CHRONIC VENOUS INSUFFICIENCY

Chronic venous insufficiency (CVI) happens when your leg veins become damaged and can’t work as they should. Normally, valves in your leg veins keep blood flowing back up to your heart. But CVI damages those valves, causing blood to pool in your legs. This increases pressure in your leg veins and causes symptoms like swelling and ulcers.

What is chronic venous insufficiency?

Chronic venous insufficiency (CVI) is a form of venous disease that occurs when veins in your legs are damaged. As a result, these veins can’t manage blood flow as well as they should, and it’s harder for blood in your legs to return to your heart. CVI causes blood to pool in your leg veins, leading to high pressure in those veins.

CVI can happen due to damage in any of your leg veins. These include your:

  • Deep veins, which are large veins deep in your body that run through your muscle.
  • Superficial veins, which are close to your skin’s surface.
  • Perforating veins, which connect your deep and superficial veins.

CVI may cause mild symptoms at first. But over time, this condition may interfere with your quality of life and lead to serious complications.

Chronic venous insufficiency vs. post-thrombotic syndrome

Both terms refer to the same problem of damaged leg veins. Post-thrombotic syndrome is chronic venous insufficiency caused by deep vein thrombosis (DVT). DVT is a blood clot in a deep vein in your leg. “Post-thrombotic” means after a blood clot (which is also called a “thrombus”). After the blood clot is gone, it can leave scar tissue that damages your vein.

About 20% to 50% of people who’ve had DVT develop post-thrombotic syndrome, usually within one to two years.

How common is chronic venous insufficiency?

Venous disease in general is very common. For example, varicose veins affect about 1 in 3 adults. Each year, about 1 in 50 adults with varicose veins go on to develop chronic venous insufficiency.

Chronic venous insufficiency usually affects people over age 50. The risk goes up the older you get.

Overall, chronic venous insufficiency affects about 1 in 20 adults.

How does chronic venous insufficiency affect my body?

Chronic venous insufficiency slows down blood flow from your legs back up to your heart. Without treatment, CVI raises the pressure in your leg veins so much that your tiniest blood vessels (capillaries) burst. When this happens, the skin in that area takes on a reddish-brown color and can easily break open if bumped or scratched.

These burst capillaries can cause:

  • Tissue inflammation in that area.
  • Tissue damage.
  • Venous stasis ulcers. These are open sores on your skin’s surface.

Venous stasis ulcers don’t heal easily, and they can become infected. The infection could spread to nearby tissue. This condition is known as cellulitis, which is dangerous if not treated right away.

What are the signs and symptoms of chronic venous insufficiency?

Chronic venous insufficiency signs and symptoms include:

  • Achy or tired legs.
  • Burning, tingling or “pins and needles” sensation in your legs.
  • Cramping in your legs at night.
  • Discolored skin that looks reddish-brown.
  • Edema (swelling) in your lower legs and ankles, especially after standing a while or at the end of the day.
  • Flaking or itching skin on your legs or feet.
  • Full or heavy feeling in your legs.
  • Leathery-looking skin on your legs.
  • Ulcers (open sores), usually near your ankles. If they’re very painful, they may be infected.
  • Varicose veins.

Severe edema in your lower leg can cause scar tissue to develop. This scar tissue traps fluid in your tissues. Your calf may feel large and hard to the touch. When this happens, your skin is more vulnerable to persistent ulcers.

You may not have all of these issues at once. Instead, you may only have one or two. Your signs and symptoms depend on how far your condition has progressed.

What are the stages of chronic venous insufficiency?

The stages of venous disorders range from 0 to 6. “Venous disorders” is a general category for many possible issues with your veins, including CVI. The stages are based on clinical signs, which are things your provider can see or feel when they examine your legs.

Venous disorder stages include:

  • Stage 0: No signs that can be seen or felt. You may feel symptoms like achy or tired legs.
  • Stage 1: Visible blood vessels, including spider veins.
  • Stage 2: Varicose veins at least 3 millimeters wide.
  • Stage 3: Edema (swelling) but no skin changes.
  • Stage 4: Changes to your skin’s color and/or texture.
  • Stage 5: Healed ulcer.
  • Stage 6: Acute (active) ulcer.

