and conditions may increase the probability that you'll develop atherosclerosis. These conditions are known as risk factors. The more risk factors you have, the greater your chances of developing atherosclerosis. Fortunately, most of these risk factors are within your control.
Image by TheVisualMD
Abnormal blood lipid levels and hypertension both increase the risk of atherosclerosis
Message From The Heart : Abnormal blood lipid levels and hypertension both increase the risk of atherosclerosis. In atherosclerosis, cholesterol and other substances create hard, waxy plaques inside your arteries, narrowing them and making it more difficult for blood to get through.
Image by TheVisualMD
Fat: What Is It Good For?
Adipose tissue (fat tissue) is a type of connective tissue. The two main types of adipose tissue in humans are subcutaneous (under the skin) and visceral (inside the abdomen). Adipose tissue performs many functions in your body. Its main job is to store energy in the form of lipids (triglycerides and cholesterol). When you eat fatty foods, often there are more lipids than you need for energy at that time. The excess lipids are stored in your adipose tissue. The same holds true for proteins and carbohydrates—when you eat more of them than you need immediately, excess amounts are converted to lipids and stored in adipose tissue for future use.
Image by TheVisualMD
Coronary Artery Disease - Risk Factors Of Atherosclerosis
Risk Factors Of Atherosclerosis : Scientists think that immune system cells may gather at injures areas of the lining of the arteries in an attempt to "heal" the damage. Lipids like cholesterol adhere as well, together with other substances in the blood like calcium and fibrin (connective tissue). Together they form the hard, fatty deposit called plaques.
Image by TheVisualMD
Getting to the Heart of Things
The cardiovascular system consists of the heart, the blood vessels, and the blood itself. Blood is mostly made up of plasma and red and white blood cells. But it contains many other substances as well, like platelets, hormones, and nutrients such as glucose. The cardiovascular system distributes these substances throughout the body as needed and collects waste products from your cells for elimination.
Image by TheVisualMD
Obese Child Showing Cardiovascular System and Visceral Fat
Most of the kids diagnosed with type 2 diabetes are obese. Normally, insulin in the blood binds with an insulin receptor on a cell surface to allow glucose (blood sugar) to enter the cell. In type 2 diabetes, insulin doesn't work to allow glucose into the cell. Obesity and its related conditions, such as high blood pressure, abnormal glucose tolerance, and high lipid levels, are major risk factors for cardiovascular disease (CVD), diseases of the heart and blood vessels. Most of us think of CVD, the leading cause of death in the US, as an adult disease. But CVD can begin early on, even in childhood, and get progressively worse. Obese children and children with abnormally high blood cholesterol and triglyceride levels can develop fatty streaks in their arteries, the first steps in the formation of plaques. Some may even develop plaques. CVD has become a pediatric disease.
Image by TheVisualMD
Obese Young Child Showing Cardiovascular System and Visceral Fat
Most of the kids diagnosed with type 2 diabetes are obese. Normally, insulin in the blood binds with an insulin receptor on a cell surface to allow glucose (blood sugar) to enter the cell. In type 2 diabetes, insulin doesn't work to allow glucose into the cell. Obesity and its related conditions, such as high blood pressure, abnormal glucose tolerance, and high lipid levels, are major risk factors for cardiovascular disease (CVD), diseases of the heart and blood vessels. Most of us think of CVD, the leading cause of death in the US, as an adult disease. But CVD can begin early on, even in childhood, and get progressively worse. Obese children and children with abnormally high blood cholesterol and triglyceride levels can develop fatty streaks in their arteries, the first steps in the formation of plaques. Some may even develop plaques. CVD has become a pediatric disease.
Image by TheVisualMD
Lipoproteins
Lipoproteins are protein spheres that transport lipids through your bloodstream.
Image by TheVisualMD
Bile Acids
Digestion of Fats : You need cholesterol in order to digest food. One of the other major uses of cholesterol is the production of bile acids (also known as bile salts) in the liver. Bile contains a number of ingredients, including water, cholesterol, and bile acids. Bile is necessary for the absorption of fats from fecal matter passing through the intestine.
Image by TheVisualMD
Statins Lowering Cholesterol
Statins lower cholesterol levels by reducing the production of cholesterol by the liver. They also increase the capacity of the liver to remove cholesterol from the blood. When less produced and more gets removed from the bloodstream, the level of cholesterol can drop significantly.
Image by TheVisualMD
Cardiovascular disease
Atherosclerosis Risk Factors, Major Risk Factors You Can Control:
Image by TheVisualMD
Triglyceride Molecule
Triglycerides are the body's primary form of stored fat. When you consume excess calories, your body converts them right away into triglycerides. In the liver, triglycerides are packaged up with cholesterol and with proteins in carriers called lipoproteins, which are transported through the blood to various sites of the body to be stored in fat cells. Luckily for anyone with a high triglyceride reading in their lipid profile, levels can often be lowered by making smart changes to the diet. Even if you are prescribed medication to lower triglyceride levels, your physician will also recommend improving food choices. In this model, carbon atoms are dark gray, hydrogen atoms are white, and oxygen atoms are red
Image by TheVisualMD
The ABC's of Vitamins
Image by TheVisualMD
Triglycerides
Roger Daniels, Bunge Oils Director of Research & Development
Excess fat cells growing on top of the muscle tissue
TheVisualMD
Lipids and Lipoproteins
TheVisualMD
2:46
Lipids, Heart Health and Baselining Your Health
TheVisualMD
Thoracic Duct
TheVisualMD
Triglyceride Molecule
TheVisualMD
Triglyceride Molecule
TheVisualMD
2:46
Lowering Triglycerides - Mayo Clinic
Mayo Clinic/YouTube
2:17
Tri HDL
ACAP Health/YouTube
Triglycerides: Liver and Intestines
TheVisualMD
Triglycerides: Triglyceride
TheVisualMD
LDL-Particles: Triglycerides
TheVisualMD
3:25
Triglycerides and HDL
Joslin Diabetes Center/YouTube
3:11
Asian Heart Hospital - What is Triglycerides?
Asian Heart Institute/YouTube
2:19
What is Plaque?
CardioTabs/YouTube
Lipid Absorption
OpenStax College
lipid vesicles in these adipocytes
M. Oktar Guloglu
Anatomy of a Lipoprotein
TheVisualMD
Anatomy of a Lipoprotein
TheVisualMD
Anatomy of a Lipoprotein
TheVisualMD
Anatomy of a Lipoprotein
TheVisualMD
Breast Milk Component Pathway
TheVisualMD
Maintaining Cardiovascular Health
TheVisualMD
Fat Cells Growing on the Surface of a Blood Vessel
A heart disease risk assessment is a type of screening tool that calculates your risk for developing heart disease in the future. The results can show if you need to take steps to prevent or reduce your chances of getting heart disease.
A heart disease risk assessment is a type of screening tool that calculates your risk for developing heart disease in the future. The results can show if you need to take steps to prevent or reduce your chances of getting heart disease.
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%
5
7.5
20
Your result is Low.
A 0 to 4.9 percent risk is considered low. Eating a healthy diet and exercising will help keep your risk low. Medication is not recommended unless your LDL, or “bad” cholesterol, is greater than or equal to 190.
Related conditions
Heart disease is a general term that refers to several types of heart conditions. The most common type is coronary artery disease, which can lead to a heart attack. Other types include stroke and heart failure. Heart disease is the leading cause of death in the United States.
A heart disease risk assessment, also known as a cardiovascular disease (CVD) risk assessment, is a type of screening tool that measures your risk of heart disease or CVD. Heart disease is a type of CVD, which is a group of diseases of the heart and blood vessels.
A heart disease risk assessment includes a series of questions about certain risk factors, including age, family history, and lifestyle habits such as diet and exercise. It then calculates your risk of developing heart disease in the future. Even if you feel healthy now, the assessment can show if you need to take steps to prevent or reduce your chances of developing heart disease later.
A heart disease risk assessment is used to check how likely it is that someone will develop heart disease in the next 10 years.
The assessment can be helpful for most adults aged 40 or older. If you are younger than 40, you may need an assessment if you have a family history of heart disease or certain CVD risk factors.
There are different types of heart disease risk assessment. They each include general questions about your health and possible risk factors for heart disease. The most common heart disease risk assessments are known as:
ACC/AHA Cardiovascular Risk Calculator
ASCVD Risk Calculator. ASCVD stands for atherosclerotic cardiovascular disease. This is a condition where plaque (fatty deposits) build up in the walls of the arteries. It can block blood flow and may lead to heart attack or stroke.
Reynolds Risk Score
Framingham General CVD Risk Profile
The test can be done by yourself online or by a health care provider. Your assessment may include questions about some or all of the following:
Age
Gender
Height and weight
Blood pressure
Cholesterol levels
Whether you smoke or have smoked in the past
Whether you have diabetes
Activity level
Diet
You don't need any special preparations for a heart disease risk assessment.
There is no risk in taking a questionnaire.
Heart disease risk assessment results are calculated based on data from clinical studies on heart disease. Your answers will be compared with patient data from these studies. Your results will be given as a percentage. A lower percentage means you have less risk of developing heart disease within the next 10 years. A higher percentage means you have a greater risk. If your percentage is high, your doctor may recommend steps to lower your risk.
Some risk factors, such as age and family history, can't be controlled. But you can take steps to lower your risk for factors you can control. These may include eating a healthy diet, getting regular exercise, and quitting smoking. These steps can benefit all adults. If you are at a high risk of heart disease, your provider may also recommend medicines such as:
Statins, which lower cholesterol
Blood pressure medicines, also called antihypertensives
Blood thinners, such as aspirin, which can help prevent heart attacks and strokes. Many people with coronary artery disease (CAD) are treated with aspirin. But aspirin therapy has some risks and is only recommended for people with certain risk factors for heart disease.
If you have questions about your results, talk to your health care provider.
Depending on the results of your assessment, your provider may order additional tests including:
Cholesterol levels, a test that measures cholesterol levels in your blood
Electrocardiogram, a test that measures electrical signals in your heart
Stress test, a test that measures how well your heart handles physical activity
Heart Disease Risk Assessment: MedlinePlus Medical Test [accessed on Feb 06, 2024]
Electrocardiogram
Electrocardiogram
Also called: EKG, ECG
An electrocardiogram (EKG) is a test that measures electrical signals in your heart. An abnormal EKG can be a sign of heart damage or disease.
Electrocardiogram
Also called: EKG, ECG
An electrocardiogram (EKG) is a test that measures electrical signals in your heart. An abnormal EKG can be a sign of heart damage or disease.
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Your result is Normal.
EKG results are normal with a consistent heartbeat and rhythm.
Related conditions
An electrocardiogram (EKG) test is a simple, painless, and quick test that records your heart's electrical activity. Each time your heart beats, an electrical signal travels through your heart. The signal triggers your heart's four chambers to contract (squeeze) in the proper rhythm so that your heart can pump blood to your body.
An EKG recording of these signals looks like wavy lines. Your provider can read these lines to look for abnormal heart activity that may be a sign of heart disease or damage.
An EKG can show:
How fast your heart is beating
Whether the rhythm of your heartbeat is steady or irregular
The strength and timing of the electrical signals passing through each part of your heart
Sometimes information from an EKG can help measure the size and position of your heart's chambers.
An EKG is often the first test you'll have if you have signs of a heart condition. It may be done in your provider's office, an outpatient clinic, in a hospital before surgery, or as part of another heart test called a stress test.
An EKG test is also called an ECG. EKG is based on the German spelling, elektrokardiogramm. EKG may be preferred over ECG to avoid confusion with an EEG, a test that measures brain waves.
An EKG test is used to help diagnose and monitor many types of heart conditions and their treatment. These conditions include:
Arrhythmia
Cardiomyopathy
Coronary artery disease
Heart attack
Heart failure
Heart valve diseases
Congenital heart defects
EKG tests are mainly used for people who have symptoms of a heart condition or have already been diagnosed with a heart condition. They are not generally used to screen people who don't have symptoms unless they have an increased risk of developing heart disease. Your provider can explain your risk for heart disease and let you know if need to have an EKG test. In certain cases, your provider may have you see a cardiologist, a doctor who specializes in heart diseases.
You may need an EKG test if you have symptoms of a heart condition, including:
Chest pain
Rapid or irregular heartbeat
Shortness of breath
Dizziness
Fatigue
A decrease in your ability to exercise
You may also need an EKG to:
Find out if you had a heart attack in the past but didn't know it
Monitor your heart if you have a known heart condition
Check how well your heart treatment is working, including medicine and/or a pacemaker
Check your heart health:
Before having surgery
If you have an increased risk for developing heart disease because:
Heart disease runs in your family
You have another condition, such as diabetes, that makes your risk higher than normal
An EKG test only takes a few minutes. It generally includes these steps:
You will lie on an exam table.
A provider will place several electrodes (small sensors that stick to your skin) on your arms, legs, and chest. The provider may need to shave body hair to make sure the electrodes stay on.
The electrodes are attached by wires to a computer or a special EKG machine
You will lie very still while your heart's electrical activity is recorded on a computer or printed on paper by an EKG machine.
You don't need any special preparations for an EKG test.
There is very little risk to having an EKG. You may feel a little discomfort or skin irritation after the electrodes are removed. The EKG doesn't send any electricity to your body. It only records electrical signals from your heart, so there's no risk of electric shock.
Your provider will check your EKG results for a steady heartbeat and rhythm. If your results are not normal, it may be a sign of a heart condition. The specific condition depends on which part of your EKG wasn't normal.
You may need to have other heart health tests before your provider can make a diagnosis. Your provider can explain what your test results mean for your heart health and treatment.
An EKG is a "snapshot" of your heart's activity over a very short time. If you have heart symptoms that come and go, a regular EKG may not catch the problem. In that case, your provider may recommend that you wear a small portable EKG monitor that can record your heart for days or longer while you do your normal activities. You may also need a longer EKG recording if your provider wants to check how well your heart is working after a heart attack or to see if treatment is helping you.
There are many types of long-term EKG monitors. The two main groups are Holter monitors, which can be worn for up to two days, and event monitors, which may record your heart activity for weeks to years depending on the type.
A Holter monitor is about the size of a small camera. You usually wear it on a belt or strap around your neck for a day or two. Wires under your clothes attach to electrodes that stick to your chest. The monitor records your heart's electrical signals the whole time you're wearing it. You may be asked to keep a diary of your symptoms during the test period. After the test period, you remove the monitor and return it according to the instructions. A provider will review the recording of your heart's electrical activity from the monitor.
An event monitor records your heart's electrical activity when you press a button or when the device detects abnormal heart activity. There two main types of event monitors:
Event monitors that you wear or carry with you. You wear some monitors on your chest or wrist. Other monitors are designed to carry. If you have symptoms, you hold the monitor to your chest. These event monitors may be used for weeks to months. Some of them wirelessly transmit information about your heart to a provider. Others must be returned so a provider can examine the recorded information.
Event monitors that are inserted under the skin of your chest. These are called implantable event monitors. They are put under your skin during minor surgery that's often done in a doctor's office. These monitors can track your heart's electrical activity for years. You may need this type of EKG monitor if you had a stroke or frequent fainting, and your provider hasn't found the cause. Implantable monitors wirelessly transmit the information they record so your provider can regularly check it.
Electrocardiogram: MedlinePlus Medical Test [accessed on Mar 09, 2023]
Electrocardiogram: MedlinePlus Medical Encyclopedia [accessed on Feb 04, 2019]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (35)
How to Read an Electrocardiogram (ECG): Introduction – Cardiology | Lecturio
Video by Lecturio Medical/YouTube
Major Types of Heart Block
Video by Jeff Otjen/YouTube
How An ECG Works
Video by LivingHealthyChicago/YouTube
This browser does not support the video element.
What are Arrhythmias?
Your heart is electric. In this video you'll see how your heart's electrical system works, and what happens when it malfunctions. Voyage inside the human body as Dr. Mehmet Oz and others explain the dangers of heart arrhythmias, including tachycardia, bradycardia, and atrial fibrillation.
Video by TheVisualMD
12 Lead ECG Explained, Animation
Video by Alila Medical Media/YouTube
Bundle Branch Block, Animation.
Video by Alila Medical Media/YouTube
QRS Transitional Zone. See link for real voice update in description!
Video by Alila Medical Media/YouTube
ECG Interpretation Basics - ST Segment Changes. See link for real voice update in description!
Video by Alila Medical Media/YouTube
Cardiac Axis Interpretation. See link for real voice update in description!
Video by Alila Medical Media/YouTube
Electrical system of the heart | Circulatory system physiology | NCLEX-RN | Khan Academy
Video by khanacademymedicine/YouTube
Cardiovascular | EKG Basics
Video by Ninja Nerd/YouTube
Cardiovascular | EKG's
Video by Ninja Nerd/YouTube
Normal sinus rhythm on an EKG | Circulatory System and Disease | NCLEX-RN | Khan Academy
Video by khanacademymedicine/YouTube
Cardiac Conduction System and Understanding ECG, Animation.
Video by Alila Medical Media/YouTube
Willem Einthoven and the ECG - Stuff of Genius
Video by Stuff of Genius - HowStuffWorks/YouTube
Electrocardiogram (ECG)
A useful tool for determining whether a person has heart disease, an electrocardiogram (ECG) is a test that records the electrical activity of the heart. An ECG, which is painless (no electricity is sent through the body), is used to measure damage to the heart, how fast the heart is beating and whether it is beating normally, the effects of drugs or devices used to control the heart (such as a pacemaker), and the size and position of the heart chambers.
Image by TheVisualMD
Cardiac cycle
Cardiac Cycle vs Electrocardiogram
Image by OpenStax College
Medical Checkups
Image by TheVisualMD
Electrocardiogram
Electrocardiograms (EKGs) are the most commonly given test used to diagnose coronary artery disease. They record the heart's electrical activity and show evidence of angina or heart attack.
Image by TheVisualMD
electrocardiogram-illustration made up from Medications
A normal tracing shows the P wave, QRS complex, and T wave. Also indicated are the PR, QT, QRS, and ST intervals, plus the P-R and S-T segments.
