Welcome to best vein, vascular and preventive medicine practice from Wellesley MA and greater Lowell MA offices, caring for the full spectrum of venous diseases and PAD patients and keeping patient healthy by streamline health screening and practicing evidence based preventive medicine. Our health screening program is based on guidelines from united states preventive services task force, American Heart Association and American College of Cardiology. Sometimes we have to customize our recommendations & we go beyond guidelines depending on individual patient needs. All screening services might not be covered by your health insurances.
CAROTID INTIMA-MEDIA THICKNESS:
Carotid intimal-media thickness (CIMT) is a way to assess the cumulative effect of atherosclerosis and is an independent predictor of future cardiovascular (CV) risk. A stroke, or “brain attack”, occurs when blood flow to the brain is interrupted. The lack of oxygen kills brain cells in the immediate area, often causing symptoms such as weakness or numbness on one side of the body, trouble walking, vision or speech changes. The more common type of stroke, the ischemic stroke, is associated with carotid artery disease. Acute strokes are best managed in dedicated stroke centers or at least acute hospitals.
In context of cardiovascular screening our focus is on carotid intima-media thickness. In research trials, CMIT has correlated with overall cardiovascular risk. Higher this value more aggressive is our approach in preventive aspect of cardiovascular risks.
AORTIC ANEURYSM (AAA) SCREENING:
Abdominal aortic aneurysms (AAA) are caused by progressive weakening of the aortic wall that causes a “ballooning” of the aorta. The aorta carries blood flow from the heart to all parts of the body including the vital organs and the legs and feet. The aneurysm will grow larger and eventually rupture if it is not diagnosed and treated. A ruptured AAA carries an 80-90% risk of death. That is why recognizing this disease BEFORE it gets too large is so important. AAA screening can identify these deadly aneurysms before they grow to a stage where they are likely to rupture.
United States Preventive Services Task Force recommends AAA Screening in.
- Men between 65 to 75.
- Who have ever smoked.
- Are asymptomatic
- Patients in this age group with other risk factors like hypertension, diabetes mellitus and high cholesterol can also be considered on case to case basis.
ABI / PAD SCREENING:
Simple measurement of blood pressures the arms and legs testing for PVD (Peripheral Vascular Disease) or PAD (Peripheral Arterial Disease). PAD progresses over time at variable rates in each individual depending on the area of circulation effected and one’s health and family history. For many, the outward indications will not appear until the artery has narrowed by 70 percent. Commonly, PAD may affect the legs by causing symptoms of leg discomfort in the calf, the thigh, or the buttock during walking. This pain is called intermittent claudication.
However, many people with PAD will experience atypical symptoms in the legs or few symptoms at all until the disease is far advanced. PAD may be so severe as to cause skin ulcers on the feet or legs or pain at rest in the lower legs and feet. Not part of recent USPTF guidelines so we use it selectively in patients to differentiate from other conditions causing similar symptoms.
An ECG – EKG is the best way to measure and diagnose abnormal rhythms of the heart, particularly abnormal rhythms caused by damage to the conductive tissue that carries electrical signals, or abnormal rhythms caused by electrolyte imbalances. After a heart attack or MI (Myocardial Infarction). EKG can also identify if the heart muscle has been damaged in specific areas.
The ECG cannot reliably measure the pumping ability of the heart, for which ultrasound-based Echocardiogram – ECHO tests are used.
Lipids are substances in the blood that are related to cholesterol. They are a kind of fat found in certain foods and made by the liver. Three types of lipids used in measuring your total cholesterol level are. Our lipid panel includes total cholesterol, LDL cholesterol, HDL Cholesterol and triglycerides.
In certain high risk patients we also check for Lipoprotien a or Lp (a). Numerous studies have confirmed strong correlation between the elevated Lp(a) and heart disease. It has led to the consensus that Lp(a) is an important and independent predictor of cardiovascular disease.
HIGH SENSITIVITY CRP:
Inflammation plays a major role in clogging arteries (atherothrombosis), and measurement of inflammatory markers such as high-sensitivity C-reactive protein (HSCRP) provides another method for detecting the overall inflammatory activity of an individuals or the risk of plaque rupture causing heart attack or stroke.
Several large-scale clinical studies have demonstrated that HSCRP is a strong & independent predictor of future myocardial infarction and stroke among apparently healthy men and women. This is reason for adding this test to standard lipid screening in our screening protocols.
We believe in "prevention is better than treatment" and we also believe that screening can increase awareness of risks and proper remedial steps can be taken before it is too late! Said that unsupervised screening can lead to:
1- Unnecessary anxiety. 2- Unnecessary and sometimes harmful advanced tests.
For that reason our screening program starts with consultation with our doctor with special interest in preventive cardiovascular medicine. Your consultation prior to tests will help to make plan which tests to order and how to proceed. Your follow up and final consultation with our doctor will explain findings of test and preventive strategy.