You’ll be diagnosed with chronic venous insufficiency if you’re at stage 3 or above. In other words, having varicose veins doesn’t mean you have CVI. But varicose veins are a sign of blood flow problems that could get worse over time. So, it’s important to tell your provider about any new varicose veins you notice.

What causes chronic venous insufficiency?

Chronic venous insufficiency happens when the valves in your leg veins don’t work properly. Your leg veins contain valves that help your blood flow in the correct direction (toward your heart). If a valve becomes damaged, it can’t close properly. Gravity takes over, and blood struggles to flow upward toward your heart. It instead flows backward, a situation known as venous reflux.

Causes of valve malfunction may be congenital, primary or secondary.

  • Congenital causes are malformations in your leg veins that you’re born with. For example, some people are born without valves in their leg veins.
  • Primary causes are any changes to your leg veins that prevent them from working as they should. For example, your vein may get too wide, preventing its valve from closing all the way.
  • Secondary causes are other medical issues that damage your leg veins. Deep vein thrombosis (DVT) is usually the culprit. The thrombus (blood clot) leaves behind scar tissue that damages your valve.

What is the most common cause of chronic venous insufficiency?

Deep vein thrombosis (DVT) is the most common cause of chronic venous insufficiency. The blood clot damages the valve in your leg vein. People with a history of DVT face a higher risk of developing CVI.

How is chronic venous insufficiency diagnosed?

Chronic venous insufficiency is diagnosed through a physical exam and ultrasound imaging. During the physical exam, your provider will:

  • Carefully examine your legs. Your provider will look for clinical signs of CVI, like ulcers or changes in skin color.
  • Perform a vascular ultrasound. This painless test uses sound waves to create an image of your veins. It shows which parts of your veins are damaged.

Your provider will also rule out other medical conditions that could be causing your symptoms. This may involve other tests like an MRI.

Many people with CVI also have peripheral artery disease (PAD). So, your provider may ask questions or run tests to check you for PAD. If you have both CVI and PAD, your provider will advise you on treatment methods and precautions you need to take with compression therapy.

What are the treatments for chronic venous insufficiency?

Treatment for chronic venous sufficiency involves lifestyle changes and compression therapy. If these measures aren’t enough, your provider may recommend a procedure or surgery. The best treatment for you depends on how far your condition has progressed and other medical conditions you have. Your provider will tailor treatment to your individual needs.

The goals of treatment are to:

  • Help your blood flow better in your veins.
  • Help ulcers heal and limit their chances of coming back.
  • Improve your skin’s appearance.
  • Reduce pain and swelling.

Lifestyle changes

Usually, providers recommend lifestyle changes as the first method of treatment for CVI. These include:

  • Leg elevation: Lifting your legs above the level of your heart can help reduce pressure in your leg veins. Your provider may suggest you do this for 30 minutes or longer at least three times per day.
  • Exercise: Walking and other forms of exercise can help blood flow better in your leg veins. Each time you take a step, your calf muscle squeezes and helps your veins pump blood back up to your heart. This “calf muscle pump” is known as your “second heart.” It helps blood in your legs defy gravity, and it’s vital for your circulation. So, making your calf muscles stronger can help improve your blood flow. Your provider may also recommend foot and ankle flexing exercises.
  • Weight management: Extra weight can put pressure on your veins and damage the valves. Ask your provider what a healthy weight is for you. Work with your provider to come up with a healthy and manageable plan for achieving that weight.

Compression therapy

Providers commonly recommend compression therapy for treating CVI. Compression therapy helps ease swelling and discomfort in your legs.

There are many types of compression bandages and stockings. Some offer more compression than others. Very tight stockings require a prescription.

Some stockings are “graduated,” meaning they’re tighter down by your ankles and less tight further up your leg. It’s essential that you follow your provider’s guidance on the type of compression you need and when to use it.