Image by CNX Openstax
What To Expect After an Electrocardiogram
Normal ECG/EKG complex with labels
Image by Derivative: Hazmat2 Original: Hank van Helvete
Cardiac Stress Test
The image shows a patient having a stress test. Electrodes are attached to the patient's chest and connected to an EKG (electrocardiogram) machine. The EKG records the heart's electrical activity. A blood pressure cuff is used to record the patient's blood pressure while he walks on a treadmill.
Image by National Heart Lung and Blood Institute
Relationship between the Cardiac Cycle and ECG
Initially, both the atria and ventricles are relaxed (diastole). The P wave represents depolarization of the atria and is followed by atrial contraction (systole). Atrial systole extends until the QRS complex, at which point, the atria relax. The QRS complex represents depolarization of the ventricles and is followed by ventricular contraction. The T wave represents the repolarization of the ventricles and marks the beginning of ventricular relaxation.
Image by CNX Openstax
The Electric Heart
Image by TheVisualMD
Electrocardiogram (EKG)
Electrocardiogram (EKG) is a test used to measure the electrical activity of the heart.
Image by U.S. National Library of Medicine
Comparison of Arrhythmia and Normal ECG
As the muscle tissue in an overstressed heart expands, it tears and scars. The resulting tissue - hardened and marred - does not conduct electricity well. The result is that the system can no longer be relied on to deliver the carefully synchronized pattern of jolts needed to keep the heart pumping smoothly. Doctors call it \"arrhythmia.\" The heart is literally \"skipping a beat.\" This can be measured by an electrocardiogram (ECG). In some cases, arrhythmia can mean simply that the heartbeat is too fast or too slow - a bothersome but not necessarily life-threatening condition. In the worst cases, the arrhythmia indicates a potentially lethal instability in the heart's electric system. The signals that control the heart's contractions get crossed and the heart spasms. If not corrected immediately, this fibrillation of the heart is often fatal. In the U.S., more than 1,000 people die every day from sudden cardiac death, or cardiac arrest.
Image by TheVisualMD
Heart Revealing Chamber and Valve
Your heart beats faster or slower depending on information from your brain, which monitors your body's need for blood. However, the basic rhythm of your heart is automatic; it does not depend on signals from your brain. Your heart cells can generate their own electrical signals, which trigger the contractions and cause the entire heart to pump in synchrony. A specialized bundle of muscle and nerve cells called the sinoatrial node (SA node) sits at the top of the right atrium and is the pacemaker of the heart. It generates the signal for the atria to contract and send blood to the ventricles. A similar node - the atrioventricular or AV node - sits at the atrioventricular septum near the bottom of the right atrium and relays the signal from the SA node to the ventricles to contract and pump blood out of the heart. An electrocardiogram (ECG) measures the electrical signals given off by these two nodes and their conduction through the heart. By looking at the frequency and the height of the peaks and valleys of these signals on an ECG, healthcare professionals get a very good idea of how well the electrical system of your heart is working.
Image by TheVisualMD
Electrocardigram
An electrocardiogram (EKG) detects and records the heart's electrical activity. When the electrical impulse passes through the atria a small peak is recorded (P), followed by a steep spike as it erupts through the ventricles (R), and then another small peak (T) as the wave passes through and the heart repolarizes (recharges) itself for the next beat.
Image by TheVisualMD
Electro- cardiogram
Electrocardiograms, or EKGs, record the electrical activity of the heart. Since injured heart muscle conducts electrical impulses abnormally, the EKG shows if the patient has had or is having a heart attack. It is usually the first test performed.
Image by TheVisualMD
SinusRhythmLabels
Schematic diagram of normal sinus rhythm for a human heart as seen on ECG. In atrial fibrillation, however, the P waves, which represent depolarization of the atria, are absent.
Image by Agateller (Anthony Atkielski)
How To Use an Automated External Defibrillator
The image shows a typical setup using an automated external defibrillator (AED). The AED has step-by-step instructions and voice prompts that enable an untrained bystander to correctly use the machine.
Image by National Heart Lung and Blood Institute
Who Needs an Implantable Cardioverter Defibrillator?
Lead II (2) ECG EKG strip of an AICD ICD converting a patient back into thier baseline cardiac ryhthm. The AICD fires near the end of the strip, where the straight line is seen.
Image by Public Domain
Cardiac Cycle
CG Animated Human Heart cut section showing the atria, ventricles and valves, synced with wiggers diagram.
Image by DrJanaOfficial/Wikimedia
Mammalian Heart and Blood Vessels
The beating of the heart is regulated by an electrical impulse that causes the characteristic reading of an ECG. The signal is initiated at the sinoatrial valve. The signal then (a) spreads to the atria, causing them to contract. The signal is (b) delayed at the atrioventricular node before it is passed on to the (c) heart apex. The delay allows the atria to relax before the (d) ventricles contract. The final part of the ECG cycle prepares the heart for the next beat.
Image by CNX Openstax
9:53
How to Read an Electrocardiogram (ECG): Introduction – Cardiology | Lecturio
Lecturio Medical/YouTube
9:23
Major Types of Heart Block
Jeff Otjen/YouTube
2:45
How An ECG Works
LivingHealthyChicago/YouTube
3:27
What are Arrhythmias?
TheVisualMD
3:27
12 Lead ECG Explained, Animation
Alila Medical Media/YouTube
3:48
Bundle Branch Block, Animation.
Alila Medical Media/YouTube
3:50
QRS Transitional Zone. See link for real voice update in description!
Alila Medical Media/YouTube
1:24
ECG Interpretation Basics - ST Segment Changes. See link for real voice update in description!
Alila Medical Media/YouTube
3:32
Cardiac Axis Interpretation. See link for real voice update in description!
Alila Medical Media/YouTube
9:43
Electrical system of the heart | Circulatory system physiology | NCLEX-RN | Khan Academy
khanacademymedicine/YouTube
52:29
Cardiovascular | EKG Basics
Ninja Nerd/YouTube
20:37
Cardiovascular | EKG's
Ninja Nerd/YouTube
8:53
Normal sinus rhythm on an EKG | Circulatory System and Disease | NCLEX-RN | Khan Academy
khanacademymedicine/YouTube
3:45
Cardiac Conduction System and Understanding ECG, Animation.
Alila Medical Media/YouTube
1:46
Willem Einthoven and the ECG - Stuff of Genius
Stuff of Genius - HowStuffWorks/YouTube
Electrocardiogram (ECG)
TheVisualMD
Cardiac cycle
OpenStax College
Medical Checkups
TheVisualMD
Electrocardiogram
TheVisualMD
electrocardiogram-illustration made up from Medications
GDJ
Electrocardiogram
CNX Openstax
What To Expect After an Electrocardiogram
Derivative: Hazmat2 Original: Hank van Helvete
Cardiac Stress Test
National Heart Lung and Blood Institute
Relationship between the Cardiac Cycle and ECG
CNX Openstax
The Electric Heart
TheVisualMD
Electrocardiogram (EKG)
U.S. National Library of Medicine
Comparison of Arrhythmia and Normal ECG
TheVisualMD
Heart Revealing Chamber and Valve
TheVisualMD
Electrocardigram
TheVisualMD
Electro- cardiogram
TheVisualMD
SinusRhythmLabels
Agateller (Anthony Atkielski)
How To Use an Automated External Defibrillator
National Heart Lung and Blood Institute
Who Needs an Implantable Cardioverter Defibrillator?
Public Domain
Cardiac Cycle
DrJanaOfficial/Wikimedia
Mammalian Heart and Blood Vessels
CNX Openstax
Coronary Angiography
Coronary Angiography
Also called: Cardiac Angiography
Coronary angiography is a procedure that uses contrast dye and x-ray pictures to look at the insides of your arteries. It can show whether plaque is blocking your arteries and how severe the blockage is. It is used to diagnose heart diseases after chest pain, sudden cardiac arrest (SCA), or abnormal results from other heart tests.
Coronary Angiography
Also called: Cardiac Angiography
Coronary angiography is a procedure that uses contrast dye and x-ray pictures to look at the insides of your arteries. It can show whether plaque is blocking your arteries and how severe the blockage is. It is used to diagnose heart diseases after chest pain, sudden cardiac arrest (SCA), or abnormal results from other heart tests.
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Your result is Normal.
A normal coronary angiogram means that the heart and heart valves look normal. It also shows that the examined blood vessels look normal, blood flow is not reduced, and there is no narrowing, blockage, bulging (aneurysm), or large buildup of plaque.
Related conditions
Coronary angiography (angiogram) is a procedure that uses contrast dye and x-ray pictures to look at the insides of your arteries. It can show whether plaque is blocking your arteries and how severe the blockage is. Doctors use this procedure to diagnose heart diseases after chest pain, sudden cardiac arrest (SCA), or abnormal results from other heart tests such as an EKG or a stress test.
You usually have a cardiac catheterization to get the dye into your coronary arteries. Then you have special x-rays while the dye is flowing through your coronary arteries. The dye lets your doctor study the flow of blood through your heart and blood vessels.
This procedure is used to diagnose heart diseases or after abnormal results from tests such as an electrocardiogram (EKG) or an exercise stress test. If you are having a heart attack, coronary angiography can help your doctors plan your treatment.
Your doctor may recommend coronary angiography if you have signs or symptoms of coronary heart disease (CHD). Signs and symptoms include:
Angina. This is unexplained pain or pressure in your chest. You also may feel it in your shoulders, arms, neck, jaw, or back. The pain my even feel like indigestion. Angina may not only happen when you're active. Emotional stress also can trigger the pain associated with angina.
Sudden cardiac arrest (SCA). This is a condition in which your heart suddenly and unexpectedly stops beating.
Abnormal results from tests such as an EKG (electrocardiogram), exercise stress test, or other test.
Coronary angiography also might be done on an emergency basis, such as during a heart attack. If angiography shows blockages in your coronary arteries, your doctor may do a procedure called percutaneous coronary intervention, also known as angioplasty (AN-jee-oh-plas-tee). This procedure can open blocked heart arteries and prevent further heart damage.
Coronary angiography also can help your doctor plan treatment after you’ve had a heart attack, especially if you have major heart damage or if you’re still having chest pain.
Coronary angiography is often done in a hospital. You will stay awake, but receive medicine to relax during the procedure. Coronary angiography is done via a cardiac catheterization procedure. For this, your doctor will clean and numb an area on the arm, groin or upper thigh, or neck before making a small hole in the skin and a blood vessel. Your doctor will insert a catheter tube into your blood vessel. Your doctor will take X-ray pictures to help place the catheter in your coronary arteries. After the catheter is in place, your doctor will inject the contrast dye through the catheter to highlight blockages and will take X-ray pictures of your heart. If blockages are detected, your doctor may use percutaneous coronary intervention, also known as coronary balloon angioplasty, usually with the use of a stent (a wire mesh that helps keep an blocked artery open), to improve blood flow to your heart.
After coronary angiography, your doctor will remove the catheter and close and bandage the opening on your arm, groin, or neck. You may develop a bruise and soreness where the catheter was inserted. You will stay in the hospital for a few hours or sometimes overnight. During this time, your healthcare team will check your heart rate, blood pressure, and the catheter insertion site.
Before having coronary angiography, talk with your doctor about:
How the test is done and how to prepare for it
Any medicines you're taking, and whether you should stop taking them before the test
Whether you have diseases or conditions that may require taking extra steps during or after the test to avoid complications. Examples of such conditions include diabetes and kidney disease.
Coronary angiography is a common procedure that rarely causes serious problems. However, as with any invasive procedure involving the heart, there is some risk. These risks include bleeding, allergic reactions to the contrast dye, kidney problems, infection, blood vessel damage, arrhythmias, and blood clots that can trigger a heart attack or stroke. The risk of complications is higher in people who are older or who have chronic kidney disease or diabetes.
Your coronary angiography images will be studied by a radiologist, who will send your results to your provider.
https://medlineplus.gov/hearthealthtests.html [accessed on Feb 23, 2022]
https://www.nhlbi.nih.gov/health/heart-tests [accessed on Feb 23, 2022]
Coronary angiography: MedlinePlus Medical Encyclopedia [accessed on Dec 12, 2018]
Angiography | BSIR [accessed on Dec 12, 2018]
Angiogram/Arteriogram - Medical Tests | Stanford Health Care [accessed on Dec 12, 2018]
Computed Tomography (CT) Angiogram | HealthLink BC [accessed on Feb 03, 2024]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (7)
Coronary angiography
Coronary angiography
Image by BruceBlaus
Coronary CT angiography of coronary arteries
Researchers have found that anti-inflammatory biologic therapies used to treat moderate to severe psoriasis can significantly reduce coronary inflammation in patients with the chronic skin condition. Scientists said the findings are particularly notable because of the use of a novel imaging biomarker, the perivascular fat attenuation index (FAI), that was able to measure the effect of the therapy in reducing the inflammation.
The study published online in JAMA Cardiology, has implications not just for people with psoriasis, but for those with other chronic inflammatory diseases, such as lupus and rheumatoid arthritis. These conditions are known to increase the risk for heart attacks and strokes. The study was funded by the National Heart, Lung, and Blood Institute (NHLBI), part of the National Institutes of Health.
In this image: Coronary CT angiography image of the coronary arteries depicting the perivascular fat attenuation index before and after biologic therapy at one-year follow-up for patients with excellent response to biologic therapy.
Image by Oxford Academic Cardiovascular CT Core Lab and Lab of Inflammation and Cardiometabolic Diseases at NHLBI
Coronary angiography (C) confirms the diagnosis, highlighting severe stenosis of the right coronary artery in the proximal and distal area, as well as in the common trunk.
Images obtained from a 73-year-old patient with chest pain. No perfusion abnormalities are observed on cardiac SPECT with 99m Tc-Tetrafosmin (A1 stress, A2 rest, A3 bullseye). PET with H 2 15 O (B1 stress, B2 rest, B3 bullseye), on the other hand, shows extensive deficits at the level of almost all the myocardium which partially disappear upon acquisition in resting conditions, to be referred to a balanced ischemia. Coronary angiography (C) confirms the diagnosis, highlighting severe stenosis of the right coronary artery in the proximal and distal area, as well as in the common trunk.
Image by Driessen et Al.
Coronary angiography
Angiogram, Blocked Artery : Angiogram showing blockage in a coronary artery.
Image by TheVisualMD
What is a Coronary Angiography and Angioplasty?
Video by SingHealth/YouTube
Coronary Angiography and Stent Interventions | Ravi Dave, MD | UCLAMDChat
Video by UCLA Health/YouTube
Coronary angiography - image intensifier basics and nomenclature
Video by Medmastery/YouTube
Coronary angiography
BruceBlaus
Coronary CT angiography of coronary arteries
Oxford Academic Cardiovascular CT Core Lab and Lab of Inflammation and Cardiometabolic Diseases at NHLBI
Coronary angiography (C) confirms the diagnosis, highlighting severe stenosis of the right coronary artery in the proximal and distal area, as well as in the common trunk.
Driessen et Al.
Coronary angiography
TheVisualMD
3:33
What is a Coronary Angiography and Angioplasty?
SingHealth/YouTube
23:51
Coronary Angiography and Stent Interventions | Ravi Dave, MD | UCLAMDChat
UCLA Health/YouTube
5:02
Coronary angiography - image intensifier basics and nomenclature
Medmastery/YouTube
Cardiac MRI Test
Cardiac MRI Test
Also called: Heart MRI, Cardiovascular Magnetic Resonance Imaging, CMR, Cardiac MRI Scan
A cardiac MRI (magnetic resonance imaging) is an imaging test that uses radio waves, magnets, and a computer to create detailed pictures of your heart. The test can provide detailed information on the type and severity of heart disease to help diagnose and treat heart problems.
Cardiac MRI Test
Also called: Heart MRI, Cardiovascular Magnetic Resonance Imaging, CMR, Cardiac MRI Scan
A cardiac MRI (magnetic resonance imaging) is an imaging test that uses radio waves, magnets, and a computer to create detailed pictures of your heart. The test can provide detailed information on the type and severity of heart disease to help diagnose and treat heart problems.
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Use the slider below to see how your results affect your
health.
Your result is Normal.
A normal cardiac MRI means no abnormalities have been found in the heart anatomy, function, and tissue composition.
Related conditions
A cardiac MRI is a painless imaging test that uses radio waves, magnets, and a computer to create detailed pictures of your heart. Magnetic resonance imaging (MRI) is a safe, noninvasive test that creates detailed pictures of your organs and tissues. "Noninvasive" means that no surgery is done and no instruments are inserted into your body.
Cardiac MRI creates both still and moving pictures of your heart and major blood vessels. Doctors use cardiac MRI to get pictures of the beating heart and to look at its structure and function. These pictures can help them decide the best way to treat people who have heart problems.
Cardiac MRI is a common test. It's used to diagnose and assess many diseases and conditions, including:
Coronary heart disease
Damage caused by a heart attack
Heart failure
Heart valve problems
Congenital heart defects (heart defects present at birth)
Pericarditis (a condition in which the membrane, or sac, around your heart is inflamed)
Cardiac tumors
Cardiac MRI can help explain results from other tests, such as x rays and computed tomography scans (also called CT scans).
Doctors sometimes use cardiac MRI instead of invasive procedures or tests that involve radiation (such as x rays) or dyes containing iodine (these dyes may be harmful to people who have kidney problems).
Cardiac MRI takes place in a hospital or medical imaging facility. A radiologist or other doctor who has special training in medical imaging oversees MRI testing. Cardiac MRI usually takes 30 to 90 minutes, depending on how many pictures are needed. The test may take less time with some newer MRI machines.
The MRI machine will be located in a special room that prevents radio waves from disrupting the machine. It also prevents the MRI machine's strong magnetic fields from disrupting other equipment.
Traditional MRI machines look like long, narrow tunnels. Newer MRI machines (called short-bore systems) are shorter, wider, and don't completely surround you. Some newer machines are open on all sides. Your doctor will help decide which type of machine is best for you. Cardiac MRI is painless and harmless. You'll lie on your back on a sliding table that goes inside the tunnel-like machine.
The MRI technician will control the machine from the next room. He or she will be able to see you through a glass window and talk to you through a speaker. Tell the technician if you have a hearing problem.
The MRI machine makes loud humming, tapping, and buzzing noises. Some facilities let you wear earplugs or listen to music during the test. You will need to remain very still during the MRI. Any movement can blur the pictures. If you're unable to lie still, you may be given medicine to help you relax.
