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Monday, October, 13, 2008

Question
tunis
07/21/08

How to determine where plaque has built up?

I've had high cholesterol (TC>330) for over 15-20 years although my BMI has been between 23-29 over that period and I have a reasonably heart healthy diet and have had regular vigorous exercise. I have not taken any medication in this period. I am now 48 years old.

 

I am trying to find out if there are imaging tests or other tests to determine if there has been plaque build up and where it is?

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Answers (1)
Martin Cane, M.D.
Martin Cane, M.D.
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Physician - Internal Medicine

Tuesday, July 22, 2008

 

tunis,

 

Thanks for your interesting question. 

 

There are a few options to look into in answering your question.  The first that comes to mind is a test called Calcium Scoring.   This is done by CT scanning (at least a 64 slice scanner) which will quantitate the amount of calcium in your vessels.  The lower the score, the less likely that there is coronary artery disease.  The test is not specific enough to tell the location of the calcium plaques.  Many insurance companies will not pay for this study, and in some cases, a doctor's order is not necessary.  You will have to investigate this in your area.

 

Another method looking for the presence of coronary artery disease is a standard exercise stress test.  Again, not very specific, and the plaques would have to be significant to affect the stress study.

 

The ultimate imaging study is cardiac catheterization which will accurately locate all of the plaques.  Because there are some associated risks with this invasive test, I doubt any physician would recommend this study without symptoms and/or a positive stress test. 

 

It is surprising that you have been aware of your high cholesterol for some time now, but have not been treated.  I'm sure you have your reasons.  From a doctor's viewpoint, you should consider medication.   Please continue your healthy diet and avoid tobacco and excessive alcohol.  Also be sure to have regular check-ups with your physician and have your blood pressure monitored, as well as checking for diabetes.  The less risk factors present, the better.  Also, review our website for other tips on getting your cholesterol down to acceptable levels.

 

Best wishes.

 

Martin Cane, M.D.

 

 

 

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