Many people with CVI struggle to wear compression stockings over the long term. But compression therapy is very important to help your veins work better and ease your symptoms. If you struggle with compression therapy, talk with your provider. You may need a different type of stocking. Or, your provider may offer advice to make the treatment plan more doable for you.

If stockings don’t help, your provider may suggest intermittent pneumatic compression (IPC). IPC devices are inflatable sleeves you wear on your legs that help blood flow through your veins.

People who have peripheral artery disease (PAD) need to be careful with compression therapy. Your provider may caution you not to use it at all depending on the extent of your PAD. Closely follow your provider’s instructions.

Medications

Medications used to treat CVI include:

  • Antibiotics to clear skin infections or ulcers caused by CVI. These medications don’t treat the underlying disease.
  • Anticoagulants, or “blood thinners,” to treat blood clots and prevent future blood clots from forming.
  • Medicated wrap known as an Unna boot. This wrap combines multilayer compression with a zinc oxide gel-based wound cover that forms a semi-rigid bandage.

Nonsurgical treatment

Nonsurgical treatments for CVI include:

  • Sclerotherapy: Your provider injects a foam or liquid solution into your spider vein or varicose vein. This causes the vein to collapse or disappear.
  • Endovenous thermal ablation: This technique targets large veins. It uses a laser or high-frequency radio waves to create intense heat. This heat closes up the diseased vein but leaves it in place so there’s minimal bleeding or bruising.

Surgical treatment

Surgical treatments for CVI include:

  • Ligation and stripping: These two procedures are often performed together. For vein ligation, your provider cuts and ties off the problem veins. Stripping is the surgical removal of larger veins through two small incisions.
  • Microincision/ambulatory phlebectomy: This is a minimally invasive procedure. It targets varicose veins near your skin’s surface. Your provider makes small incisions or needle punctures over your veins. Then, they use a phlebectomy hook to remove the problem veins.
  • Subfascial Endoscopic Perforator Surgery (SEPS): This is a minimally invasive procedure. It targets your perforating veins above your ankle. Your provider uses a clip to block off damaged veins so blood doesn’t flow through them. SEPS helps ulcers heal and also helps prevent them from coming back.
  • Vein bypass: This is similar to heart bypass surgery, just in a different location. Your provider takes part of a healthy vein from somewhere else in your body and uses it to reroute blood around your damaged vein. Providers only use this method in severe cases when no other treatment is effective.

What are the risk factors for chronic venous insufficiency?

If you have risk factors for CVI, you’re more likely than other people to develop the disease. Risk factors include:

  • History of deep vein thrombosis (most important).
  • Varicose veins or a family history of varicose veins.
  • Obesity.
  • Pregnancy.
  • Not getting enough physical activity.
  • Smoking and tobacco use.
  • Sitting or standing for long periods of time.
  • Sleeping in a chair or recliner.
  • May-Thurner syndrome.
  • Being female or designated female at birth (DFAB).
  • Being over age 50.

How can I prevent chronic venous insufficiency?

Sometimes, CVI can’t be prevented. But you can lower your risk of CVI and other vein problems by making some lifestyle changes. These include:

  • Avoid smoking and tobacco use.
  • Avoid wearing restrictive clothing like tight girdles or belts.
  • Don’t sit or stand for too long at a time. Get up and move around as often as you can.
  • Eat a heart-healthy diet. This includes reducing your sodium (salt) intake.
  • Exercise regularly.
  • Keep a healthy weight.

If you’ve had DVT, your provider may recommend anticoagulants.

What can I expect if I have chronic venous insufficiency?

CVI usually isn’t life-threatening and doesn’t result in amputation. But it’s a progressive disease that can cause discomfort, pain and reduced quality of life. Treatment can help manage your symptoms and give you a better quality of life.

Venous ulcers are difficult to treat, and they may return even after treatment. It’s important to keep all your medical appointments and closely follow your provider’s guidance.