The technician might ask you to hold your breath for 10 to 15 seconds at a time while he or she takes pictures of your heart. Researchers are studying ways that will allow someone having a cardiac MRI to breathe freely during the exam, while achieving the same image quality.
A contrast agent, such as gadolinium, might be used to highlight your blood vessels or heart in the pictures. The substance usually is injected into a vein in your arm using a needle. You may feel a cool sensation during the injection and discomfort when the needle is inserted. Gadolinium doesn't contain iodine, so it won't cause problems for people who are allergic to iodine.
Your cardiac MRI might include a stress test to detect blockages in your coronary arteries. If so, you'll get other medicines to increase the blood flow in your heart or to increase your heart rate.
You'll be asked to fill out a screening form before having cardiac MRI. The form may ask whether you've had any previous surgeries. It also may ask whether you have any metal objects or medical devices (like a cardiac) in your body.
Some implanted medical devices, such as man-made heart valves and coronary stents, are safe around the MRI machine, but others are not. For example, the MRI machine can:
Cause implanted cardiac pacemakers and defibrillators to malfunction.
Damage cochlear (inner-ear) implants. Cochlear implants are small, electronic devices that help people who are deaf or who can't hear well understand speech and the sounds around them.
Cause brain aneurysm (AN-u-rism) clips to move as a result of the MRI's strong magnetic field. This can cause severe injury.
Talk to your doctor or the MRI technician if you have concerns about any implanted devices that may interfere with the MRI.
Your doctor will let you know if you shouldn't have a cardiac MRI because of a medical device. If so, consider wearing a medical ID bracelet or necklace or carrying a medical alert card that states that you shouldn't have an MRI.
If you're pregnant, make sure your doctor knows before you have an MRI. No harmful effects of MRI during pregnancy have been reported; however, more research on the safety of MRI during pregnancy is needed.
Your doctor or technician will tell you whether you need to change into a hospital gown for the test. Don't bring hearing aids, credit cards, jewelry and watches, eyeglasses, pens, removable dental work, or anything that's magnetic near the MRI machine.
Tell your doctor if being in a fairly tight or confined space causes you anxiety or fear. If so, your doctor might give you medicine to help you relax. Your doctor may ask you to fast (not eat) for 6 hours before you take this medicine on the day of the test.
Some newer cardiac MRI machines are open on all sides. If you're fearful in tight or confined spaces, ask your doctor to help you find a facility that has an open MRI machine.
Your doctor will let you know whether you need to arrange for a ride home after the test.
Cardiac MRI has few risks. In rare instances, the contrast dye may harm people who have kidney or liver disease, or it may cause an allergic reaction.
The doctor supervising your scan will provide your doctor with the results of your cardiac MRI. Your doctor will discuss the findings with you.
Cardiac MRI can reveal various heart diseases and conditions, such as:
Coronary heart disease
Damage caused by a heart attack
Heart failure
Heart valve problems
Congenital heart defects (heart defects present at birth)
Pericarditis (a condition in which the membrane, or sac, around your heart is inflamed)
Cardiac tumors
Cardiac MRI is a fast, accurate tool that can help diagnose a heart attack. The test does this by detecting areas of the heart that don't move normally, have poor blood supply, or are scarred.
Cardiac MRI also can show whether any of the coronary arteries are blocked. A blockage prevents your heart muscle from getting enough oxygen-rich blood, which can lead to a heart attack.
Currently, coronary angiography is the most common procedure for looking at blockages in the coronary arteries. Coronary angiography is an invasive procedure that uses x rays and iodine-based dye.
Researchers have found that cardiac MRI can sometimes replace coronary angiography, avoiding the need to use x-ray radiation and iodine-based dye. This use of MRI is called MR angiography (MRA).
Echocardiography (echo) is the main test for diagnosing heart valve disease. However, your doctor also might recommend cardiac MRI to assess the severity of valve disease.
A cardiac MRI can confirm information about valve defects or provide more detailed information about heart valve disease.
This information can help your doctor plan your treatment. An MRI also might be done before heart valve surgery to help your surgeon plan for the surgery.
Researchers are finding new ways to use cardiac MRI. In the future, cardiac MRI may replace x rays as the main way to guide invasive procedures such as cardiac catheterization.
Also, improvements in cardiac MRI will likely lead to better methods for detecting heart disease in the future.
https://www.nhlbi.nih.gov/health-topics/cardiac-mri [accessed on Aug 25, 2021]
https://medlineplus.gov/ency/article/003795.htm [accessed on Feb 25, 2022]
Bluemke, David A.. Reference ranges (“normal values”) for cardiovascular magnetic resonance (CMR) in adults and children: 2020 update. Journal of Cardiovascular Magnetic Resonance. Dec 14, 2020. doi:10.1186/s12968-020-00683-3 [accessed on Apr 03, 2024]
CMR Normal Values [accessed on Apr 03, 2024]
Additional Materials (32)
What To Expect During Cardiac MRI
Aberrant subclavian artery in MRI / MRA. Maximum intension projection.
Image by National Heart, Lung and Blood Institute / NIH
MRI of Aneurysm within Chest lateral cross section
Specialized test, like a computerized tomography (CT) scan or a magnetic resonance imaging (MRI) scan, may be needed to confirm the presence of an aneurysm.
Image by TheVisualMD
Enlarged right ventricle with poor function in a patient with repaired tetralogy of Fallot by CMR
Enlarged right ventricle with poor function in a patient with repaired tetralogy of Fallot by CMR
Image by Jccmoon (talk)
Having a Cardiac MRI scan
Video by Birmingham Women's and Children's NHS Trust/YouTube
MRI and CT Scan the differences
Video by Vijayan Ragavan/YouTube
British Heart Foundation - Your guide to a cardiac MRI, heart disease test
Video by British Heart Foundation/YouTube
Seeing Inside the Heart with MRI
Video by Mayo Clinic/YouTube
Cardiac MRI flow visualization
Cardiac MRI flow visualization
Image by Vasanawala
Cardiac MRI streamlines
Cardiac MRI streamlines visualization
Image by Vasanawala
Aberrant subclavian artery in MRI / MRA. Maximum intension projection.
Aberrant subclavian artery in MRI / MRA. Maximum intension projection.
Image by Hellerhoff
Spectrum of Medical Imaging
This composite image was created in recognition of The Society of Photo-Optical Instrumentation Engineers (SPIE) designation of 2015 as the “International Year of Light.” Medical imaging scientists and engineers contribute to the quest for the improved human condition by providing imaging that spans the entire usable electro-magnetic spectrum (seen at bottom). From the humblest of beginnings with simple magnification of objects and focusing with lenses, to the biological observation of cells with rudimentary microscopes in the visible spectrum, medical imaging today has both extended away from the visible spectrum towards longer and shorter wavelengths (low and high energies) and exploited the hyperspectral nature of the visible which was once considered “commonplace” or rudimentary. Considering yet a different cross-section through the various imaging modalities across the spectrum, the medically useful information gained spans anatomic, physiologic, and molecular regimes. Systems and algorithms have been developed as single-modality acquisition systems, and also as multiple-modalities with conjoint reconstruction, each informing the other in the quest to optimize image quality and information content. In addition, the role of light-based technologies in enabling advanced computations in tomographic reconstructions, computer-aided diagnosis, machine learning (neural networks, deep learning, etc.) , and 3D visualizations as well as in data-enriched storage of medical images has further extended the potential knowledge “seen” through imaging. The breadth of the electromagnetic spectrum offers limitless opportunities for improvement and inquiry, in our quest to answer human life’s difficult questions. This montage was first published on the cover of the SPIE’s Journal of Medical Imaging (July-Sept. 2015, vol. 3, no. 3) and is but a small tribute to the multitude of medical imaging scientists who have contributed to the wealth of new knowledge as we interrogate the human condition. The gray-scale whole body images (from Left to Right) are acquired from longer wavelength modalities to shorter wavelength modalities spanning the (currently) usable electromagnetic spectrum. The background images include: a coronal Magnetic Resonance Image (MRI) T2 weighted image slice, a posterior surface Infra Red (IR) heat map, a coronal non-contrast Computed Tomography (CT) slice, and a coronal 18F-fluoro-deoxyglucose Positron Emission Tomography (FDG-PET) slice. The selection of color inset images includes (from Top-to-Bottom, then Left to Right): [1] diffusion tensor magnetic resonance imaging (MRI) used to image long white matter tracts within and around the human brain illustrating neuronal connectivity (coloring refers to bluish=vertical direction; green=horizontal A-P direction; red=horizontal lateral direction) (courtesy of Arthur Toga, PhD); [2] registered and superimposed coronal proton-MRI (gray-scale) and a hyper polarized 129Xe ventilation MRI scan (color scale) within the same patient’s lungs, prior to their receiving a bronchial stent (courtesy of Bastiaan Driehuys, PhD); [3] coronal slice through a microwave-based image reconstruction of the Debye parameter ε (epsilon) in a heterogeneously dense human breast phantom (courtesy of Susan Hagness, PhD); [4] juxtaposed optical image of the retina and vertical and horizontal Optical Coherence Tomograph (OCT) slices showing pigmentosa retinopathy (courtesy of Jean-Michel Muratet, MD); [5] functional 3-D photoacoustic imaging of melanoma (gray scale) in vivo, surrounded by highly optically absorptive blood vessels (red) (courtesy of Lihong Wang, PhD); [6] optical micrograph of HeLa cells stained for microtubules (blue) and co-stained with DAPI for actin visualization (red); HeLa cells are the world's first stem cell line, originally derived from the aggressive cervical cancer cells of Henrietta Lacks (courtesy Tom Deerinck/NCMIR); [7] visualization of the pelvis highlighting the colon, which is imaged with contrast x-ray computed tomography (CT), and after digital surface rendering can be used in virtual colonoscopy, thus avoiding a physical visible light-based colonoscopy; [8] registered and fused sagittal 99mTc-sestamibi dedicated molecular single photon emission computed tomography (SPECT, heat color scale) and low-dose CT slice (gray scale) of a patient’s uncompressed, pendant breast containing two surgically confirmed DCIS loci in the posterior breast (courtesy of Martin Tornai, PhD); [9] classic, early x-radiograph of Wilhelm Röntgen’s wife’s hand (adapted from http://en.wikipedia.org/wiki/100_Photographs_that_Changed_the_World); [10] transverse pelvic CT (gray scale) with multiple superimposed simulated x-ray photon radiotherapy beams, and their cumulative 20Gy (red) deposited dose isocontours at the focus of a tumor (courtesy of Paul Read, MD, PhD); [11] false-colored scanning electron micrograph of human immunodeficiency virus (HIV) particles (yellow) infecting a human H9 T-cell (turquoise) (adapted from http://biosingularity.com/category/infection/); [12] transverse 18F-dopa positron emission tomography (PET) slice through a Parkinson patient’s brain showing decreased in vivo quantitative uptake in the right caudate and putamen (courtesy of Christaan Schiepers, MD, PhD); [13] registered and fused transverse head CT (gray scale) and registered superimposed PET image (color) of a patient immediately after radio-therapeutic proton irradiation showing endogenously created 15O-positron emitter (2 min half-life) within the nasopharyngeal tumor focus (courtesy of Kira Grogg, PhD). [14] transverse (long axis) cardiac 99mTc-sestamibi SPECT slice illustrating thinned myocardial apical wall in a procedure performed thousands of times daily around the world (adapted from www.medscape.com). These images are but a small sampling of the breadth of the spectrum of light that is currently being investigated the world over by passionate scientists and engineers on a quest for the betterment of the human condition. All contributors for these images used herein have given their permission for their use, and are graciously thanked.
Image by Martin Tornai
Cardiac Cycle
CG Animated Human Heart cut section showing the atria, ventricles and valves, synced with wiggers diagram.
Image by DrJanaOfficial/Wikimedia
Magnetic Resonance Angiography
Figure A shows the heart's position in the body and the location and angle of the MRI pictures shown in figure C. Figure B is an MRI angiogram, which is sometimes used instead of a standard angiogram. Figure C shows MRI pictures of a normal left ventricle (left image), a left ventricle damaged from a heart attack (middle image), and a left ventricle that isn't getting enough blood from the coronary arteries (right image).
Image by National Heart Lung and Blood Institute (NIH)
Cardiac magnetic resonance imaging perfusion
Animated sagittal MRI slice of my beating heart
Image by Bionerd
Cardiac magnetic resonance imaging perfusion
Animated image of an MRI of the heart, showing a large myxoma plunging to and fro from atrium to ventricle across the mitral valve.
Image by Jccmoon at English Wikipedia
Low-field MRI system for cardiac and lung imaging
Video by NHLBI/YouTube
Annual report : National Institutes of Health. National Heart, Lung, and Blood Advisory Council
At head of title, 1976: National Heart, Blood Vessel, Lung, and Blood Program
Title varies slightly
Reports describe the activities of the National Heart, Lung, and Blood Institute
Description based on: 9th (Sept. 1981)
Subjects: National Heart, Lung, and Blood Institute; National Heart, Lung, and Blood Advisory Council; Heart; Heart; Lungs; Lungs; Blood; Blood; Cardiology; Cardiovascular Diseases; Hematology; Lung Diseases
Document by
National Heart, Lung, and Blood Advisory Council
National Heart, Lung, and Blood Institute. cn
/Wikimedia
Cardiac magnetic resonance Arrhythmogenic right ventricular dysplasia
A short axis view of the heart showing a cine cardiac magnetic resonance. In this case, the scan demonstrates features of Arrhythmogenic right ventricular dysplasia with fatty infiltration of the left and right ventricles.
Image by Jccmoon at English Wikipedia/Wikimedia
Cardiac MRI vector
Cardiac MRI vector visualization
Image by Vasanawala/Wikimedia
Cardiac MRI: What you should know if your doctor orders a cardiac MRI
Video by Cleveland Clinic/YouTube
Tests and Procedures~Cardiac MRI
Video by CardioSmart/YouTube
Cardiac MRI
Video by MRI Michigan/YouTube
Indications for Cardiac Magnetic Resonance Imaging
Video by Medmastery/YouTube
Seeing Inside the Heart With MRI - Mayo Clinic
Video by Mayo Clinic/YouTube
Cardiac Stress Perfusion MRI Scan
Video by UHP_NHS/YouTube
New Cardiac MRI Leads to Better Diagnosis
Video by NationwideChildrens/YouTube
PET/MR
Hybrid device for PET/MR diagnostics with a magnetic field strength of 3 Tesla.
Image by Tomáš Vendiš/Wikimedia
Sensitive content
This media may include sensitive content
John survived death: Cardiopulmonary rehabilitation
John Boudreaux is a colonel in the U.S. Air Force. In 2016, he suffered a critical sudden cardiac arrest. He was dead for several minutes. Less than 6% of out-of-hospital cardiac arrest victims survive the trip to the hospital. John's doctors gave him less than 1%. Today, as a group commander at Cannon Air Force Base, New Mexico, he bears the scars that remind him for every one of him, there are 99 others buried in the ground. (U.S. Air Force photo by Senior Airman Lane T. Plummer)
Image by U.S. Air Force photo by Senior Airman Lane T. Plummer
Lp-PLA2, Coronary heart disease
Coronary heart disease is the leading cause of death for both men and women. There is no single biomarker that can perfectly predict a person's risk of heart disease; half of all people who suffer heart attacks have normal cholesterol. This is why researchers have developed additional biomarkers for heart disease, such as Lp-PLA2 (or lipoprotein-associated phospholipase A2), an enzyme linked to the inflammation of blood vessels. Individuals with high levels of Lp-PLA2 are at much higher risk of heart attack and stroke even if their cholesterol levels are normal.
Image by TheVisualMD
Coronary Artery Blockage
This video shows blockage that can occur within coronary arteries of the heart. Coronary arteries is a network of blood vessels that delivers the heart its own supply of blood. Here, the video reveals an angiogram of a patient showing blockages in the 4 coronary arteries.
Image by TheVisualMD
Coronary catheterization
Representative Reconstructed Images of CTO Lesions at the Left Anterior Descending Coronary Artery (LAD) and Right Coronary Artery (RCA).1A, 1D: Coronary angiography (CAG) image; 1B, 1E: Multiplanar reconstruction images; 1C, 1F: Three-dimensional volume rendering (Tree) image.
A cardiac CT scan is an imaging test that uses X-rays to take many detailed pictures of your heart and its blood vessels. This test can help diagnose or evaluate ischemic heart disease, calcium buildup in the coronary arteries, problems with the aorta, problems with heart function and valves, and pericardial disease.
A cardiac CT scan is an imaging test that uses X-rays to take many detailed pictures of your heart and its blood vessels. This test can help diagnose or evaluate ischemic heart disease, calcium buildup in the coronary arteries, problems with the aorta, problems with heart function and valves, and pericardial disease.
A cardiac CT scan is a painless imaging test that uses x rays to take many detailed pictures of your heart and its blood vessels. Computers can combine these pictures to create a three-dimensional (3D) model of the whole heart.
This imaging test can help doctors detect or evaluate ischemic heart disease, calcium buildup in the coronary arteries, problems with the aorta, problems with heart function and valves, and pericardial disease. This test also may be used to monitor the results of coronary artery bypass grafting or to follow up on abnormal findings from earlier chest x rays. Different CT scanners are used for different purposes. A multidetector CT is a very fast type of CT scanner that can produce high-quality pictures of the beating heart and can detect calcium or blockages in the coronary arteries. An electron beam CT scanner also can show calcium in coronary arteries.
Many x-ray pictures are taken during a cardiac CT scan. A computer puts the pictures together to make a three-dimensional (3D) picture of the whole heart. This picture shows the inside of the heart and the structures that surround the heart.
Doctors use cardiac CT to detect or evaluate:
Coronary heart disease (CHD). In CHD, a waxy substance called plaque narrows the coronary arteries and limits blood flow to the heart. Contrast dye might be used during a cardiac CT scan to show whether the coronary arteries are narrow or blocked. When contrast dye is used, the test is called a coronary CT angiography, or CTA.
Calcium buildup in the walls of the coronary arteries. This type of CT scan is called a coronary calcium scan. Calcium in the coronary arteries may be an early sign of CHD.
