Atherosclerosis Symptoms and Diagnosis

Atherosclerosis is the buildup of plaque — a combination of cholesterol, fat, calcium, and blood elements — on and inside the walls of your arteries. This causes arteries to narrow and stiffen, reducing blood flow throughout the body and potentially causing damage to organs and tissues.

Atherosclerosis develops gradually, and people with mild forms of the disease may not experience any symptoms at all.

Many people with atherosclerosis don’t know they have the condition until their arteries are so narrow or clogged that they can’t supply adequate blood to organs and tissues. (1)

In fact, most people learn that they have atherosclerosis when they experience a medical emergency, such as a stroke or heart attack, according to the National Heart, Lung, and Blood Institute. (2)

If symptoms of atherosclerosis do occur, their location and severity will depend on which blood vessels are affected and how clogged they are. (3)

Early diagnosis and treatment of atherosclerosis can help prevent the condition from worsening and reduce your risk of serious complications.

If you think you have atherosclerosis, talk to your doctor immediately, as it’s a serious health condition. (1)

Signs and Symptoms of Atherosclerosis

Symptoms of moderate to severe atherosclerosis can vary widely depending on where the disease occurs.

Most symptoms are caused by reduced blood flow to the area of your body that connects to the affected arteries. It’s rare for you to feel or notice any changes in the arteries themselves. (2)

Here’s what to expect from atherosclerosis in different areas of your body:

Coronary Arteries

These arteries supply blood to your heart. If they become narrow or blocked — a condition called coronary artery disease (CAD) — you may experience:

  • Chest pain (angina)
  • Irregular heartbeat (arrhythmia)
  • Shortness of breath

Angina often feels like a squeezing sensation on your chest, and the pain may move into your shoulders, jaw, back, or arms. It tends to get worse with physical activity and can also be triggered by emotional stress. (2,3)

You may or may not notice an abnormal heartbeat (arrhythmia), which can feel like racing or fluttering in your chest — or you may notice that your heartbeat is inconsistent. (4)

Carotid Arteries

These arteries supply blood to your brain. If they become narrow or blocked — called carotid artery disease — you may experience symptoms similar to those of a stroke, including:

  • Weakness, often sudden
  • Numbness or paralysis in your face, arms, or legs (especially on one side of your body)
  • Confusion
  • Difficulty breathing
  • Trouble speaking or understanding speech
  • Impaired vision
  • Dizziness or loss of balance
  • Sudden, severe headache
  • Loss of consciousness (2,3)

These symptoms indicate a transient ischemic attack (TIA) when they only last for a short period of time, and often predict a future stroke — so it’s important to seek urgent medical attention if you experience them. (1)

Peripheral Arteries

These arteries supply blood to your arms, legs, and pelvis. If they become narrow or blocked — called peripheral artery disease (PAD) — you may experience the following symptoms in one or more of the affected areas:

  • Numbness
  • Pain, especially during movement (known as claudication)
  • Signs of infection (2,3)

Infections related to PAD are less common than numbness or pain, but they can be especially dangerous. (2)

Renal arteries

These arteries supply blood to your kidneys. If they become narrow or blocked, you may develop chronic kidney disease, which causes a gradual loss of kidney function.

As chronic kidney disease advances, symptoms may include:

  • Fatigue
  • Changes in urination frequency
  • Loss of appetite
  • Nausea
  • Swelling in your hands or feet
  • Itching or numbness (anywhere in your body)
  • Difficulty concentrating (2,3)

How Is Atherosclerosis Diagnosed?

Atherosclerosis is typically diagnosed based on your personal and family medical history, a physical exam, and test results. (2)

During a physical exam, your doctor may find signs of narrowed or hardened arteries, such as:

  • Weak or absent pulse in the affected area
  • Reduced blood pressure in an affected limb
  • Whooshing sounds (known as bruits) heard through a stethoscope on the affected artery
  • Signs of poor circulation or wound healing in the affected area (1,2,5)

Depending on the results of your physical exam, your doctor may suggest one or more of the following diagnostic tests:

Blood Tests Elevated blood cholesterol or glucose (sugar) levels can help establish that you’re at higher risk for atherosclerosis. You’ll need to fast for 9 to 12 hours before these tests.

Electrocardiogram (ECG or EKG) This test records your heart’s electrical activity and can help detect any arrhythmia (irregular heartbeat). It can also show signs of damage to your heart from coronary artery disease (CAD), or a previous heart attack.

If you experience troubling symptoms during physical activity, your doctor may perform a stress test on you by having you walk on a treadmill or ride a stationary bicycle while monitoring your ECG.

Ankle-Brachial Index This test can detect peripheral artery disease (PAD) in your legs and feet by comparing the blood pressure in your ankle with the blood pressure in your arm.

Doppler Ultrasound This test uses a special device to measure your blood flow at different points along your arm or leg. It can help detect blockages or slowed blood flow in your arteries.

Stress Test This procedure involves taking several different measurements during physical activity or while administering medication that increases the heart rate or dilates coronary arteries.

During the exercise stress test, you’ll walk or jog on a treadmill or ride a stationary bicycle while your heart rate, heart rhythm (electrical activity), blood pressure, and breathing are recorded.

In some versions of the test, images of your heart are also taken. This can show how well blood is flowing in various parts of your heart, as well as how effectively it pumps blood.

Angiogram This test involves injecting a dye into the arteries of your heart — using a thin tube that’s inserted into an artery in your arm, groin, or neck — and taking X-ray images to reveal any plaque buildup or blockages.

Echocardiogram This test creates a moving image of your heart to reveal how well its chambers and valves are working — including any areas or poor blood flow or weakened muscle.

Other imaging tests Your doctor may look for plaque buildup in your arteries using computerized tomography (CT), magnetic resonance imaging (MRI), or positron emission tomography (PET) scans.

Additional reporting by Quinn Phillips.

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