Can chronic venous insufficiency be reversed?

Treatment can’t reverse the damage to your vein valves. But it can reverse your symptoms so that you feel better and have a better quality of life. Some procedures and surgeries can target and remove the damaged veins so that blood doesn’t flow through them anymore.

Similarly, chronic venous insufficiency can’t be cured. But you can manage the condition with lifestyle changes and other treatments your provider recommends.

How do I take care of myself with chronic venous insufficiency?

Your provider will tell you how to manage CVI at home. Some general tips include:

  • Avoid long periods of standing or sitting. On long car or plane rides, flex and extend your legs, feet and ankles about 10 times every 30 minutes. This helps your blood flow through your leg veins. If you have to stand for a while, take breaks often to sit down and elevate your feet.
  • Check your skin. Each time you shower, check your skin. If you notice any changes, like new ulcers, call your provider.
  • Elevate your legs. When sitting or lying down, elevate your legs above the level of your heart.
  • Exercise on a regular basis. Walking is especially helpful for your leg veins.
  • Manage your weight. Keep a weight that’s healthy for you. Talk with your provider about what that weight is.
  • Practice good skin hygiene. Wash and moisturize your skin every day. Ask your provider what kind of moisturizer is best for your skin. Keeping your skin moisturized will help prevent flaking and cracks, which could become infected. Your provider may also recommend creams to reduce itching, protect your skin or prevent fungal infections.
  • Wear compression stockings if your provider recommends them. This is one of the best ways to manage CVI. There are many different types, so follow your provider’s guidance on which type is best for you. Also, ask your provider how best to wash and care for your stockings.

When should I see my healthcare provider?

See your provider if you have any risk factors for chronic venous insufficiency. Your provider can assess your risk factors and help you lower them.

If you have CVI, keep all your medical appointments, and follow your provider’s guidance on when to return.

Call your provider if:

  • You have any questions about your condition.
  • You have new or changing symptoms.
  • Your compression stockings don’t fit right. There shouldn’t be any bunching. Elastic stockings that don’t fit right can make your condition worse by blocking blood flow in the area where they’re bunched up.

When should I go to the ER?

Call your local emergency number right away if you have symptoms of a pulmonary embolism. This is a life-threatening complication of deep vein thrombosis. It needs immediate medical attention.

What questions should I ask my healthcare provider?

There’s a lot to learn about chronic venous insufficiency. Don’t hesitate to ask your provider any question that comes to mind. You may also want to ask:

  • What stage of chronic venous insufficiency am I at?
  • How can I manage CVI at home?
  • How can you help me stick with compression therapy?
  • Do I need a procedure or surgery?
  • What can I do to prevent my CVI from getting worse?

A note from QBan Health Care Services

Vein problems are often more than just a cosmetic concern. Chronic venous insufficiency gets worse over time and can greatly interfere with your quality of life.

If you’ve been dealing with venous disease for a while, you’re probably frustrated and wish it would just go away. Luckily, there’s a lot you can do on your own to manage your symptoms and feel better. But sticking with the program is essential. Talk with your provider about strategies for keeping up a daily treatment plan and making compression therapy doable for you.

TRANSIENT ISCHEMIC ATTACK

Transient ischemic attacks (TIAs) are often incorrectly called “mini-strokes,” but they’re every bit as serious as a true stroke. Having a TIA often means you could have a stroke in the very near future. A TIA is a medical emergency you shouldn’t ignore. More importantly, it’s a chance to get treatment that can prevent a future stroke.

What is a transient ischemic attack?

A transient ischemic attack is like a temporary stroke. It means there’s a temporary (transient) lack of blood flow to part of your brain. Without blood flow, the brain cells malfunction and start to die (ischemia).

Often shortened to TIA, a transient ischemic attack is a medical emergency that’s very similar to an ischemic stroke. The symptoms of the two are the same, but TIA symptoms go away within 24 hours (most go away in minutes).