Problems with the aorta. The aorta is the main artery that carries oxygen-rich blood from the heart to the body. Cardiac CT can detect two serious problems in the aorta:
Aneurysm (AN-u-rism). An aneurysm is a diseased area of a blood vessel wall that bulges out. An aneurysm can be life threatening if it bursts.
Dissection. A dissection is a split in one or more layers of the artery wall. The split causes bleeding into and along the layers of the artery wall. This condition can cause pain and may be life threatening.
A pulmonary embolism (PE). A PE is a sudden blockage in a lung artery, usually due to a blood clot.
Problems in the pulmonary veins. The pulmonary veins carry blood from the lungs to the heart. Problems with these veins may lead to an irregular heart rhythm called atrial fibrillation (AF). The pictures that cardiac CT creates of the pulmonary veins can help guide procedures used to treat AF.
Problems with heart function and heart valves. In some cases, doctors may recommend cardiac CT instead of echocardiography or cardiac MRI (magnetic resonance imaging) to look for problems with heart function or heart valves.
Pericardial disease. This is a disease that occurs in the pericardium, the sac around your heart. Cardiac CT can create clear, detailed pictures of the pericardium.
Results of coronary artery bypass grafting (CABG). In CABG, arteries from other areas in your body are used to bypass (that is, go around) narrow coronary arteries. A CT scan can help determine whether the grafted arteries remain open after the surgery.
Doctors also might recommend cardiac CT scans before or after other heart procedures, such as cardiac resynchronization therapy. A CT scan can help your doctor pinpoint the areas of the heart or blood vessels where the procedure should be done. The scan also can help your doctor check your heart after the procedure.
Because the heart is in motion, a fast type of CT scanner, called multidetector computed tomography (MDCT), might be used to take high-quality pictures of the heart. MDCT also might be used to detect calcium in the coronary arteries.
Another type of CT scanner, called electron-beam computed tomography (EBCT), also is used to detect calcium in the coronary arteries.
Cardiac CT is done in a hospital or outpatient office. A doctor who has experience with CT scanning will supervise the test.
The doctor may want to use an iodine-based dye (contrast dye) during the cardiac CT scan. If so, a needle connected to an intravenous (IV) line will be put in a vein in your hand or arm.
The doctor will inject the contrast dye through the IV line during the scan. You may have a warm feeling when this happens. The dye will make your blood vessels visible on the CT scan pictures.
The technician who runs the cardiac CT scanner will clean areas on your chest and apply sticky patches called electrodes. The patches are attached to an EKG (electrocardiogram) machine. The machine records your heart's electrical activity during the scan.
The CT scanner is a large machine that has a hollow, circular tube in the middle. You will lie on your back on a sliding table. The table can move up and down, and it goes inside the tunnel-like machine.
The table will slide slowly into the opening in the machine. Inside the scanner, an x-ray tube moves around your body to take pictures of different parts of your heart. A computer will put the pictures together to make a three-dimensional (3D) picture of the whole heart.
The technician controls the CT scanner from the next room. He or she can see you through a glass window and talk to you through a speaker.
Moving your body can cause the pictures to blur. You'll be asked to lie still and hold your breath for short moments, while each picture is taken.
A cardiac CT scan usually takes about 15 minutes to complete. However, it can take more than an hour to get ready for the test and for the medicine to slow your heart rate.
Your doctor will tell you how to prepare for the cardiac CT scan. He or she may tell you to avoid caffeine and not eat anything for 4 hours before the scan. You’re usually allowed to drink water before the test.
If you take medicine for diabetes, talk with your doctor about whether you'll need to change how you take it on the day of your cardiac CT scan.
Tell your doctor whether you:
Are pregnant or might be pregnant. Even though cardiac CT uses a low radiation dose, the x rays may harm your fetus.
Have asthma or kidney problems or are allergic to any medicines, iodine, or shellfish. These problems can increase your chance of having an allergic reaction to the contrast dye that's sometimes used during cardiac CT.
A technician will ask you to remove your clothes above the waist and wear a hospital gown. You also will be asked to remove any jewelry from around your neck or chest.
If you don't have asthma, COPD (chronic obstructive pulmonary disease), or heart failure, your doctor may give you medicine to slow your heart rate. A slower heart rate will help produce better quality pictures. The medicine will be given by mouth or injected into a vein.
Cardiac CT involves radiation, although the amount used is considered small. Depending on the type of CT scan you have, the amount of radiation is similar to the amount you’re naturally exposed to over 1–5 years.
There is a small chance that cardiac CT will cause cancer because of the radiation. The risk is higher for people younger than 40 years old. New cardiac CT methods are available that reduce the amount of radiation used during the test.
Cardiac CT scans are painless. Some people have side effects from the contrast dye that might be used during the scan. An itchy feeling or a rash may appear after the contrast dye is injected. Normally, neither side effect lasts for long, so medicine often isn't needed.
If you do want medicine to relieve the symptoms, your doctor may prescribe an antihistamine. This type of medicine is used to help stop allergic reactions.
Although rare, it is possible to have a serious allergic reaction to the contrast dye. This reaction may cause breathing problems. Doctors use medicine to treat serious allergic reactions.
People who have asthma, COPD (chronic obstructive pulmonary disease), or heart failure may have breathing problems during cardiac CT if they're given beta blockers to slow their heart rates.
https://www.nhlbi.nih.gov/health-topics/cardiac-ct-scan [accessed on Aug 25, 2021]
Additional Materials (8)
Cardiac CT scan
Video by UHP_NHS/YouTube
Having a Cardiac CT Scan in Hospital
Video by Oxford AHSN/YouTube
DENSITY OF CORONARY ARTERY CALCIUM MAY HELP PREDICT RISK OF HEART ATTACK AND STROKE
Video by TheJAMAReport/YouTube
Calcium Score: Detecing Heart Disease EARLY!
Video by HeartSmartMD/YouTube
Dr Henson's Calcium Score
Video by Executive Health/YouTube
Coronary Calcium Scan
Coronary Calcium Scan. Figure A shows the position of the heart in the body and the location and angle of the coronary calcium scan image. Figure B is a coronary calcium scan image showing calcifications in a coronary artery.
Image by NHLBI/NIH
Human Heart
Composited image profile of a heart as seen through various rendering techniques. With volume rendering software, slices of Magnetic Resonance Imagery (MRI), and Computer Tomography (CT) scans can be compiled to produce a three-dimensional (3D) model of an organ such as a heart. Models can be viewed in various ways. As individual slices, as is seen along the left or as enhanced color, gray scale volume and 3D transparency, as is seen along the right.
Image by TheVisualMD
Computed tomography of the heart
Contrast enhanced dual-source CT-angiograph.
Image by Scheffel H, Alkadhi H, Plass A, Vachenauer R, Desbiolles L, Gaemperli O, Schepis T, Frauenfelder T, Schertler T, Husmann L, Grunenfelder J, Genoni M, Kaufmann PA, Marincek B, Leschka S.
5:04
Cardiac CT scan
UHP_NHS/YouTube
4:59
Having a Cardiac CT Scan in Hospital
Oxford AHSN/YouTube
2:00
DENSITY OF CORONARY ARTERY CALCIUM MAY HELP PREDICT RISK OF HEART ATTACK AND STROKE
TheJAMAReport/YouTube
1:37
Calcium Score: Detecing Heart Disease EARLY!
HeartSmartMD/YouTube
5:59
Dr Henson's Calcium Score
Executive Health/YouTube
Coronary Calcium Scan
NHLBI/NIH
Human Heart
TheVisualMD
Computed tomography of the heart
Scheffel H, Alkadhi H, Plass A, Vachenauer R, Desbiolles L, Gaemperli O, Schepis T, Frauenfelder T, Schertler T, Husmann L, Grunenfelder J, Genoni M, Kaufmann PA, Marincek B, Leschka S.
Coronary Calcium Scan
Coronary Calcium Scan
Also called: Coronary CT calcium scan, Calcium scan test, Cardiac CT for calcium scoring, Cardiac CT scan, Heart CT scan
A coronary calcium scan is a CT scan of your heart that detects and measures the amount of calcium in the walls of your coronary arteries. Buildup of calcium, or calcifications, are a sign of atherosclerosis, coronary heart disease, or coronary microvascular disease.
Coronary Calcium Scan
Also called: Coronary CT calcium scan, Calcium scan test, Cardiac CT for calcium scoring, Cardiac CT scan, Heart CT scan
A coronary calcium scan is a CT scan of your heart that detects and measures the amount of calcium in the walls of your coronary arteries. Buildup of calcium, or calcifications, are a sign of atherosclerosis, coronary heart disease, or coronary microvascular disease.
https://www.nhlbi.nih.gov/health-topics/coronary-calcium-scan [accessed on Apr 09, 2020]
https://medlineplus.gov/ency/article/007344.htm [accessed on Apr 09, 2020]
Additional Materials (13)
DENSITY OF CORONARY ARTERY CALCIUM MAY HELP PREDICT RISK OF HEART ATTACK AND STROKE
Video by TheJAMAReport/YouTube
Calcium Score: Detecing Heart Disease EARLY!
Video by HeartSmartMD/YouTube
Detecting Heart Disease with Calcium Score - Scottsdale Medical Imaging
Video by SMILLTD/YouTube
Coronary Artery Disease
Image by TheVisualMD
Coronary catheterization
Coronary angiography of a critical sub-occlusion of the common trunk of the left coronary artery and the circumflex artery. (See arrows).
Image by Maria A Pantaleo, Anna Mandrioli, Maristella Saponara, Margherita Nannini, Giovanna Erente, Cristian Lolli and Guido Biasco
Living With Coronary Heart Disease
Low magnification micrograph of the distal right coronary artery with complex atherosclerosis and luminal narrowing : Micrograph of the distal right coronary artery, which supplies the heart, showing significant atherosclerosis and marked luminal narrowing (the space where blood can flow is narrower than normal).
Image by Nephron
Atherosclerosis
Illustration of Atherosclerosis and plaque that may lead to Angina.
Image by OpenStax College
Coronary Calcium Scan
Coronary Calcium Scan. Figure A shows the position of the heart in the body and the location and angle of the coronary calcium scan image. Figure B is a coronary calcium scan image showing calcifications in a coronary artery.
Image by NHLBI/NIH
Dr Henson's Calcium Score
Video by Executive Health/YouTube
What Does Cardiac CT (Computer Tomography) Show?
The illustration shows the major signs and symptoms of coronary heart disease.
Image by National Heart Lung and Blood Insitute (NIH)
Angiograms Can Detect Blockages
If someone has symptoms or risk factors for heart disease, a doctor can use different tests to evaluate heart function and detect blockages. Electrocardiograms, or EKGs, can show if the heart has been damaged. Exercise tolerance tests, also know as stress tests, measure the heart's ability to supply the body with oxygen. But for pinpointing blockages, X-ray images called angiograms are essential.
Image by TheVisualMD
Chest Radiograph
Medical X-rays
Image by Nevit Dilmen
What To Expect During a Coronary Calcium Scan
3D reconstruction of the thin multislice CT, covering human heart and lungs
Image by Semnic
2:00
DENSITY OF CORONARY ARTERY CALCIUM MAY HELP PREDICT RISK OF HEART ATTACK AND STROKE
TheJAMAReport/YouTube
1:37
Calcium Score: Detecing Heart Disease EARLY!
HeartSmartMD/YouTube
3:51
Detecting Heart Disease with Calcium Score - Scottsdale Medical Imaging
SMILLTD/YouTube
Coronary Artery Disease
TheVisualMD
Coronary catheterization
Maria A Pantaleo, Anna Mandrioli, Maristella Saponara, Margherita Nannini, Giovanna Erente, Cristian Lolli and Guido Biasco
Living With Coronary Heart Disease
Nephron
Atherosclerosis
OpenStax College
Coronary Calcium Scan
NHLBI/NIH
5:59
Dr Henson's Calcium Score
Executive Health/YouTube
What Does Cardiac CT (Computer Tomography) Show?
National Heart Lung and Blood Insitute (NIH)
Angiograms Can Detect Blockages
TheVisualMD
Chest Radiograph
Nevit Dilmen
What To Expect During a Coronary Calcium Scan
Semnic
Stress Tests
Stress Tests
Also called: Cardiac Stress Test, Cardiac Diagnostic Test
Stress tests shows how well your heart works when it's pumping hard. They can find problems with blood flow to your heart muscle and other heart conditions. Reduced blood flow can be a sign of a serious heart disease.
Stress Tests
Also called: Cardiac Stress Test, Cardiac Diagnostic Test
Stress tests shows how well your heart works when it's pumping hard. They can find problems with blood flow to your heart muscle and other heart conditions. Reduced blood flow can be a sign of a serious heart disease.
Stress tests show how well your heart works when it's pumping hard. Some heart diseases are easier to find when your heart is working its hardest to pump blood through your body. So stress tests check your heart while you exercise on a treadmill or stationary bicycle. If you're not able to exercise, medicine can be used to make your heart work harder , as if you were exercising.
There are different types of stress tests. They all check:
Blood flow in your heart
Your blood pressure
The rate and rhythm of your heartbeat
The strength of the electrical signals that control your heartbeat
Some stress tests also take pictures of your heart at rest and when it's working hard. The pictures provide more detail about how your heart is working.
Stress tests are most often used to find the cause of symptoms that may be from a heart problem.
The tests can help diagnose certain heart conditions, including:
Coronary artery disease (CAD)
Angina
Arrhythmia
Heart failure
Heart valve diseases
Cardiomyopathy
Stress testing is also used:
To find out how serious a known heart condition is, including the chance that you'll have a heart attack in the future.
To help make treatment decisions for a heart condition.
You may need a stress test if you have symptoms that could be from a heart condition. Symptoms may include:
Chest pain or discomfort without a known cause
Shortness of breath
Irregular or rapid heartbeat that may feel like a fluttering in your chest
Feeling dizzy or lightheaded
You may also need a stress test to check your heart health if you:
Have a heart condition with new or worsening symptoms.
Are going to have surgery. Your health care provider may want to see if your heart is strong enough for the operation.
Are being treated for heart disease. The test can show how much treatment is helping, including heart surgery.
Have a high risk for heart disease. Your risk may be higher than normal if you have a family history of heart disease and/or certain conditions, such as diabetes, that are linked to heart disease.
Plan to start an exercise program. If you have a heart condition or a high risk for a heart condition, a stress test can show what level of exercise is safe for you. (Always talk with your provider before starting any strenuous, new exercise.)
Stress tests may be done with or without imaging (pictures of your heart). The most common type of test is an exercise stress test. It doesn't include pictures. But the main steps of an exercise stress test are part of all stress tests:
You'll have a blood pressure cuff on your arm to check your blood pressure.
Electrodes will be placed on your body for an electrocardiogram test (also called EKG or ECG). Electrodes are small sensors that stick to your skin. Wires connect the electrodes to a computer or an EKG machine that records the electrical activity in your heart during the stress test.
If you're unable to exercise: An intravenous (IV) line will be inserted into a vein in your arm. You'll get medicine through the IV. The medicine will make your heart work harder for 10 to 20 minutes while an EKG records your heart's electrical activity. Medicine can be used instead of exercise for all types of stress tests.
If you can exercise: You'll walk on a treadmill or ride a stationary bicycle. On a treadmill, the speed will slowly increase. The treadmill may also tilt so you feel like you're walking uphill. On a bicycle, the resistance will slowly increase, so it's harder to pedal.
You'll exercise for about 10 to 15 minutes until you reach a target heart rate based on your age and fitness level. But you may stop the test sooner if:
You develop chest pain, shortness of breath, dizziness, fatigue or other symptoms
The EKG shows a problem with your heart
After all types of stress tests, you'll be monitored for 10-15 minutes or until your heart rate returns to normal.
Stress tests with pictures include stress echocardiograms, nuclear stress tests, and cardiac (heart) MRI stress tests. These tests have extra steps:
A stress echocardiogram or "echo" takes moving pictures of your heart using doppler ultrasound. The pictures show the size and shape of your heart and blood flow through your heart. Pictures will be taken before and after your heart has worked its hardest. You'll lie on your left side on a table as a provider moves an ultrasound device on your chest. If you exercise on a bicycle, the second set of pictures may be taken while you're pedaling.
A nuclear stress test takes pictures of your heart using a small amount of a radioactive substance called a "tracer" and a special camera that scans your heart. A provider injects the tracer into your bloodstream through an IV line that's placed in a vein. Your heart and blood vessels absorb the tracer, which makes them show up more clearly in the pictures.
Pictures are taken while you lie on a table before and after your heart has worked its hardest. After the test, the tracer naturally leaves your body in your urine (pee). Drinking lots of water will help remove it faster.
A cardiac MRI stress test takes the most detailed pictures of your heart using radio waves, magnets, and a computer. It is a newer test that's mostly used for very serious heart problems. For an MRI stress test:
A provider may inject dye into your bloodstream through an IV line placed in your arm. Some cardiac MRIs, but not all, use dye to help show very small details on the pictures.
Pictures of your heart may be taken before and after your heart has worked hard. To take the pictures, you'll lie on a table that slides into a large, tunnel-like MRI machine. You'll hear loud sounds as the machine takes pictures. If you're exercising for the test, you may use a treadmill near the MRI, or you may exercise while lying in the MRI machine using special devices to move your arms or legs.
Wear comfortable shoes and clothing for exercise. Your provider will tell you what else to do before a stress test. You'll usually need to fast (not eat or drink) and stop smoking for at least a few hours before the test. You may need to avoid drinks with caffeine, such as coffee, tea, and colas, for a longer period of time.
If you take medicines or supplements, ask your provider if you should take them as usual. Don't stop taking any medicine unless your provider tells you to. If your test uses MRI, tell your provider about any metal you have in your body. An MRI can heat certain metal and cause burns.
Stress tests are usually safe. You will be closely watched during the test. If a problem develops, you'll be treated quickly. Medicines that make your heart work harder sometimes cause symptoms such as chest pain, dizziness, or nausea. An IV may bruise your arm.
The tracers and dyes used in nuclear and MRI stress tests may cause an allergic reaction, but this is rare. If you are or could become pregnant or are breastfeeding, talk with your provider before you have these tests.
A normal test result means no blood flow problems were found. Your heart is working well.
