My carotid ultrasound did not reveal significant atherosclerotic plaque or inflammation. What are my next steps?

If your carotid ultrasound did not reveal significant atherosclerotic arterial injury/disease (seen as “plaque” or inflammation in your artery wall), and your arterial age is significantly younger than your chronological age, that provides some peace of mind.

However, there may be disease in your coronary or other arteries. The following recommendations become stronger as you get older and if you have other common risk factors like family history of stroke, heart attack, stents or bypass surgery, high cholesterol, diabetes or prediabetes, high blood pressure, smoking or others. It is more important for a 60 year old with Type 2 Diabetes and hyperlipidemia than a 35 year old with few if any risk factors.

The next step in searching for arterial disease is Coronary Artery Calcium Score (CACS).If you’ve already had this test, we would be happy to review your results. Coronary Artery Calcium Score above zero means you have calcified atherosclerotic plaque/atheroma in your coronary arteries. Non calcified or homogeneous plaque/atheroma, which is the stage of plaque evolution that is the greatest risk for an event, is not detected by this test.‍ ‍

If you want a CACS, do an internet search for “Coronary Artery Calcium Score near me” online.  You should be able to find an imaging center or hospital that will offer this without a physician order. Call our office at 217-321-1987 or request a Discovery Zoom Call with Dr. Backs to discuss your results.

Beware: Coronary Artery Calcium Score is offered at a low entry price but typically followed by recommendations for cardiology consultation, stress tests, echocardiograms and the slippery slope to stents and surgery. Before you respond to invitations from the intervention focused cardiology program, schedule a Discovery Zoom Call to discuss your findings and options. The only stent any of my patients have needed was to fix the failure of a stent placed a couple of years earlier with no symptoms and for no evidence based benefit.

A recent upgrade to coronary artery screening/imaging iscoronary CT angiogram with AI image processing

This is becoming more widely available and affordable. But, as a screening test, it suffers from exposure to radiation and IV contrast, limited availability in mostly urban centers and cost. But for those who want an option to prove they DON’T have arterial disease with a negative CIMT and CACS, it can provide peace of mind or early detection to motivate action and changes that otherwise might be delayed without this motivating information. I personally think it’s primary indication is as a cost effective, less invasive and risky alternative to elective coronary angiogram to evaluate symptoms that could represent coronary blood flow restriction to analyze options for response.

Of course, if you have had a stroke, TIA, heart attack, stent or surgery for vascular disease or other manifestation or proof of atherosclerosis/arterial disease, screening test results are not needed to get started. Click here to schedule and start development of your personalized CurePlan, a game plan to put your disease into remission.

Finally, if you are interested in and willing to address the results with lifestyle changes, supplements or medications, consider the cardiometabolic root cause lab profile described at https://www.thecurecenter.life/curefaqs/what-tests-are-done-at-the-curecenter-to-measure-arterial-disease-and-its-root-causes

The findings can point to risk of neuropathy, dementia, microvascular disease and other conditions not identified by other imaging tests. Cash cost (because “screening” is not covered by third parties) is less than $400.

Many of these are covered by https://www.functionhealth.com/ However, there can be also a lot of “noise” that can obscure signal. You would be wise to get guidance from a professional who knows how to “put it all together” beyond the generic advice from artificial intelligence to guide your DIY effort. Any plan should be personalized and realistic to be sustainable over years and decades. Beware of opportunists who promote more “amusement” medicine to sell you their proprietary profitable program without clear measurable outcome measures. As bad as Pharma and mainstream medicine can be, the nutraceutical and consumer medical device market is even less regulated and prone to grift.

The most useful wearable is continuous glucose monitor available without a prescription at an affordable price at www.stelo.com

Finally, resist the standard testing approach in the absence of symptoms. The slippery slope to stress testing, stents and surgery is all risk and no benefit. If you have exertional chest discomfort or shortness of breath, that is different. Stents and bypass surgery are beneficial only in the relief of symptoms and rescue from a heart attack or stroke. If unsure what to do, click www.thecurecenter.life/discovery-call‍ ‍

What does a CureScreen carotid ultrasound with plaque/atheroma vs. no plaque/atheroma look like?

Click here to see a Discover Scan carotid ultrasound with plaque.

Click here to see a Discover Scan carotid ultrasound with no plaque.