IMPORTANT: A transient ischemic attack is a medical emergency just like a stroke is. That’s because there’s no way to predict how long a TIA will last, and every minute counts. Seek immediate medical help if you have signs of stroke, including balance issues, vision changes, face and arm drooping, and speech difficulties.

If you or someone you’re with has TIA or stroke symptoms, you should immediately call 911 (or the local emergency services number in your area). Don’t wait to see if the symptoms will subside, and don’t avoid calling if the symptoms get better after a few minutes of resting. A TIA can be the precursor to a stroke, so get medical attention right away!

TIA vs. mini-stroke — which is the correct name?

A common nickname for TIAs is “mini-strokes.” But that’s not an accurate name. A TIA isn’t necessarily “mini” or smaller, and TIAs can easily affect large brain areas. Importantly, a stroke may occur after a TIA, within a matter of minutes, hours or days.

There are also two critical differences between strokes and TIAs. The first is that a TIA stops on its own. A stroke doesn’t, and it needs treatment to stop and reverse the effects. A stroke also leaves behind evidence on a magnetic resonance imaging (MRI) scan. The changes remain even if your symptoms go away.

What are the symptoms of a TIA?

The possible symptoms of a TIA are nearly identical to the possible symptoms of a stroke.

The symptoms of an ischemic stroke can involve one or more of the following:

What causes a TIA?

Transient ischemic attacks and ischemic strokes happen for the same reasons. Those reasons include:

  • Formation of a clot in your brain (thrombosis).
  • A fragment of a clot that formed elsewhere in your body that breaks free and travels through your blood vessels until it gets stuck in your brain (thromboembolism).
  • Small vessel blockage (lacunar stroke).
  • Cryptogenic TIA (the word “cryptogenic” means “hidden origin,” so these are TIAs that happen with an unknown cause).

What are the risk factors for this condition?

Many factors can contribute to a TIA or make one more likely to happen. Risk factors include:

  • High blood pressure (hypertension). This is the most significant of all risk factors for TIA. It’s one of the reasons why managing blood pressure is so essential.
  • Type 2 diabetes.
  • Tobacco use (especially smoking or vaping).
  • Atrial fibrillation (Afib). This irregular heart rhythm (arrhythmia) can cause blood to swirl and pool in one of your heart’s chambers rather than smoothly flow through. That can allow clots to form, and these can then travel through your carotid arteries and into your brain.
  • A history of stroke or TIA. Having a previous stroke or TIA raises the risk of having a TIA.

Other risk factors that can contribute to a TIA include:

  • Heart disease and a previous heart attack (especially a recent one).
  • High cholesterol (hyperlipidemia).
  • Having excess weight or obesity.
  • Nonmedical drug use (including recreational drugs) and alcohol overuse.
  • Age. As people age, their blood vessels become less flexible for several reasons. That can contribute to atherosclerosis, narrowed blood vessels and other concerns that can contribute to a TIA.

What are the complications of a transient ischemic attack?

The main reason that a TIA is a medical emergency is because it’s often a warning that a stroke is possible or even imminent. Up to 20% of people who have a TIA have a stroke within 90 days, and half of those strokes happen within the first two days after a TIA.

How is a transient ischemic attack diagnosed?

A healthcare provider can diagnose a TIA using a combination of methods, including:

  • Medical history. This involves asking you questions about your health history and symptoms.
  • Physical and neurological exam. These help a provider learn more about your symptoms, especially if you’re still experiencing them at the time of the exam.
  • Imaging scans. Healthcare providers can get a computed tomography (CT) scan in only a few minutes. It helps them to quickly see if you’re having a brain bleed or not and, if so, provide treatment immediately. An MRI scan helps your care team tell if you had a stroke or a TIA. If there’s visible damage (even though your symptoms are completely gone), it was a stroke, not a TIA.

Other tests may also be possible, depending on your symptoms and if your healthcare provider suspects another health issue is causing or contributing to the TIA and its symptoms. Your healthcare provider can tell you more about the tests they recommend and why those tests could be helpful.