If your test result was not normal, it may mean you have heart disease. Ask your provider to explain what condition you may have. You may need more tests to find out how serious your condition is.
Stress Tests: MedlinePlus Medical Test [accessed on Mar 09, 2023]
Exercise Tolerance Test
Exercise Tolerance Test
Also called: Treadmill Stress Testing, Exercise Stress Test, Cardiopulmonary Exercise Test, CPX Test
Exercise tolerance testing is a form of cardiac stress testing that uses treadmill exercise with electrocardiogram (EKG) and blood pressure monitoring. The test is used to determine a patient’s functional capacity, assess the probability and extent of coronary artery disease (CAD) as well as assess risks, prognosis and effects of therapy.
Exercise Tolerance Test
Also called: Treadmill Stress Testing, Exercise Stress Test, Cardiopulmonary Exercise Test, CPX Test
Exercise tolerance testing is a form of cardiac stress testing that uses treadmill exercise with electrocardiogram (EKG) and blood pressure monitoring. The test is used to determine a patient’s functional capacity, assess the probability and extent of coronary artery disease (CAD) as well as assess risks, prognosis and effects of therapy.
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Use the slider below to see how your results affect your
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(mL/kg)/min
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Your result is Good.
VO2 max refers to the maximum amount of oxygen that an individual can utilize during intense or maximal exercise. The greater your VO2 max, the more oxygen your body can consume and transport to your organs, muscles, and tissues, enabling you to have better endurance and performance for a given effort.
Related conditions
This test allows your doctor to learn how your heart reacts to exercise. As you walk on the treadmill, an EKG (electrocardiogram) will check your heart’s electrical activity. The EKG may show if your heart lacks blood flow or has abnormal heartbeats during exercise. The stress test also helps your doctor decide if you need further tests to evaluate your heart.
Before the test begins, your nurse or doctor will explain it to you. Feel free to ask questions and voice concerns at this time. When you understand what will happen, you will be asked to sign a consent for the test to be performed.
To monitor your heart during exercise, adhesive patches, called electrodes, will be put on your chest. Your chest will be cleansed with alcohol and shaved in some areas (if necessary) before these electrodes are placed.
You will be asked about symptoms you have had with exercise in the past. Describe, as completely as you can, any chest discomfort, breathing problems, lightheadedness or dizziness, fluttering in the chest, weakness, fatigue, or anything else you think may be relevant. Also, mention anything you feel while you are being prepared for the test.
A nurse or doctor will be with you throughout the test. Your heart rate and rhythm and your blood pressure will be checked during the test.
Generally, the treadmill’s pace and incline will increase every 3 minutes. It is important that you describe anything you feel as you exercise. If you become short of breath, the nurse may ask you to rate it as “mild,” “moderate,” or “severe.” If you have chest discomfort, you will be asked to describe it as best you can and rate it on a scale of 1 to 10 (1 is very mild; 10 is very severe). There is no right or wrong number. This helps your doctor know how you are doing and gives us a better way to compare how you feel before and after the test.
Keep walking until you are told to stop or until you cannot walk any longer. Let the nurse know when you need to slow down. Keep walk-ing as the treadmill slows. Do not jump off.
While you rest, your heart will continue to be monitored.
Inform the doctor or nurse about any temporary or permanent condition that could affect your ability to move, walk, bear weight, or keep your balance. If possible, discuss this when you are first scheduled for the test. It is also important that the doctor and/or nurse conducting the test have this information.
Carefully follow your doctor’s instructions about medications. Some medications should be stopped for 48 hours before the test; others should not be stopped. If you do not have clear instructions about all your medications (including those for your heart, blood pressure, or other medications), contact your doctor or nurse a few days before the test.
Avoid caffeine, alcohol, and nicotine 8 hours before the test. Do not eat 2 hours before the test, and do not drink liquids 1 hour before the test. If your exercise test is combined with heart imaging (such as a thallium scan), follow the specific instructions for that test.
Try to be as well rested as possible. You may need to reschedule the test if you feel unwell (for example, if you have a cold). If you do not feel you can give your maximum exercise effort, contact your nurse or doctor before the test.
Wear loose, comfortable clothing with a separate top and bottom. Women should wear bras. Wear comfortable, flat shoes that will not slip off while you are walking.
After the procedure:
You can eat and drink as usual.
Depending on how you feel, you may go about your normal routine or take it easy if the test tired you.
Do not take a hot shower for at least an hour after the test. Your blood vessels expand with exercise and need time to return to normal. A hot shower may expand them more, causing low blood pressure and dizziness.
Procedures/Diagnostic Tests. Exercise tolerance test. National Institutes of Health Clinical Center. [accessed on Dec 11, 2018]
Vilcant V, Zeltser R. Treadmill Stress Testing. [Updated 2018 Oct 27]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2018 Jan-. [accessed on Dec 11, 2018]
Am Fam Physician. 2017 Sep 1;96(5):293-299. Exercise Stress Testing: Indications and Common Questions. Garner KK, Pomeroy W, Arnold JJ. [accessed on Dec 11, 2018]
Am Fam Physician. 1999 Jan 15;59(2):401-10. Ordering and understanding the exercise stress test. Darrow MD. [accessed on Dec 11, 2018]
Harvard Men's Health. Cardiac exercise stress testing: What it can and cannot tell you. [accessed on Dec 11, 2018]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Stress Echocardiography
Stress Echocardiography
Also called: Echocardiography Stress Test, Stress Echo
Stress echocardiography, or echo, is a test that uses sound waves to create moving pictures of your heart. A stress echo is done as part of a stress test. Some heart problems, such as coronary heart disease, are easier to diagnose when the heart is working hard and beating fast.
Stress Echocardiography
Also called: Echocardiography Stress Test, Stress Echo
Stress echocardiography, or echo, is a test that uses sound waves to create moving pictures of your heart. A stress echo is done as part of a stress test. Some heart problems, such as coronary heart disease, are easier to diagnose when the heart is working hard and beating fast.
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Use the slider below to see how your results affect your
health.
Your result is Normal.
A normal result means that blood flow through the coronary arteries is probably normal.
Related conditions
https://medlineplus.gov/ency/article/007150.htm [accessed on Feb 23, 2022]
https://medlineplus.gov/lab-tests/stress-tests/ [accessed on Feb 23, 2022]
https://www.nhlbi.nih.gov/health-topics/echocardiography [accessed on Feb 23, 2022]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Ankle Brachial Index
Ankle Brachial Index
Also called: ABI, Ankle Blood Pressure Measurement
The ankle brachial index, or ABI, is a simple test that compares blood pressure in your ankle with the blood pressure in your arm to see how well your blood is flowing. This test can help diagnose peripheral artery disease.
Ankle Brachial Index
Also called: ABI, Ankle Blood Pressure Measurement
The ankle brachial index, or ABI, is a simple test that compares blood pressure in your ankle with the blood pressure in your arm to see how well your blood is flowing. This test can help diagnose peripheral artery disease.
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Use the slider below to see how your results affect your
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{ratio}
0.5
0.9
1
1.4
Your result is Normal.
Normal ABI ranges from 1.0 to 1.4. Pressure is normally higher in the ankle than the arm.
Related conditions
Ankle Brachial Index Test - Health Encyclopedia - University of Rochester Medical Center [accessed on Oct 02, 2018]
Ankle-brachial index - Mayo Clinic [accessed on Oct 02, 2018]
Ankle Brachial Index | Stanford Medicine 25 | Stanford Medicine [accessed on Oct 02, 2018]
Ankle–brachial pressure index - Wikipedia [accessed on Oct 02, 2018]
Ankle-brachial index - Harvard Health [accessed on Oct 02, 2018]
Ankle-Brachial Index (ABI) | Cleveland Clinic [accessed on Oct 02, 2018]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (15)
Ankle-Brachial Index (ABI) Testing
Video by AllHealthGo/YouTube
Vascular Diseases
Ankle brachial pressure index - The illustration shows the ankle-brachial index test. The test compares blood pressure in the ankle to blood pressure in the arm. As the blood pressure cuff deflates, the blood pressure in the arteries is recorded.
Image by Jmarchn
Facts about Peripheral Arterial Disease (P.A.D.) for African Americans
Facts about Peripheral Arterial Disease (P.A.D.) for African Americans
Document by National Heart, Lung, and Blood Institute
Diagnosis of Atherosclerosis: Ankle-Brachial Index – Vascular Medicine | Lecturio
Video by Lecturio Medical/YouTube
Measuring the Ankle-Brachial Index
Video by Larry Mellick/YouTube
Ankle Brachial Index (ABI) Test: How to Perform
Video by Stanford Medicine 25/YouTube
Understanding Ankle Brachial Pressure Index (ABPI) in Peripheral Vascular Disease
Video by Zero To Finals/YouTube
How to perform an ankle brachial index
Video by St. Michael's Hospital/YouTube
Knee Dislocation - Everything You Need To Know - Dr. Nabil Ebraheim
Video by nabil ebraheim/YouTube
What Is Peripheral Vascular Disease? | Heart Disease
Video by Howcast/YouTube
What is Peripheral Arterial Disease?
Video by CardioTabs/YouTube
What Is Peripheral Artery Disease?
The illustration shows how P.A.D. can affect arteries in the legs. Figure A shows a normal artery with normal blood flow. The inset image shows a cross-section of the normal artery. Figure B shows an artery with plaque buildup that's partially blocking blood flow. The inset image shows a cross-section of the narrowed artery.
Image by National Heart Lung and Blood Institute
Other Names for Peripheral Artery Disease
The image shows how smoking can affect arteries in the heart and legs. Figure A shows the location of coronary heart disease and peripheral arterial disease. Figure B shows a detailed view of a leg artery with atherosclerosis-plaque buildup that's partially blocking blood flow. Figure C shows a detailed view of a coronary (heart) artery with atherosclerosis.
Image by National Heart, Lung, and Blood Institute / NIH
Peripheral Artery Disease
Peripheral Artery Disease.
Image by Blausen.com staff (2014). "Medical gallery of Blausen Medical 2014
Peripheral artery disease
Image by Injurymap.com
2:08
Ankle-Brachial Index (ABI) Testing
AllHealthGo/YouTube
Vascular Diseases
Jmarchn
Facts about Peripheral Arterial Disease (P.A.D.) for African Americans
National Heart, Lung, and Blood Institute
4:52
Diagnosis of Atherosclerosis: Ankle-Brachial Index – Vascular Medicine | Lecturio
Lecturio Medical/YouTube
3:23
Measuring the Ankle-Brachial Index
Larry Mellick/YouTube
7:44
Ankle Brachial Index (ABI) Test: How to Perform
Stanford Medicine 25/YouTube
4:41
Understanding Ankle Brachial Pressure Index (ABPI) in Peripheral Vascular Disease
Zero To Finals/YouTube
6:25
How to perform an ankle brachial index
St. Michael's Hospital/YouTube
13:18
Knee Dislocation - Everything You Need To Know - Dr. Nabil Ebraheim
nabil ebraheim/YouTube
2:17
What Is Peripheral Vascular Disease? | Heart Disease
Howcast/YouTube
4:38
What is Peripheral Arterial Disease?
CardioTabs/YouTube
What Is Peripheral Artery Disease?
National Heart Lung and Blood Institute
Other Names for Peripheral Artery Disease
National Heart, Lung, and Blood Institute / NIH
Peripheral Artery Disease
Blausen.com staff (2014). "Medical gallery of Blausen Medical 2014
A Doppler ultrasound is an imaging test that uses sound waves to evaluate the blood flow and blood pressure within the arteries and veins of any part of your body. The test shows the speed and direction of blood flow in real time.
A Doppler ultrasound is an imaging test that uses sound waves to evaluate the blood flow and blood pressure within the arteries and veins of any part of your body. The test shows the speed and direction of blood flow in real time.
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Use the slider below to see how your results affect your
health.
Your result is Normal.
A normal result indicates that you have no abnormalities that could affect the normal blood flow in the examined area. It also means that the blood pressure in your arteries is normal.
Related conditions
A Doppler ultrasound is an imaging test that uses sound waves to show blood moving through blood vessels. A regular ultrasound also uses sound waves to create images of structures inside the body, but it can't show blood flow.
Doppler ultrasound works by measuring sound waves that are reflected from moving objects, such as red blood cells. This is known as the Doppler effect.
There are different types of Doppler ultrasound tests. They include:
Color Doppler. This type of Doppler uses a computer to change sound waves into different colors. These colors show the speed and direction of blood flow in real time.
Power Doppler, a newer type of color Doppler. It can provide more detail of blood flow than standard color Doppler. But it cannot show the direction of blood flow, which can be important in some cases.
Spectral Doppler. This test shows blood flow information on a graph, rather than color pictures. It can help show how much of a blood vessel is blocked.
Duplex Doppler. This test uses standard ultrasound to take images of blood vessels and organs. Then a computer turns the images into a graph, as in spectral Doppler.
Continuous wave Doppler. In this test, sound waves are sent and received continuously. It allows for more accurate measurement of blood that flows at faster speeds.
Doppler ultrasound tests are used to help health care providers find out if you have a condition that is reducing or blocking your blood flow. It may also be used to help diagnose certain heart diseases. The test is most often used to:
Check heart function. It is often done along with an electrocardiogram, a test that measures electrical signals in the heart.
Look for blockages in blood flow. Blocked blood flow in the legs can cause a condition called deep vein thrombosis (DVT).
Check for blood vessel damage and for defects in the structure of the heart.
Look for narrowing of blood vessels. Narrowed arteries in arms and legs can mean you have condition called peripheral arterial disease (PAD). Narrowing of arteries in the neck can mean you have a condition called carotid artery stenosis.
Monitor blood flow after surgery.
Check for normal blood flow in a pregnant woman and her unborn baby.
You may need a Doppler ultrasound if you have symptoms of reduced blood flow or a heart disease. Symptoms vary depending on the condition causing the problem. Some common blood flow conditions and symptoms are below.
Symptoms of peripheral arterial disease (PAD) include:
Numbness or weakness in your legs
Painful cramping in your hips or leg muscles when walking or climbing stairs
Cold feeling in your lower leg or foot
Change in color and/or shiny skin on your leg
Symptoms of heart problems include:
Shortness of breath
Swelling in your legs, feet, and/or abdomen
Fatigue
You may also need a Doppler ultrasound if you:
Have had a stroke. After a stroke, your health care provider may order a special kind of Doppler test, called transcranial Doppler, to check blood flow to the brain.
Had an injury to your blood vessels.
Are being treated for a blood flow disorder.
Are pregnant and your provider thinks you or your unborn baby might have a blood flow problem. Your provider may suspect a problem if your unborn baby is smaller than it should be at this stage of pregnancy or if you have certain health problems. These include sickle cell disease or preeclampsia, a type of high blood pressure that affects pregnant women.
A Doppler ultrasound usually includes the following steps:
You will lie a table, exposing the area of your body that's being tested.
A health care provider will spread a special gel on the skin over that area.
The provider will move a wand-like device, called a transducer, over the area.
The device sends sound waves into your body.
The movement of blood cells causes a change in the pitch of the sound waves. You may hear swishing or pulse-like sounds during the procedure.
The waves are recorded and turned into images or graphs on a monitor.
After the test is over, the provider will wipe the gel off your body.
The test takes about 30-60 minutes to complete.
To prepare for a Doppler ultrasound, you may need to:
Remove clothing and jewelry from the area of the body that is getting tested.
Avoid cigarettes and other products that have nicotine for up to two hours before your test. Nicotine causes blood vessels to narrow, which can affect your results.
For certain types of Doppler tests, you may be asked to fast (not eat or drink) for several hours before the test.
Your health care provider will let you know if you need to do anything to prepare for your test.
There are no known risks to having a Doppler ultrasound. It is also considered safe during pregnancy.
If your results were not normal, it may mean you have:
A blockage or clot in an artery
Narrowed blood vessels
Abnormal blood flow
An aneurysm, a balloon-like bulge in the arteries. It causes the arteries to become stretched and thin. If the wall becomes too thin, the artery can rupture, causing life-threatening bleeding.
Results may also show if there is abnormal blood flow in an unborn baby.
The meaning of your results will depend what area of the body was being tested. If you have questions about your results, talk to your health care provider.
https://medlineplus.gov/lab-tests/doppler-ultrasound/ [accessed on May 31, 2019]
https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=av2854 [accessed on Mar 17, 2019]
https://www.mayoclinic.org/doppler-ultrasound/expert-answers/faq-20058452 [accessed on Mar 17, 2019]
https://medlineplus.gov/ency/article/003775.htm [accessed on Mar 17, 2019]
https://www.healthline.com/health/doppler-ultrasound-exam-of-an-arm-or-leg [accessed on Mar 17, 2019]
https://www.radiologyinfo.org/en/glossary/glossary1.cfm?gid=96 [accessed on Mar 17, 2019]
http://www.imagingpathways.health.wa.gov.au/index.php/consumer-info/imaging-procedures/doppler-ultrasound [accessed on Mar 17, 2019]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (43)
Clogged Artery
Plaque lining the intima of an artery.
Image by Scientific Animations Inc.
Coronary Artery Disease
Figure A shows the location of the heart in the body. Figure B shows a normal coronary artery with normal blood flow. The inset image shows a cross-section of a normal coronary artery. Figure C shows a coronary artery narrowed by plaque. The buildup of plaque limits the flow of oxygen-rich blood through the artery. The inset image shows a cross-section of the plaque-narrowed artery.
Image by National Heart Lung and Blood Insitute (NIH)
Carotid ultrasonography
color flow ultrasonography (Doppler) of a carotid artery - scanner and screen
Image by Etan J. Tal
What Is Transesophageal Echocardiography?
Figure A shows a transesophageal echocardiography probe in the esophagus, behind the heart. Sound waves from the probe create high-quality pictures of the heart. Figure B shows an echocardiogram of the heart's lower and upper chambers (ventricles and atrium, respectively).
Image by National Heart Lung and Blood Institute (NIH)
Image by Patrick J. Lynch, medical illustrator/Wikimedia
Atherosclerosis
The illustration shows an artery with normal blood flow (Figure A) and an artery containing plaque buildup (Figure B).
Image by National Heart Lung and Blood Insitute (NIH)
Schematic diagram of normal sinus rhythm for a human heart as seen on ECG.
