Atherosclerosis II: Clinical Manifestations and Diagnostic Tests

Atherosclerosis manifests differently based on affected arteries. In coronary arteries, it causes coronary artery disease with angina and dyspnea. Cerebrovascular involvement compromises brain blood flow, causing transient ischemic attacks. Peripheral arterial disease in limb arteries causes intermittent claudication. Renal artery atherosclerosis leads to secondary hypertension and chronic kidney disease, while aortic involvement can cause life-threatening aneurysms.

Physical examination identifies key indicators of atherosclerosis by detecting bruits, which are abnormal artery sounds, diminished pulses, and changes in skin color or temperature. These findings suggest reduced blood flow and arterial narrowing. Combined with patient history, physical examination findings guide further diagnostic testing and help clinicians assess disease severity and affected vascular regions.

Blood tests measure cholesterol levels, triglycerides, and C-reactive protein to evaluate cardiovascular risk factors associated with atherosclerosis. Elevated cholesterol and triglycerides indicate increased plaque formation risk, while C-reactive protein reflects arterial inflammation. These tests help clinicians stratify risk, monitor disease progression, and guide treatment decisions for atherosclerosis prevention and management.

The Ankle-Brachial Index compares blood pressure measurements in the ankle and arm to detect peripheral arterial disease. A lower ankle pressure relative to arm pressure indicates reduced blood flow in limb arteries due to atherosclerotic narrowing. This non-invasive test is sensitive for identifying PAD and helps clinicians assess disease severity and determine whether advanced imaging or intervention is needed.

Coronary angiography uses contrast dye and X-rays to visualize coronary artery blockages and assess blood flow patterns. Intravascular ultrasound produces detailed images of artery walls, precisely measuring plaque thickness and volume. While angiography shows vessel patency and blockage location, intravascular ultrasound provides cross-sectional detail of plaque composition and vessel wall changes, offering complementary diagnostic information.

Computed tomography angiography provides detailed arterial images that identify plaque accumulation locations and severity throughout the vascular system. This advanced imaging technique visualizes arterial narrowing caused by atherosclerotic buildup and helps clinicians assess disease extent across multiple vascular beds. CTA guides treatment planning and risk stratification by revealing plaque burden and potential blockage sites.

Electrocardiogram monitors the heart's electrical activity to detect signs of coronary artery disease and ischemia. Echocardiography evaluates heart structure and function, identifying heart muscle and valve issues caused by atherosclerotic coronary disease. Together, these tests assess cardiac consequences of atherosclerosis and help clinicians determine disease impact on heart function and guide appropriate management strategies.