Frequently Asked Questions

Q. Please advise the purpose of an ultrasound of the carotid arteries. Recently during a physical, my husband's doctor did not like the sound of his carotid arteries and has ordered an ultrasound.
A. An ultrasound provides information about how blood flows in your arteries both as a waveform that looks similar to a heart EKG and as an image of the artery. The shape of the waveform gives the doctor useful information about the blood flow. The images help to determine if you have plaque, narrowed arteries or blockages in the blood vessels of the carotid. The ultrasound can give a doctor information about the speed of the blood at different points along the carotid, or if it slows or speeds up which would indicate a narrowing. (Think of a river. If it goes through a narrow channel, it will go faster than if it then goes through a wider section). Often ultrasounds are in color which also lets the doctor know if the blood is flowing correctly or not.

The advantages are that it does not hurt to have the exam. Your husband will lie on an exam table. Gel is spread on his neck and an ultrasound instrument will be moved over the neck to track the flow in the carotid artery. It would be normal for an adult to have some narrowing, but if the narrowing is significant, the risk for a stroke or TIA increases.

The results of the ultrasound exam will help the doctor determine if additional treatment is needed at this time.

Q. Do doctors routinely perform an ultrasound or scan of the abdominal area to check for AAA's? Otherwise how do you know if you have one if you don't have any symptoms?
A. If someone has high risks for AAA, it should be checked by ultrasound. The other way to possibly identify a large AAA, is by a physical exam. However, this is not highly accurate. Also, it is not as useful in obese per- sons. A recently published article (Journal of Vascular Surgery, January 2004, pp 267-269.) recommends screening for all men 60-85 years; women 60-85 with cardiovascular risk factors; and anyone over 50 with family history of AAA.

Q. I have been having chronic leg pain mostly at night but it also occurs while I'm sitting. This has disrupted my sleep. I cannot get comfortable in bed, and I don't like for my legs to touch each other because of the pain. Could this be PAD?
A. We can be reasonably sure that this is not PAD. If it were rest pain, it would be primarily at night or when lying down, and be relieved when the legs were down/dependent, as in sitting or standing (See our cover article on CLI). Nor does it sound like it is venous or lymphatic. Lymphedema is painless, and venous pain is relieved to by lying down and made worse by standing or walking, and both are associated with swelling, which you did not mention. If you have diabetes, the pain can be from damage to the nerves in the feet, and you should discuss this with the doctor who manages your diabetes.