Carotid ultrasound: a test for heart disease?

Followers of my blog posts know that I am a vocal advocate of CT heart scans (not to be confused with CT coronary angiograms, the test that has lately been the subject of news reports discussing the high radiation exposure associated with these tests). If you have access to a heart scan, that's the best way to go. It's a direct and accurate detector of hidden coronary atherosclerosis. If you don't have access to a heart scan, carotid ultrasound can serve as a second best. Even better, get both tests and have direct gauge of these terribly common diseases-hopefully years before danger is present and preventive efforts can pay off with big rewards.

*Now that much of the public is going straight to the medical literature for in-depth medical information, it's important to clear up a common point of confusion. There is a measure obtainable with carotid ultrasound called "carotid intimal-medial thickness," or CIMT. This is a measure of very early carotid atherosclerosis, a measure of the thickness of the tissue-like lining of the artery that thickens even before early blockages are present. For example, a 30% blockage would ordinarily be regarded as an "early" blockage. However, CIMT will be abnormal years before the 30% blockage is even present. Unfortunately, it is rarely performed in clinical ultrasound laboratories.

CIMT is the measure often used in research studies that is an accurate gauge of atherosclerosis in other arteries like the coronaries. However, in real-life clinical practice, CIMT is rarely measured and most ultrasound facilities are not set up to perform it.