How is noncoronary atherosclerosis diagnosed?

Updated: Dec 23, 2019
  • Author: F Brian Boudi, MD, FACP; Chief Editor: Yasmine S Ali, MD, FACC, FACP, MSCI  more...
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Answer

Answer

Examination findings of noncoronary atherosclerosis are highly variable but may provide objective evidence of extracellular lipid deposition, stenosis or dilatation of large muscular arteries, or target organ ischemia or infarction, such as the following:

  • Hyperlipidemia: Xanthelasma and tendon xanthomata

  • Cerebrovascular disease: Diminished carotid pulses, carotid artery bruits, and focal neurologic deficits

  • Peripheral vascular disease: Decreased peripheral pulses, peripheral arterial bruits, pallor, peripheral cyanosis, gangrene, and ulceration

  • Abdominal aortic aneurysm: Pulsatile abdominal mass, peripheral embolism, and circulatory collapse

  • Atheroembolism: Livedo reticularis, gangrene, cyanosis, ulceration, digital necrosis, GI bleeding, retinal ischemia, cerebral infarction, and renal failure

Laboratory testing

  • Lipid profile

  • Blood glucose and hemoglobin A1c

Imaging studies

  • Ultrasonography: For evaluating brachial artery reactivity and carotid artery intima-media thickness (measures of vessel wall function and anatomy, respectively) [1]

  • Intravascular ultrasonography: Generally considered the criterion standard for the anatomic study of the vessel wall (provides images of the thickness and the acoustic density of the vessel wall)

  • Magnetic resonance imaging: For noninvasive assessment of blood vessel wall structure and characterization of plaque composition

  • Nuclear perfusion imaging with single-photon emission computed tomography (SPECT) scanning or positron emission tomography (PET) scanning


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