Schematic representation of normal ECG trace (sinus rhythm) with waves, segments, and intervals labeled. The QT interval is marked by blue stripe at bottom.
Image by Created by Agateller (Anthony Atkielski), converted to svg by atom.
This browser does not support the video element.
Atherosclerosis
Obesity and Atherosclerosis : Atherosclerosis is a disease in which hard, fatty deposits called plaque build up inside your arteries. Being obese-defined as having a body mass index over 30--makes it much more likely that you'll develop atherosclerosis.
Video by TheVisualMD
Spectrum of Medical Imaging
This composite image was created in recognition of The Society of Photo-Optical Instrumentation Engineers (SPIE) designation of 2015 as the “International Year of Light.” Medical imaging scientists and engineers contribute to the quest for the improved human condition by providing imaging that spans the entire usable electro-magnetic spectrum (seen at bottom). From the humblest of beginnings with simple magnification of objects and focusing with lenses, to the biological observation of cells with rudimentary microscopes in the visible spectrum, medical imaging today has both extended away from the visible spectrum towards longer and shorter wavelengths (low and high energies) and exploited the hyperspectral nature of the visible which was once considered “commonplace” or rudimentary. Considering yet a different cross-section through the various imaging modalities across the spectrum, the medically useful information gained spans anatomic, physiologic, and molecular regimes. Systems and algorithms have been developed as single-modality acquisition systems, and also as multiple-modalities with conjoint reconstruction, each informing the other in the quest to optimize image quality and information content. In addition, the role of light-based technologies in enabling advanced computations in tomographic reconstructions, computer-aided diagnosis, machine learning (neural networks, deep learning, etc.) , and 3D visualizations as well as in data-enriched storage of medical images has further extended the potential knowledge “seen” through imaging. The breadth of the electromagnetic spectrum offers limitless opportunities for improvement and inquiry, in our quest to answer human life’s difficult questions. This montage was first published on the cover of the SPIE’s Journal of Medical Imaging (July-Sept. 2015, vol. 3, no. 3) and is but a small tribute to the multitude of medical imaging scientists who have contributed to the wealth of new knowledge as we interrogate the human condition. The gray-scale whole body images (from Left to Right) are acquired from longer wavelength modalities to shorter wavelength modalities spanning the (currently) usable electromagnetic spectrum. The background images include: a coronal Magnetic Resonance Image (MRI) T2 weighted image slice, a posterior surface Infra Red (IR) heat map, a coronal non-contrast Computed Tomography (CT) slice, and a coronal 18F-fluoro-deoxyglucose Positron Emission Tomography (FDG-PET) slice. The selection of color inset images includes (from Top-to-Bottom, then Left to Right): [1] diffusion tensor magnetic resonance imaging (MRI) used to image long white matter tracts within and around the human brain illustrating neuronal connectivity (coloring refers to bluish=vertical direction; green=horizontal A-P direction; red=horizontal lateral direction) (courtesy of Arthur Toga, PhD); [2] registered and superimposed coronal proton-MRI (gray-scale) and a hyper polarized 129Xe ventilation MRI scan (color scale) within the same patient’s lungs, prior to their receiving a bronchial stent (courtesy of Bastiaan Driehuys, PhD); [3] coronal slice through a microwave-based image reconstruction of the Debye parameter ε (epsilon) in a heterogeneously dense human breast phantom (courtesy of Susan Hagness, PhD); [4] juxtaposed optical image of the retina and vertical and horizontal Optical Coherence Tomograph (OCT) slices showing pigmentosa retinopathy (courtesy of Jean-Michel Muratet, MD); [5] functional 3-D photoacoustic imaging of melanoma (gray scale) in vivo, surrounded by highly optically absorptive blood vessels (red) (courtesy of Lihong Wang, PhD); [6] optical micrograph of HeLa cells stained for microtubules (blue) and co-stained with DAPI for actin visualization (red); HeLa cells are the world's first stem cell line, originally derived from the aggressive cervical cancer cells of Henrietta Lacks (courtesy Tom Deerinck/NCMIR); [7] visualization of the pelvis highlighting the colon, which is imaged with contrast x-ray computed tomography (CT), and after digital surface rendering can be used in virtual colonoscopy, thus avoiding a physical visible light-based colonoscopy; [8] registered and fused sagittal 99mTc-sestamibi dedicated molecular single photon emission computed tomography (SPECT, heat color scale) and low-dose CT slice (gray scale) of a patient’s uncompressed, pendant breast containing two surgically confirmed DCIS loci in the posterior breast (courtesy of Martin Tornai, PhD); [9] classic, early x-radiograph of Wilhelm Röntgen’s wife’s hand (adapted from http://en.wikipedia.org/wiki/100_Photographs_that_Changed_the_World); [10] transverse pelvic CT (gray scale) with multiple superimposed simulated x-ray photon radiotherapy beams, and their cumulative 20Gy (red) deposited dose isocontours at the focus of a tumor (courtesy of Paul Read, MD, PhD); [11] false-colored scanning electron micrograph of human immunodeficiency virus (HIV) particles (yellow) infecting a human H9 T-cell (turquoise) (adapted from http://biosingularity.com/category/infection/); [12] transverse 18F-dopa positron emission tomography (PET) slice through a Parkinson patient’s brain showing decreased in vivo quantitative uptake in the right caudate and putamen (courtesy of Christaan Schiepers, MD, PhD); [13] registered and fused transverse head CT (gray scale) and registered superimposed PET image (color) of a patient immediately after radio-therapeutic proton irradiation showing endogenously created 15O-positron emitter (2 min half-life) within the nasopharyngeal tumor focus (courtesy of Kira Grogg, PhD). [14] transverse (long axis) cardiac 99mTc-sestamibi SPECT slice illustrating thinned myocardial apical wall in a procedure performed thousands of times daily around the world (adapted from www.medscape.com). These images are but a small sampling of the breadth of the spectrum of light that is currently being investigated the world over by passionate scientists and engineers on a quest for the betterment of the human condition. All contributors for these images used herein have given their permission for their use, and are graciously thanked.
Image by Martin Tornai
Atherosclerosis - Stable vs. Unstable Plaque
Stable vs. Unstable Plaque
Image by BruceBlaus
Atherosclerosis - Normal vs. Partially-Blocked Vessel
Normal vs. Partially-Blocked Vessel
Image by BruceBlaus
New Compact Ultrasound
A new compact ultrasound-delivering device helps alleviate osteoarthritis of the knee. An osteoarthritic knee has damaged joint surfaces, inflammation and swelling. This creates a stagnant environment. Just like a saturated sponge will not accept more water, the osteoarthritic joint is slow to soak up nutrients. However, ultrasound delivered at a low volume for a long time through a newly designed compact transducer agitates remaining cartilage and tissues. The ultrasound penetrates the joint and tissues. It stimulates the joint thermally and mechanically and improves permeability, creating a dynamic environment conducive to healing. Similar to a sponge that has been wrung out, the treated knee is now able to absorb nutrients. The waste is removed and swelling subsides.
Image by Zina Deretsky, National Science Foundation
What Is Atherosclerosis?
Figure A shows a normal artery with normal blood flow. The inset image shows a cross-section of a normal artery. Figure B shows an artery with plaque buildup. The inset image shows a cross-section of an artery with plaque buildup.
Image by National Heart Lung and Blood Insitute (NIH)
Micrograph of the distal right coronary artery with complex atherosclerosis and luminal narrowing
Low magnification micrograph of the distal right coronary artery with complex atherosclerosis and luminal narrowing. Masson's trichrome.
Arteries have three layers (tunica intima, tunica media and tunica adventitia). These can be seen on the micrograph:
Adventitia (outermost layer) = green fluffy material (collagen),
Media (middle (muscular) part) = red (smooth muscle actin),
Intima (inner part, in contact with the blood) = green (collagen) with some red (smooth muscle actin).
Features of atherosclerosis seen on the micrograph:
The tunica intima is severely thickened; it measures up to approximately 1/3 of a millimetre. Normally, it is one cell layer thick (approximately 10 micrometres).
There is fragmentation of the internal elastic lamina (a very thin black wavy layer) between the intima and media.
There is a partial duplication of the internal elastic lamina.
There is smooth muscle infiltration of the intima (from the media), i.e. red staining of the intima.
There is significant luminal narrowing. The section of the artery shown has only 25-35% of the cross-sectional area it once had; the artery's original lumen was approximately where the double layer of elastin is seen (the internal elastic lamina).
Features that may be seen in atherosclerosis but are not evident in the micrograph:
Calcifications.
Cholesterol crystals.
Image by Nephron
Atherosclerosis - Glossary
Atherosclerosis disease progression. Progression of atherosclerosis to late complications.
Image by Npatchett
Atherosclerosis
Illustration of Atherosclerosis and plaque that may lead to Angina.
Image by OpenStax College
Echocardiography
CONTINGENCY OPERATING BASE SPEICHER, TIKRIT, Iraq - Col. John Scott, of Silver Spring, Md., the only American pediatric cardiologist in Iraq, is joined by the father of Dayah to look at the boy's echocardiogram at the 47th Combat Support Hospital, Sept. 17. The examination was part of a diagnostic cardiovascular screening session designed to link potential sponsors from various non-governmental organizations to fund the children's heart surgery.
Image by U.S. Army photo by Spc. Jazz Burney, 3rd Infantry Brigade Combat Team
Start with an Exam
Doctors may find evidence of atherosclerosis in the course of a physical exam. Signs may include:Whooshing sounds (bruits), heard with a stethoscope
Weak or absent pulse in affected regions
Decreased blood pressure in a limb
Poor wound healing in affected regions
Signs of an aneurysm in the abdomen or below the knee
Image by TheVisualMD
Diagnosing Atherosclerosis
Doctors may find evidence of atherosclerosis during a physical exam, such as sounds (bruits) heard through a stethoscope, weak pulse, or poor wound healing. If signs of atherosclerosis are present, diagnostic tests may be performed. These can include blood tests, electrocardiograms (EKGs), angiograms or other imaging tests, and Doppler ultrasounds. If signs of atherosclerosis are present, diagnostic tests may be performed. Diagnostic tests may include one or more of the following:
Image by TheVisualMD
Image by Kristoffer Lindskov Hansen, Michael Bachmann Nielsen and Caroline Ewertsen / https://commons.wikimedia.org/wiki/File:Doppler_ultrasound_of_systolic_velocity_(Vs),_diastolic_velocity_(Vd),_acceleration_time_(AoAT),_systolic_acceleration_(Ao_Accel)_and_resistive_index_(RI)_of_normal_kidney.jpg
Ultrasonography of orchitis
Doppler ultrasound of the scrotum, in the axial plane, of a 70 year old man with left-sided pain in the region, as well as CRP elevation. It shows orchitis (as part of epididymo-orchitis) as a hypoechogenic and slightly heterogenic left testicular tissue (right in image), with an increased blood flow. There is also swelling of peritesticular tissue.
Image by Mikael Häggström, M.D. - Author info - Reusing imagesWritten informed consent was obtained from the individual, including online publication./Wikimedia
Carotid arterial ultrasound
A patient has an ultrasonic transducer placed against their neck during a carotid arterial ultrasound at Yokota Air Base, Japan, May 11, 2016. The transducer works on similar principals to radar and sonar systems, converting ultrasound waves into electrical signals. (U.S. Air Force photo by Senior Airman David C. Danford/Released)
Image by U.S. Air Force photo by Senior Airman David C. Danford/Released
Spectral Doppler
Medical spectral Doppler of common carotid artery By Daniel W. Rickey 2006
Image by Drickey/Wikimedia
Doppler ultrasound image of inferior vena cava
Pulsed wave Doppler ultrasound image of inferior vena cava
Echocardiography, animation of a mitral valve insufficiency in a dog, left apical view.
Image by Kalumet
Sensitive content
This media may include sensitive content
Vaginal Ultrasound
Vaginal Ultrasound
Image by BruceBlaus
Fetal Ultrasound
Ultrasound image (sonogram) of a fetus in the womb.
Image by BruceBlaus/Wikimedia
Transcranial Doppler
Transcranial Doppler Insonation of the Cerebral Circulation
Image by Runeaaslid at English Wikipedia
Angiogenesis of a breast tumor can be viewed in an Doppler ultrasound and in magnetic resonance imaging after contrast agent has been injected.
Tumor angiogenesis is the proliferation of a network of blood vessels that penetrates into cancerous growths, supplying nutrients and oxygen and removing waste products. Tumor angiogenesis actually starts with cancerous tumor cells releasing molecules that send signals to surrounding normal host tissues. This signaling activates certain genes in the host tissue that, in turn, make proteins to encourage growth of new blood vessels. Angiogenesis of a breast tumor can be viewed in an Doppler ultrasound and in magnetic resonance imaging after contrast agent has been injected.
Image by TheVisualMD
Tumor angiogenesis signaling activates certain genes in the host tissue that, in turn, make proteins to encourage growth of new blood vessels.
Tumor angiogenesis is the proliferation of a network of blood vessels that penetrates into cancerous growths, supplying nutrients and oxygen and removing waste products. Tumor angiogenesis actually starts with cancerous tumor cells releasing molecules that send signals to surrounding normal host tissues. This signaling activates certain genes in the host tissue that, in turn, make proteins to encourage growth of new blood vessels. Angiogenesis of a breast tumor can be viewed in an Doppler ultrasound and in magnetic resonance imaging after contrast agent has been injected.
Image by TheVisualMD
Doppler Ultrasound, Investigation
Image by Beeki/Pixabay
Sonoline fetal doppler - Ultrasound - 5412
Sonoline B fetal doppler - 3MHz Ultrasound
Image by Amada44
Ultrasound is partly reflected by blood cells and plasma back toward the speaker-microphone. Because the cells are moving, two Doppler shifts are produced—one for blood as a moving observer, and the other for the reflected sound coming from a moving source. The magnitude of the shift is directly proportional to blood velocity.
Schematic diagram of normal sinus rhythm for a human heart as seen on ECG.
Created by Agateller (Anthony Atkielski), converted to svg by atom.
2:23
Atherosclerosis
TheVisualMD
Spectrum of Medical Imaging
Martin Tornai
Atherosclerosis - Stable vs. Unstable Plaque
BruceBlaus
Atherosclerosis - Normal vs. Partially-Blocked Vessel
BruceBlaus
New Compact Ultrasound
Zina Deretsky, National Science Foundation
What Is Atherosclerosis?
National Heart Lung and Blood Insitute (NIH)
Micrograph of the distal right coronary artery with complex atherosclerosis and luminal narrowing
Nephron
Atherosclerosis - Glossary
Npatchett
Atherosclerosis
OpenStax College
Echocardiography
U.S. Army photo by Spc. Jazz Burney, 3rd Infantry Brigade Combat Team
Start with an Exam
TheVisualMD
Diagnosing Atherosclerosis
TheVisualMD
Kristoffer Lindskov Hansen, Michael Bachmann Nielsen and Caroline Ewertsen / https://commons.wikimedia.org/wiki/File:Doppler_ultrasound_of_systolic_velocity_(Vs),_diastolic_velocity_(Vd),_acceleration_time_(AoAT),_systolic_acceleration_(Ao_Accel)_and_resistive_index_(RI)_of_normal_kidney.jpg
Ultrasonography of orchitis
Mikael Häggström, M.D. - Author info - Reusing imagesWritten informed consent was obtained from the individual, including online publication./Wikimedia
Carotid arterial ultrasound
U.S. Air Force photo by Senior Airman David C. Danford/Released
Carotid ultrasound uses an ultrasound machine to detect plaque buildup in the carotid arteries in the neck and see whether the buildup is blocking blood flow to the brain. Test results help your doctor plan treatment to remove the plaque and help prevent a stroke.
Carotid ultrasound uses an ultrasound machine to detect plaque buildup in the carotid arteries in the neck and see whether the buildup is blocking blood flow to the brain. Test results help your doctor plan treatment to remove the plaque and help prevent a stroke.
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Use the slider below to see how your results affect your
health.
%
50
70
Your result is Normal.
The results will tell your doctor how open or narrowed your carotid arteries are. The lower the degree of arterial stenosis the better.
Related conditions
Carotid ultrasound is a painless imaging test that uses high-frequency sound waves to create pictures of the inside of your carotid arteries.
This test uses an ultrasound machine, which includes a computer, a screen, and a transducer. The transducer is a handheld device that sends and receives sound waves.
If combined with Doppler ultrasound, this test also can show how blood is moving through your arteries.
Carotid ultrasound is done to detect plaque buildup in one or both of the carotid arteries in the neck and to see whether the buildup is narrowing your carotid arteries and blocking blood flow to the brain.
Test results will help your doctor plan treatment to remove the plaque and help prevent a stroke.
A carotid ultrasound can show whether plaque buildup has narrowed one or both of your carotid arteries. If so, you might be at risk of having a stroke. The risk depends on the extent of the blockage and how much it has reduced blood flow to your brain.
To lower your risk of stroke, your doctor may recommend medical or surgical treatments to reduce or remove plaque from your carotid arteries.
Carotid ultrasound usually is done in a doctor's office or hospital. The test is painless and often doesn't take more than 30 minutes.
The ultrasound machine includes a computer, a screen, and a transducer. The transducer is a hand-held device that sends and receives ultrasound waves.
You will lie on your back on an exam table for the test. Your technician or doctor will put gel on your neck where your carotid arteries are located. The gel helps the ultrasound waves reach the arteries.
Your technician or doctor will put the transducer against different spots on your neck and move it back and forth. The transducer gives off ultrasound waves and detects their echoes as they bounce off the artery walls and blood cells. Ultrasound waves can't be heard by the human ear.
The computer uses the echoes to create and record pictures of the insides of the carotid arteries. These pictures usually appear in black and white. The screen displays these live images for your doctor to review.
Your carotid ultrasound test might include a Doppler ultrasound. Doppler ultrasound is a special test that shows the movement of blood through your arteries. Blood flow through the arteries usually appears in color on the ultrasound pictures.
