CIMT- Ultrasound Test for Fatty Plaque

CIMT- Ultrasound Test for Fatty Plaque



If you could do a simple 10-minute test in a doctor’s office to find out if your arteries are getting clogged, would you do it? There’s an ultrasound of the neck that shows early stage thickening and plaque of the carotid artery: Cimt - Carotid Intima Media Thickness.

If you knew that the No. 1 killer we face is clogged arteries, would you want to prevent it, monitor it and clean it off? Even a little fatty plaque could break off and cause a clot like a heart attack or stroke. Sudden death is the first symptom in 50 percent of cardio-vascular disease.



If you knew that 80 percent of heart attacks are preventable, would you make sure that you’re not at risk? Risk factors that we know about in 2012 go beyond the traditional factors (see footnote).

So let’s look at two people and how they approached this risk:

JD and JQP are 45-year-old men who have the same amount of artery wall thickness and very early stages of atherosclerosis “fatty” plaque.



JD thinks that he is OK since he has not had any of the traditional cardiovascular risk factors. He considers himself rather knowledgeable about health issues like which type is the good cholesterol, etc. He admits that at 45 he should get a check-up. He has noticed a few extra pounds on the belly and is surprised that his bmi (body mass index) is 28; not quite obesity of 30 but not ideal like 25.

His blood pressure and cholesterol are borderline high. He reluctantly follows the doctor’s advice, gets a CIMT but does not follow-up. He is determined to get healthier and in fact lowers his weight and blood pressure. He didn’t want to take any pills and figures that in two years his CIMT would show that he has cleaned off his arteries. He would have been correct because lifestyle changes sometimes clean off arteries.

JQP doesn’t know much about “cholesterol stuff”. At 45 he feels fine but realizes that he could have done a better job living healthier. He smoked for several years in the past, he’s had a little beer belly since his 30s and he’s loves beef and rich food. He gets a CIMT and takes what the doctor advised: a single combination pill that lowers blood pressure and cholesterol and an aspirin. He makes some lifestyle changes at first like some walking exercise and watching his food intake, but human nature takes over and he’s back to his old ways.

JQP who took the pill, showed improvement on his CIMT test the following year. The doctor explained how not only has the plaque lessened, but it has a more stable edge that is less likely to break off to clot. The low-strength aspirin helped keep down clotting also. He still looks a bit unfit but the doctor knows that his arteries are looking more fit. He still encourages diet and exercise, otherwise diabetes might develop and more pills will be necessary to try to counter a continued unhealthy lifestyle.


JD did not do so well. He had a good idea to get even more fit but he was unlucky. He started a strenuous exercise plan without getting cleared by a treadmill stress test. He did not want to take the aspirin a day. He declined the prescription for a statin for his cholesterol. Even though he only had a small amount of plaque in the lining of his arteries, it was the unstable type. One day it broke off causing clots that traveled to his heart and brain. He had always said “ya gotta die sometime” and the clot causing the heart attack would have caused sudden death if it had set off fibrillation. Instead a third of the heart muscle was damaged from loss of blood supply and now he has heart failure. Another clot caused the stroke and he is paralyzed on one side.

The above stories are happening daily but there is no specific or actual cases of JD (John Doe) or JQP(John Q. Public).

The take-home message remains the same: get a regular physical and ask about available screening blood tests. Ask about the risks of testing and of taking medicines. If you decline testing or treatment, be sure to understand options and get specialists’ opinions.



Note: Visit my website: PvilleHealth.blogspot.com to see discussions of traditional and emerging risk factors: Traditional: cholesterol, blood pressure, obesity, smoking, genetics, diabetes. Emerging: subtypes of cholesterol (LDL, small LDL, Lpa, HDL, HDL2, non-hdl, TG, apo A and B) , CRP-hs & LPpla2, apoE, HbA1c and glycomark, etc.

Vasolabs.com has information about their ultrasound techs who can come to doctors’ offices to do CIMT sonograms.

Also a future article on CIMT will be written if there is interest. If you want to leave any comments or questions, just type it in the comment space. It will not be published unless the writer requests it be. The comment space on this site was set up so that people do not need to leave any name or email. No individual medical advice will be given but future articles and blog entries will address these comments.