Carotid ultrasound screenings can benefit at-risk stroke patients

A carotid ultrasound can’t predict when a stroke will occur, but it will show whether plaque has built up in the carotid arteries, a clear warning sign for stroke.

Patients at risk for stroke might benefit from a carotid ultrasound.

The test can’t predict when a stroke will occur, but it will show whether plaque has built up in the carotid arteries, a clear warning sign for stroke.

Nadeem A. Talpur, M.D., a neurologist with Norton Neurology Services, says whether an ultrasound is indicated depends on the physical exam during a routine checkup and whether the patient has risk factors such as hypertension, obesity or smoking.

Patients experiencing lightheadedness, memory loss or other warning signs of a stroke or mini stroke are good candidates for a carotid ultrasound. So are patients with a carotid bruit and those with conditions that raise their risk of stroke.

“Family history of early strokes or any of the cardiovascular diseases is very important,” Dr. Talpur said.

He recommends seeing patients at high risk for stroke more frequently.

Joint guidelines issued by the American Heart Association/American Stroke Association (AHA/ASA) and other health care organizations say carotid artery screening may help assess the stroke risk for asymptomatic patients with peripheral artery disease, coronary artery disease, atherosclerosis or aortic aneurysm.

“Noninvasive screening examinations have proved to be accurate in detecting vascular disease prior to active warning signs and before a major medical incident such as stroke,” the society said.

Screening gives primary care providers a chance to detect disease at the earliest, most treatable stage — and before a potentially fatal or debilitating stroke.

An ultrasound of the carotid arteries should be done before a CT or MRI, Dr. Talpur said.

Stroke is of particular concern in Kentucky, which ranks eighth in age-adjusted cardiovascular disease death and 10th in stroke mortality. The state Stroke Registry Data Summary Report found that 35 percent of Kentucky adults have high cholesterol, and 41 percent of men and 37 percent of women in the state have high blood pressure. Kentuckians rank worse than U.S. rates for most stroke risk factors.

AHA/ASA guidelines say carotid ultrasound should be considered if you have at least two of the following risk factors:

  • High blood pressure
  • High cholesterol
  • Smoking history
  • A first-degree relative who developed atherosclerosis before age 60
  • Family history of ischemic stroke

The Society for Vascular Medicine recommends that carotid ultrasounds be considered for those over age 55 with:

  • High blood pressure
  • Diabetes
  • Smoking history
  • High cholesterol
  • Cardiovascular disease


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