Carotid ultrasound has no risks because the test uses harmless sound waves. They are the same type of sound waves that doctors use to record pictures of fetuses in pregnant women.
https://www.nhlbi.nih.gov/health-topics/carotid-ultrasound [accessed on Aug 28, 2021]
https://medlineplus.gov/ency/article/003774.htm [accessed on Aug 28, 2021]
https://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/cardiology/peripheral-arterial-disease-carotid/ [accessed on Aug 28, 2021]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (32)
Carotid Artery Ultrasound
Video by ConemaughHealthSyst/YouTube
A Carotid Artery Screening - using ultrasound to detect your risk for a stroke.
Video by healthscreenings/YouTube
The Doctors TV Show-HeartSmart IMT -- The Test that could save your life
Video by ProactiveWellnessCtr/YouTube
Common Carotid Artery
3D visualization based on scanned human data of the main vasculature to the head. Since the brain uses about one fifth of the oxygen absorbed into the lungs and brain tissue is at risk of permanent damage just after 5 minutes of blood deprivation, 2 pairs of large vessels - one running through the vertebrae, the other arising from the chest - ensure a generous, constant supple of blood.
Image by TheVisualMD
What Is Carotid Artery Disease?
Carotid Artery: Figure A shows the location of the right carotid artery in the head and neck. Figure B is a cross-section of a normal carotid artery that has normal blood flow. Figure C shows a carotid artery that has plaque buildup and reduced blood flow.
Image by National Heart Lung and Blood Institute (NIH)
Cervical Spine with Carotid Artery Aneurysm
3D visualization based on scanned human data of an aneurysm in the left carotid artery. A carotid artery aneurysm can after trauma, infection or previous surgery of the carotid artery.
Image by TheVisualMD
Plaque Build Up in Carotid Artery
This 3D visualization reveals plaque buildup and atherosclerosis within the carotid artery.
Image by TheVisualMD
What To Expect During Carotid Ultrasound
Carotid ultrasound: Figure A shows how the ultrasound probe (transducer) is placed over the carotid artery. Figure B is a color ultrasound image showing blood flow (the red color in the image) in the carotid artery. Figure C is a waveform image showing the sound of flowing blood in the carotid artery.
Image by National Heart Lung and Blood Institute (NIH)
Carotid stenting
Carotid Artery Stenting: The illustration shows the process of carotid artery stenting. Figure A shows an internal carotid artery that has plaque buildup and reduced blood flow. The inset image shows a cross-section of the narrowed carotid artery. Figure B shows a stent being placed in the carotid artery to support the inner artery wall and keep the artery open. Figure C shows normal blood flow restored in the stent-widened artery. The inset image shows a cross-section of the stent-widened artery.
Image by National Heart Lung and Blood Insitute (NIH)
Carotid ultrasonography
color flow ultrasonography (Doppler) of a carotid artery - scanner and screen
Image by Etan J. Tal
Blockage in Carotid Artery of Head and Neck
An ischemic stroke happens when a blockage occurs in the arteries leading to, and within, the brain. Ischemic strokes are more common than hemorrhagic strokes and fall into different categories. A person suffers a thrombotic stroke if the blockage is a is clot or a narrowing of the artery leading to the brain. An embolic stroke happens when a clot breaks off from its original site and moves through the bloodstream to block one of the smaller arteries in the brain. Embolic strokes tend to occur very suddenly. Thrombotic strokes may occur slowly over a period of time, and may actually be preceded by transient ischemic attacks or mini-strokes.
Image by TheVisualMD
Treatment
Coronary Heart Disease and Heart Attack Treatment
Image by TheVisualMD
Living With Carotid Artery Disease
Segments of the internal carotid artery, delineated on an MRA of the head.
Image by Behrang Amini
Carotid endarterectomy
Carotid endarterectomy: The illustration shows the process of carotid endarterectomy. Figure A shows a carotid artery that has plaque buildup. The inset image shows a cross-section of the narrowed carotid artery. Figure B shows how the carotid artery is cut and the plaque removed. Figure C shows the artery stitched up and normal blood flow restored. The inset image shows a cross-section of the artery with plaque removed and normal blood flow restored.
Image by National Heart Lung and Blood Institute (NIH)
Carotid Artery
Human head anatomy with external and internal carotid arteries
Image by Patrick J. Lynch from North Haven, Connecticut, United States
Image by Ruben Sebben, MD, at Dr Jones and Partners Medical Imaging (Adelaide, Australia)
Carotid Arteries of Heart
Major vasculature is revealed in this image looking up at a man's neck and head. Visible are the common carotid arteries, a pair of blood vessels that run along both sides of the neck supplying freshly oxygenated blood to the head and neck. The right common carotid artery is a branch off the brachiocephalic trunk- the first branch of the aorta. The left common carotid artery is the second branch of the aorta. Each common carotid bifurcates in the neck into an internal and external carotid artery. The external carotid artery supplies the tissues of the face and neck, while the internal carotid artery travels straight up into the skull to deliver blood to the brain.
Image by TheVisualMD
Carotid Duplex Exam
Video by Sonographic Tendencies/YouTube
Carotid artery testing
Video by CVADOCS/YouTube
Carotid Artery Disease and Stroke: Prevention and Treatment | Q&A
Video by Johns Hopkins Medicine/YouTube
Carotid Artery Disease & Stroke Angioplasty - Dr. May Nour | UCLAMDChat
Video by UCLA Health/YouTube
Carotid arterial ultrasound
A patient has an ultrasonic transducer placed against their neck during a carotid arterial ultrasound at Yokota Air Base, Japan, May 11, 2016. The transducer works on similar principals to radar and sonar systems, converting ultrasound waves into electrical signals. (U.S. Air Force photo by Senior Airman David C. Danford/Released)
Image by U.S. Air Force photo by Senior Airman David C. Danford/Released
external and internal carotid arteries
Human head anatomy with external and internal carotid arteries
Image by Patrick J. Lynch from North Haven, Connecticut, United States
Venous Insufficiency
Video by CVADOCS/YouTube
Carotid Protocol (Esther Collado, RN, RVI)
Video by Houston Methodist DeBakey CV Education/YouTube
Identifying carotid artery disease with ultrasound
Video by Medmastery/YouTube
Who Should be Screened for Carotid Disease?
Video by SVS Vascular/YouTube
Ask ADC: Carotid Ultrasound
Video by The Austin Diagnostic Clinic (ADCHealth)/YouTube
Carotid artery ultrasound scan to detect plaque
American Screening Association’s Cardiovascular Technician Lashawn Hines performs Carotid artery ultrasound scan to detect plaque in Vascular Technician Linda Callirgosm as she demonstrate one of several types of ultrasound procedures available during the U.S. Department of Agriculture (USDA) National Work and Family Month Open House and Expo on Thursday, October 16, 2014, in the Whitten building patio and South Building cafeteria meeting rooms, in Washington, D.C. USDA
Image by U.S. Department of Agriculture Photo by Lance Cheung.
Doppler ultrasound analyzer of blood velocity
Doppler ultrasound analyzer of blood velocity produced by JSC "Bioss" (Zelenograd, Moscow, Russia).
Image by Юрий Петрович Маслобоев / Yury Petrovich Masloboev
Doppler Ultrasound, Investigation
Image by Beeki/Pixabay
Sonoline fetal doppler - Ultrasound - 5412
Sonoline B fetal doppler - 3MHz Ultrasound
Image by Amada44
8:44
Carotid Artery Ultrasound
ConemaughHealthSyst/YouTube
2:24
A Carotid Artery Screening - using ultrasound to detect your risk for a stroke.
healthscreenings/YouTube
4:42
The Doctors TV Show-HeartSmart IMT -- The Test that could save your life
ProactiveWellnessCtr/YouTube
Common Carotid Artery
TheVisualMD
What Is Carotid Artery Disease?
National Heart Lung and Blood Institute (NIH)
Cervical Spine with Carotid Artery Aneurysm
TheVisualMD
Plaque Build Up in Carotid Artery
TheVisualMD
What To Expect During Carotid Ultrasound
National Heart Lung and Blood Institute (NIH)
Carotid stenting
National Heart Lung and Blood Insitute (NIH)
Carotid ultrasonography
Etan J. Tal
Blockage in Carotid Artery of Head and Neck
TheVisualMD
Treatment
TheVisualMD
Living With Carotid Artery Disease
Behrang Amini
Carotid endarterectomy
National Heart Lung and Blood Institute (NIH)
Carotid Artery
Patrick J. Lynch from North Haven, Connecticut, United States
What To Expect After Carotid Endarterectomy
Ruben Sebben, MD, at Dr Jones and Partners Medical Imaging (Adelaide, Australia)
Carotid Arteries of Heart
TheVisualMD
12:25
Carotid Duplex Exam
Sonographic Tendencies/YouTube
2:09
Carotid artery testing
CVADOCS/YouTube
10:08
Carotid Artery Disease and Stroke: Prevention and Treatment | Q&A
Johns Hopkins Medicine/YouTube
12:49
Carotid Artery Disease & Stroke Angioplasty - Dr. May Nour | UCLAMDChat
UCLA Health/YouTube
Carotid arterial ultrasound
U.S. Air Force photo by Senior Airman David C. Danford/Released
external and internal carotid arteries
Patrick J. Lynch from North Haven, Connecticut, United States
4:07
Venous Insufficiency
CVADOCS/YouTube
7:34
Carotid Protocol (Esther Collado, RN, RVI)
Houston Methodist DeBakey CV Education/YouTube
4:18
Identifying carotid artery disease with ultrasound
Medmastery/YouTube
3:57
Who Should be Screened for Carotid Disease?
SVS Vascular/YouTube
2:33
Ask ADC: Carotid Ultrasound
The Austin Diagnostic Clinic (ADCHealth)/YouTube
Carotid artery ultrasound scan to detect plaque
U.S. Department of Agriculture Photo by Lance Cheung.
Doppler ultrasound analyzer of blood velocity
Юрий Петрович Маслобоев / Yury Petrovich Masloboev
Doppler Ultrasound, Investigation
Beeki/Pixabay
Sonoline fetal doppler - Ultrasound - 5412
Amada44
Treatment
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When Arteries Become Blocked
Video by TheVisualMD
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When Arteries Become Blocked
People who need angioplasty have blocked arteries, caused by a condition called atherosclerosis. Take a trip inside the vessels to see how they become blocked, the role cholesterol plays, and why it's a matter of life and death to increase blood flow.
Video by TheVisualMD
How Is Atherosclerosis Treated?
If you have a diagnosis of atherosclerosis, work with your healthcare team to set up a treatment plan that works for you based on your lifestyle, your home and neighborhood environment, and your culture. Your 10-year or lifetime risk assessment is a good way to start the conversation.
Heart-healthy lifestyle changes
Heart-healthy living is very important for preventing and treating atherosclerotic plaque buildup throughout your lifetime.
Steps for a healthy lifestyle include:
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. Routine physical activity can help manage risk factors such as high blood cholesterol, 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 doctor what level of physical activity is right for you.
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. Greater amounts of weight loss can also improve blood pressure readings.
Limit how much alcohol you drink. Drinking less is better for health than drinking more. Men should limit their intake to 2 drinks or less in a day. Women should drink 1 drink or less per day.
Manage stress. Learning how to manage stress, relax, and cope with problems can improve your emotional and physical health.
Quit smoking and avoid secondhand smoke. Visit Smoking and Your Heart and Your Guide to a Healthy Heart. Although these resources focus on heart health, they include basic information about how to quit smoking. For free help and support to quit smoking, you can call the National Cancer Institute's Smoking Quitline at 1-877-44U-QUIT (1-877-448-7848). Talk to your doctor if you vape. There is scientific evidence that nicotine and flavorings found in vaping products may damage your heart and lungs.
Get enough good-quality sleep. The recommended amount for adults is 7 to 9 hours of sleep a day.
Medicines
Medicines can help manage risk factors and treat atherosclerosis or its complications. Your doctor may also prescribe medicines to treat other medical conditions, such as high blood pressure, that can worsen plaque buildup.
Medicines often used to treat atherosclerosis or related conditions are listed below.
ACE inhibitors and beta blockers help lower blood pressure and lower the heart's workload.
Anti-platelet or anti-clotting medicines may help reduce risk of complications for some people who have atherosclerosis. Aspirin is not recommended for most people.
Calcium channel blockers lower blood pressure by relaxing blood vessels.
Medicines to control blood sugar, such as empagliflozin, canagliflozin, and liraglutide, help lower your risk for complications if you have atherosclerosis and diabetes.
Metformin helps control plaque buildup 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 treat unhealthy blood cholesterol levels. Your doctor may recommend a statin if you have a higher risk for coronary heart disease or stroke or if you have diabetes and are between ages 40 and 75.
Other cholesterol-lowering medicines, such as ezetimibe, PCSK9 inhibitor, bempedoic acid, and omega-3 fatty acids, may be used if you are unable to take statins or when statins have not worked to treat unhealthy blood cholesterol and triglyceride levels.
Thrombolytic medicines, sometimes called clot busters, may be used to treat blood clots resulting from atherosclerosis. These medicines can dissolve Blood clots that block arteries, causing a stroke, heart attack, mesenteric Ischemia or other problems. Ideally, the medicine should be given as soon as possible.
Complementary and alternative treatments
Some dietary supplements and foods have shown signs in studies that they may help manage atherosclerosis risk factors. Talk with your doctor about possible benefits of nutritional supplements and particular foods. Be sure to discuss any nutritional supplements you’re already taking. Some may interfere with other treatments or cause side effects. Read more about use of dietary supplements in cholesterol management.
Procedures or surgeries
You may need a procedure, heart surgery, or other types of surgery to treat disease resulting from plaque buildup. The type of procedures or surgery depends on arteries affected.
Percutaneous coronary intervention (PCI) opens coronary arteries that are narrowed or blocked by the buildup of plaque. A small mesh tube called a stent is usuallyimplanted after PCI to prevent the artery from narrowing again.
Coronary artery bypass grafting (CABG) improves blood flow to the heart by using normal arteries from the chest wall or veins from the legs to bypass the blocked arteries. Surgeons typically use CABG to treat people who have severe plaque buildup in arteries in the heart. Bypass grafting can also treat arteries in other parts of the body, such as the arteries leading to the intestines.
Transmyocardiallaser revascularizationor coronary endarterectomy treats severe angina associated with coronary heart disease when other treatments are too risky or did not work.
Carotid endarterectomy treats carotid artery disease. Other treatment options for this disease may include angioplasty and carotid artery stenting.
Weight-loss surgery may help reduce inflammation leading to plaque buildup in people who have severe obesity.
Angioplasty opens narrowed or blocked arteries. Doctors may use angioplasty to treat peripheral artery disease affecting the legs, in the arteries of the heart to treat coronary heart disease, or in the neck to treat carotid artery disease. Your doctor may inflate a small balloon in the artery to help flatten the plaque. Sometimes the balloon is coated with medicine to help the artery heal. Your doctor may also insert a small mesh tube called a stent to reduce the chances of the artery narrowing again.
To help relieve symptoms of peripheral artery disease, your doctor will recommend a supervised exercise program in a clinic or a home-based exercise program. Most home programs include health coaching, activity monitors, or regular check-ins with a coach by telephone. Talk with your doctor regularly about your progress.
If you have had a complication from atherosclerosis, your doctor may recommend a cardiac rehabilitation program.
Behavioral therapy or coaching support helps many people stick with heart-healthy lifestyle changes. Counseling may also improve people’s quality of life after they’ve had a complication.
Source: National Heart, Lung, and Blood Institute (NHLBI)
Additional Materials (14)
How Is Atherosclerosis Treated?
Treatments of Atherosclerosis
Image by TheVisualMD
Atheroma - Blocked Artery Due to Plaque
What To Expect Before a Stent Procedure
Angioplasty Balloon in External Iliac Artery
What To Expect After a Stent Procedure
Completed Angioplasty of External Iliac Artery
1
2
3
4
5
Blocked Artery / Balloon Angioplasty / Insertion of Stent
1) Blocked Artery
2) Pre Expansion of balloon
3) Balloon Angioplasty
4) Insertion of Stent
5) With-drawl of Catheter
Interactive by TheVisualMD
Atherosclerosis: Definition, Diagnosis & Treatment – Vascular Medicine | Lecturio
Video by Lecturio Medical/YouTube
Treatment of Atherosclerosis: Therapy Goals & Lifestyle Measures – Vascular Medicine | Lecturio
Video by Lecturio Medical/YouTube
Stiffening arteries
For the last several decades, atherosclerosis was thought to be mostly a result of eating too many fatty foods—especially those containing cholesterol—together with other unhealthy lifestyle practices or certain medical conditions. Now, scientists are finding that cholesterol and even saturated fat may not be the villains they were once thought to be. New research shows that most forms of cholesterol may be “innocent bystanders” in the process of atherosclerosis. The real problem is the body’s own inflammatory, or immune, response to chronic (long-term) injury—and that injury may come from some unexpected sources. Plaques are the body’s mistaken attempt to heal the injured inner lining of your arteries, the blood vessels that carry oxygenated blood from your heart to your body’s tissues. The smooth lining of the arteries may be damaged by toxic substances carried through the bloodstream, like alcohol, nicotine, and trans fats. Your blood vessels can also be injured by high blood pressure or by certain diseases, like diabetes. And elevated blood levels of glucose (blood sugar) from a diet high in refined carbohydrates and starches can also damage your arteries and lead to atherosclerosis.
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Going In
More aggressive treatment may be necessary if symptoms of atherosclerosis are severe or if a life-threatening blockage is present.Angioplasty. A catheter (a long, thin hose) is guided into the blocked portion of the artery. A tiny, deflated balloon is passed into the artery via the catheter and inflated, sometimes several times, to open the blocked portion. Then a stent (a small coil of wire mesh, about ¾" long) is inserted into the artery to keep it from narrowing again. The balloon catheter is removed and the stent remains permanently in place. Angioplasty is a procedure and is considered less risky than surgery, but there are still risks, including bleeding, blockage of blood flow (very rare), infection, damage to a heart valve or blood vessel, kidney failure, arrhythmias, allergic reaction to the X-ray dye, and stroke (rare).
Endarterectomy. Plaques are surgically removed from the walls of the walls of the affected artery using a scalpel. There is a low risk of stroke following the surgery. There is also a risk of arterial restenosis (reblockage) and temporary nerve injury, leading to hoarseness, difficulty with swallowing, or numbness.
Thrombolytic therapy. A clot-dissolving drug is inserted into the artery at the point at which it is blocked.
Bypass surgery. The blocked artery is bypassed by creating a new artery, called a graft. The graft may be created either from another blood vessel in the body (usually from the leg) or from a synthetic tube. One end of the graft is attached above the blockage and the other is attached below, creating a new route for the blood to flow. Complications of bypass surgery can include blockage of the graft, bleeding from the incision, infection, heart attack, kidney failure, and stroke.
Image by TheVisualMD
Going In
More aggressive treatment may be necessary if symptoms of atherosclerosis are severe or if a life-threatening blockage is present.Angioplasty. A catheter (a long, thin hose) is guided into the blocked portion of the artery. A tiny, deflated balloon is passed into the artery via the catheter and inflated, sometimes several times, to open the blocked portion. Then a stent (a small coil of wire mesh, about ¾" long) is inserted into the artery to keep it from narrowing again. The balloon catheter is removed and the stent remains permanently in place. Angioplasty is a procedure and is considered less risky than surgery, but there are still risks, including bleeding, blockage of blood flow (very rare), infection, damage to a heart valve or blood vessel, kidney failure, arrhythmias, allergic reaction to the X-ray dye, and stroke (rare).
Endarterectomy. Plaques are surgically removed from the walls of the walls of the affected artery using a scalpel. There is a low risk of stroke following the surgery. There is also a risk of arterial restenosis (reblockage) and temporary nerve injury, leading to hoarseness, difficulty with swallowing, or numbness.
Thrombolytic therapy. A clot-dissolving drug is inserted into the artery at the point at which it is blocked.
Bypass surgery. The blocked artery is bypassed by creating a new artery, called a graft. The graft may be created either from another blood vessel in the body (usually from the leg) or from a synthetic tube. One end of the graft is attached above the blockage and the other is attached below, creating a new route for the blood to flow. Complications of bypass surgery can include blockage of the graft, bleeding from the incision, infection, heart attack, kidney failure, and stroke.
Image by TheVisualMD
Treatments
More aggressive treatment may be necessary if symptoms of atherosclerosis are severe or if a life-threatening blockage is present.
Image by TheVisualMD
Atherectomy
Atherectomy. See a full animation of this medical topic.
Image by Blausen Medical Communications, Inc.
Put Out the Fire
Tobacco contains nicotine, which causes blood pressure to surge 5-10 mm Hg or more for up to an hour after you smoke. If you smoke throughout the day, your blood pressure remains high throughout the day as well. Smoking makes arteries temporarily constrict (become narrower), contributing to high blood pressure. But smoking narrows arteries in the long term, too. Tobacco contains literally thousands of chemicals. Many of them are toxic and injure the arteries, causing hard plaques to build up inside the vessel walls. Plaques further narrow the arteries, making hypertension worse over time. To quit smoking, it helps to seek support from loved ones, other quitters, counselors, and your doctor, who may recommend medical treatment options.
Image by TheVisualMD
Atherectomy
Atherectomy Rotational
Image by BruceBlaus
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Wake-Up Call
The old adage, "An ounce of prevention is worth a pound of cure," is more relevant than ever, even in today's world of high-tech medicine and science. Neurologist, wellness expert, and author Dr. John Castaldo talks about the need to take action before it's too late.
Video by TheVisualMD
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Dr. Fail Performs Angioplasty: Part 1
This video features a case study of Dr. Fail performing an angioplasty on a patient with a clogged coronary artery.
Video by TheVisualMD
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Dr. Fail Performs Angioplasty: Part 2
This video features a case study of Dr. Fail performing an angioplasty on a patient with a clogged coronary artery.
Video by TheVisualMD
How Is Atherosclerosis Treated?
TheVisualMD
Blocked Artery / Balloon Angioplasty / Insertion of Stent
TheVisualMD
2:09
Atherosclerosis: Definition, Diagnosis & Treatment – Vascular Medicine | Lecturio
Lecturio Medical/YouTube
4:39
Treatment of Atherosclerosis: Therapy Goals & Lifestyle Measures – Vascular Medicine | Lecturio
Lecturio Medical/YouTube
Stiffening arteries
TheVisualMD
Sensitive content
This media may include sensitive content
Going In
TheVisualMD
Going In
TheVisualMD
Treatments
TheVisualMD
Atherectomy
Blausen Medical Communications, Inc.
Put Out the Fire
TheVisualMD
Atherectomy
BruceBlaus
1:08
Wake-Up Call
TheVisualMD
2:39
Dr. Fail Performs Angioplasty: Part 1
TheVisualMD
3:50
Dr. Fail Performs Angioplasty: Part 2
TheVisualMD
Prevention
Keeping Arteries Healthy
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Keeping Arteries Healthy
Losing as little as 5-10 lbs can bring LDL levels back to normal. Have regular checkups and keep track of your cholesterol levels and blood pressure readings Being constantly stressed damages arteries, so find ways to relax Get 7-8 hours of sleep every night
Image by TheVisualMD
How Can Atherosclerosis Be Prevented?
Taking action to control your risk factors can help prevent or slow down plaque buildup. If lifestyle changes aren’t enough, your doctor may prescribe medicine to control your atherosclerosis risk factors. Take all of your medicines as your doctor advises.
A heart-healthy lifestyle starts early in life
Atherosclerosis often begins in childhood and continues developing throughout life. Heart-healthy living — never smoking, eating healthy, and being physically active — starting in childhood and continuing throughout life can prevent atherosclerosis and its complications. Help your kids follow a heart-healthy lifestyle and encourage them to not smoke or vape.
Medicines to control blood cholesterol levels
Doctors now have a range of medicines they can prescribe to manage blood cholesterol levels. Your doctor may prescribe a statin or another medicine, depending on a several factors: your risk for complications, such as heart attack and stroke; whether you have diabetes; your age; and your cholesterol levels. High levels of “bad” cholesterol are an important risk factor for plaque buildup.
Talk with your healthcare team about whether medicines can help you reduce your risk for plaque buildup. Even If you take a medicine as part of your treatment plan, be sure to continue your healthy lifestyle changes.
Treating other health conditions
Certain medical conditions are risk factors for plaque buildup and complications of atherosclerosis. Your healthcare team can help with treating conditions such as chronic kidney disease; diabetes; high blood pressure; high blood triglycerides; and infections, such as HIVexternal link, hepatitis C, and bacterial infections.
Make an appointment with your healthcare team to talk about how to keep your heart healthy. Talk to your doctor about your blood pressure, cholesterol, and blood glucose (sugar) numbers.
Source: National Heart, Lung, and Blood Institute (NHLBI)
Additional Materials (6)
Preventing an Angioplasty
With atherosclerosis, there's good news and there's bad news. The bad news is that atherosclerosis may be slow in developing, but its end results can be debilitating and often fatal. But the good news is that you have the power to prevent and even reverse atherosclerosis by changing the ways in which you live, work, and play. An active, healthy lifestyle is your first line of defense against atherosclerosis.
Image by TheVisualMD
Prevention is Key
Plaque buildup and atherosclerosis may be slow in developing, but the consequences can be debilitating and often fatal. Fortunately, you have the power to keep your blood vessels healthy and clear by making wise choices in the ways in which you live, work, and play.
Image by TheVisualMD
Before - Obese man lifting weights / After - Man lifting weights after weight loss
Exercise Helps Rebuild the Body
Your body is a never-ending construction project. As you read this, old cells in your bones are being broken down and replaced by new ones. Neurons in your brain are making new connections based on information taken in by your senses. When you exercise, muscle cells repair themselves and grow stronger. Nature's regenerative processes are amazing, but remember: You are the foreman of this construction project. Choosing the right combination of aerobic and anaerobic exercise and sticking with your plan will help build a better you. See how exercise builds muscle and helps burn fat.
Interactive by TheVisualMD
Q & A with Dr. Hazen about Coronary Artery Disease Prevention
Video by Cleveland Clinic/YouTube
Benefits of Weight Loss
Losing only 5-10% of body weight has a very significant benefit: it lowers the chances of having a heart attack or stroke. Weight loss can improve blood pressure, lower triglyceride and LDL-cholesterol (the "bad" cholesterol) levels while raising the level of HDL-cholesterol (the "good" cholesterol), and decrease levels of inflammation throughout the body. Diet and exercise increase blood flow which itself is protective against blood vessel inflammation and blockage. Plus, weight loss lessens stress on joints (including the feet), aids sleep, and may reduce risk of cancer.
Image by TheVisualMD
Atherosclerosis: Prevention is the Best Medicine
Video by Demystifying Medicine/YouTube
Preventing an Angioplasty
TheVisualMD
Prevention is Key
TheVisualMD
Exercise Helps Rebuild the Body
TheVisualMD
12:01
Q & A with Dr. Hazen about Coronary Artery Disease Prevention
Cleveland Clinic/YouTube
Benefits of Weight Loss
TheVisualMD
3:44
Atherosclerosis: Prevention is the Best Medicine
Demystifying Medicine/YouTube
Prevention Is Key
Prevention is Key
Image by TheVisualMD
Prevention is Key
Plaque buildup and atherosclerosis may be slow in developing, but the consequences can be debilitating and often fatal. Fortunately, you have the power to keep your blood vessels healthy and clear by making wise choices in the ways in which you live, work, and play.
Image by TheVisualMD
Atherosclerosis: Prevention Is Key
Plaque buildup and atherosclerosis may be slow in developing, but the consequences can be debilitating and often fatal. Fortunately, you have the power to keep your blood vessels healthy and clear by making wise choices in the ways in which you live, work, and play.
Diets high in fruits, vegetables, and fiber help protect against high cholesterol. And if you smoke, quit now-smoking or using tobacco in any form is a high risk factor for atherosclerosis.
For atherosclerosis, prevention is the best medicine. Staying active is key: like any other muscle in your body, your heart benefits from exercise. Exercise increases the amount of HDL cholesterol in the blood and reduces the level of LDL cholesterol. And exercise reduces stress, which has been found to raise cholesterol levels.
Healthy lifestyle choices include:
Quitting smoking
Losing weight if overweight
Eating a healthy diet with few saturated fats and no trans fats; more fruits, vegetables, and fiber; and moderate alcohol intake
Exercising regularly (30-45 minutes, 3-5 times per week)
Controlling diabetes and high blood pressure
Managing stress
In addition to living a healthy lifestyle and taking any prescribed medications, it's important to have regular cholesterol screenings. Doctors recommend being screened once every 5 years if you're 20 years or older, and more often if you have risk factors for atherosclerosis.
Source: TheVisualMD
Living With
Controlling Cholesterol
Image by TheVisualMD
Controlling Cholesterol
Controlling Cholesterol with Medicine
Image by TheVisualMD
Living With Atherosclerosis
If you think that you or someone else has symptoms of heart attack or stroke, call 9-1-1 immediately. Every minute matters.
Heart-healthy living, along with ongoing medical care, can help prevent complications of atherosclerosis and make for a long, healthy life. Plaque buildup can take away years of life, especially for people who have complications. For example, a heart attack takes away more than 16 years of life on average. People with heart failure lose an average of nearly 10 years.
Everyone can take steps to adopt heart-healthy living. Research shows that women who have a healthy lifestyle could expect to live 14 years longer than those who did not, while men would have 12 more years of life.
What health problems can atherosclerosis cause?
Complications of atherosclerosis may occur suddenly with no warning signs. Some conditions, such as heart attack and stroke, may lead to disability or death.
As plaque continues to grow in the arteries, so does the risk of life-threatening complications.
Brain conditions: Plaque buildup in arteries that supply oxygen-rich blood to the brain can lead to a transient ischemic attack or stroke. Plaque can break off or cause a blood clot that travels to the brain, also causing a stroke. Vascular dementia can result from plaque buildup that reduces blood flow to the brain. Vascular dementia causes cognitive decline beyond the normal aging process.
Heart problems: Coronary heart disease can cause aortic aneurysm, arrhythmia (irregular heartbeat), cardiac arrest, heart failure, or a heart attack.
Organ damage: Plaque buildup can block blood flow to your organs, causing conditions such as chronic kidney disease. If your kidneys can’t filter your blood, you may need dialysis or a kidney transplant. Narrowing of the arteries that supply blood to your intestines (mesenteric artery ischemiaexternal link) cause intestinal tissue to die or serious infections. Organ damage can be fatal.
Problems with your limbs: Peripheral artery disease (PAD) can cause long-term poor blood flow in your arms or legs (critical limb ischemia). Signs include sores, infections, and death of tissue (gangrene) due to lack of blood flow. A sudden drop in blood flow to your leg (acute limb ischemia) is a serious medical emergency.
Figure A is an overview of a heart and coronary artery showing damage (dead heart muscle) caused by a heart attack. Figure B is a cross-section of the coronary artery with plaque buildup and a blood clot.
Tips for managing atherosclerosis
If you have atherosclerosis or its risk factors, work closely with your doctor to avoid serious problems, such as heart attack and stroke.
Follow your treatment plan and take all medicines regularly, as your doctor prescribes. Do not change the amount of your medicine or skip a dose unless your doctor tells you to.
To monitor your atherosclerosis risk factors, your doctor may review your 10-year risk for serious complications and also repeat the following tests:
Lipid panels to see if blood cholesterol levels remain at healthy levels
Blood sugar tests for monitoring blood sugar levels
Regularblood pressure checks to be sure your blood pressure is in the healthy range
Learn to take precautions while using statins
Statin are the most common medicine used to treat plaque buildup. Here are some tips to stay safe if your doctor prescribes a statin.
Keep taking your statin medicine as prescribed. If you started taking a statin after you recently had a heart attack, a stroke, or another complication, you should not stop taking this medicine on your own, because that can increase your risk for a repeat event or even death.
Ask your doctor what medicines, nutritional supplements, or foods you should avoid. Some of these can interact with statins to cause serious side effects or make them less effective. For example, grapefruit (fresh or as juice) affects how your liver breaks down some statins.
Tell your doctor about any symptoms or side effects. Sometimes, people report muscle problems while taking statins. If you start having muscle pain, your doctor may order a blood test to look for muscle damage. The pain may go away if you switch to a different statin. Muscle damage with statins is rare, and your muscles may heal when you switch to a different medicine.
If you are a woman who is planning to become pregnant, talk to your doctor about your options. You should stop taking statins about 3 months before getting pregnant. Also, you should not take statins if you are breastfeeding.
When to call your doctor
Talk with your doctor about how often you should schedule office visits and blood tests. Between visits, call your doctor if you get new symptoms, if your symptoms worsen, or if you have problems with your blood pressure or blood sugar.
Let your healthcare team know if you are having problems with any part of your treatment plan. Even if your symptoms get better, be sure to see your doctor for ongoing care.
Take care of your mental health
Having an atherosclerosis-related disease may cause fear, anxiety, depression, and stress. You may worry about having heart problems or making lifestyle changes that are necessary for your health. Talk with your healthcare team about how you feel and actions you can take.
Talk to a counselor. If you have depression or anxiety, medicines or other treatments may also help improve your quality of life.
Join a patient support group. This may help you adjust to living with heart disease. You can find out how other people manage similar symptoms. Your doctor may be able to recommend local support groups, or you can check with an area medical center.
Seek support from family and friends. Let your loved ones know how you feel. Talk with them about what they can do to help relieve your stress and anxiety.
What are the connections between COVID-19 and atherosclerosis?
People who have conditions caused by plaque buildup are more likely to have more serious symptoms if they get COVID-19. Severe COVID-19 increases the chance of needing to be hospitalized in an ICU (intensive care unit), having long-term effects, and dying from the illness. COVID-19 may make plaque buildup worse through inflammatory effects and may cause blood clots to form in blood vessels. These effects may raise the risk of serious complications, such as heart attacks or strokes, from plaque buildup.
However, scientists have seen that some people who are in the hospital for COVID-19 and taking statins or PCSK9 inhibitor medicines for atherosclerosis seem to have a better chance of surviving. More research is needed to see whether the COVID-19 Treatment Guidelines should include these medicines. The guidelines recommend that people with COVID-19 keep taking statins or PKCS9 inhibitors if their doctors prescribed them for atherosclerosis diseases.
Source: National Heart, Lung, and Blood Institute (NHLBI)
Additional Materials (6)
Atherosclerosis may start with your body's own inflammatory (immune system) response
What is Atherosclerosis : Atherosclerosis may start with your body's own inflammatory (immune system) response. When there is long-term injury to the lining of your arteries, like that caused by smoking or high blood pressure, immune system cells and other substances accumulate at the damaged parts of the artery. Over time, the result is clogged, stiffened arteries.
Image by TheVisualMD
Top Five Foods for Clear Arteries - Preventing atherosclerosis
The best foods for preventing plaque build up in your arteries and avoid atherosclerosis are:
Managing Atherosclerosis Risk : Certain lifestyle habits, traits, and conditions may increase the probability that you'll develop atherosclerosis. These conditions are known as risk factors. The more risk factors you have, the greater your chances of developing atherosclerosis. Fortunately, most of these risk factors are within your control.
Image by TheVisualMD
Secrets for living well with heart disease
Video by Mayo Clinic/YouTube
Atherosclerosis Plaque Buildup
Arteries can become clogged with plaque buildup in a process called atherosclerosis, which can lead to clot formation, heart attack, and stroke. Plaque consists of fatty substances such as cholesterol, which is sticky and will adhere to the walls of blood vessels. Over time, the fat accumulates and hardens, all the while narrowing the open space of the artery. This impedes on the flow of blood, as there is now a much narrower tube for it to pass through. Blood pressure tends to increase as a normal volume of blood attempts to pass through areas that are too narrow or in worse cases, completely blocked. Circulation can become compromised in the body part that the artery supplies.
Image by TheVisualMD
How COVID-19 Affects Your Blood
Video by NHLBI/YouTube
Atherosclerosis may start with your body's own inflammatory (immune system) response
TheVisualMD
Top Five Foods for Clear Arteries - Preventing atherosclerosis
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Atherosclerosis
Atherosclerosis or arteriosclerosis is hardening and narrowing of the arteries where plaque builds up inside your arteries. It can block blood flow and may lead to heart attack or stroke. The good news is that atherosclerosis is preventable and treatable. Learn about symptoms, causes, prevention strategies, and treatments for atherosclerosis.