How is a transient ischemic attack treated?

A TIA, by definition, is a temporary issue. But it indicates that a stroke — which isn’t temporary — could happen. That means treating the condition(s) that caused the TIA can help prevent a stroke.

Healthcare providers often recommend treating these conditions aggressively. That’s because a stroke is a much more serious — and dangerous — condition. Strokes are also often more difficult to treat. It’s also because even with treatment, strokes can cause permanent damage or death.

The most common treatments to prevent a stroke after a TIA include:

  • Medications.
  • Catheter-based procedures.
  • Surgery.

Medications for post-TIA stroke prevention

Many types of medications can help treat the conditions that cause or contribute to a TIA and prevent TIA or stroke from happening in the future. They include:

  • Aspirin. This is one of the most common medications that healthcare providers recommend. It helps prevent stroke by reducing your risk of blood clots. Other alternatives include clopidogrel (Plavix®), ticagrelor (Brilinta®) and Aggrenox (a combination pill of aspirin and dipyridamole).
  • Blood pressure medications. These help reduce pressure strain on your blood vessels from the inside. Common medications for this include calcium channel blockers, angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers (ARBs), diuretics and more.
  • Statins. Statins are cholesterol-lowering medications. They generally reduce low-density lipoprotein (LDL) cholesterol levels in your blood. That’s the cholesterol that can build up inside blood vessels, narrowing them and causing atherosclerosis. Atorvastatin (Lipitor®) and rosuvastatin (Crestor®) are effective and likely the best-known of these medications.
  • Blood thinners. These medications make it harder for your blood to clot, which can lower the risk of a clot forming and getting stuck in a blood vessel in your brain. These include anticoagulants like warfarin (Coumadin®), apixaban (Eliquis®), rivaroxaban (Xarelto®) or dabigatran (Pradaxa®). These medications are often recommended if you have atrial fibrillation or blood clots in your heart.

Catheter-based procedures

“Endovascular procedures” is the blanket term for all procedures that use thin, tube-like devices threaded into your blood vessels through very small incisions in your skin. Endovascular means “inside a blood vessel,” and these procedures treat problems from the inside without full surgery.

These usually involve your carotid arteries, the main vessels that carry blood from your heart to your brain. Narrowing (stenosis) in your carotid arteries can lead to a TIA or a stroke.

Some examples of endovascular procedures that can help prevent a stroke after a TIA include:

  • Endovascular thrombectomy. This is a procedure to remove the blood clot. It opens up the artery, restoring blood flow to your brain.
  • Stenting. This involves placing a stent, a mesh scaffold-like device, inside a blood vessel. The stent helps hold open narrowed blood vessel sections so blood can flow through.
  • Angioplasty. This involves a catheter with a balloon attachment at its tip. Inflating the balloon can widen narrowed arteries.

Endarterectomy

When catheter-based procedures aren’t possible, surgery may be an option to widen blood vessels. That can prevent another TIA or stroke. An example of a surgery like this is carotid endarterectomy to clean up the plaque and create a wider space for blood to flow through into your brain.

Procedures for other conditions that can contribute to a TIA

Other procedures are also possible, depending on what conditions you have. For example, your cardiovascular or cerebrovascular care team may determine that your TIA or stroke is due to conditions like patent foramen ovale (PFO), a hole in the wall that separates the lower two chambers of your heart. PFO can allow blood clots to travel to your brain. Your provider may recommend closing the hole to reduce the odds of having a stroke.

Can a transient ischemic attack be prevented?

Sometimes, but not always. Many TIAs happen for preventable reasons. But a TIA can also happen for unpredictable or unexpected reasons.

You can do many things to reduce your risk of having an ischemic stroke. While this doesn’t mean you can prevent a stroke, it can lower your risk. Actions you can take include:

  • See a primary care provider yearly for a checkup (this can detect symptomless concerns like high blood pressure and Type 2 diabetes sooner).
  • Reach and maintain a weight that’s healthy for you.
  • Manage what you eat (your primary care provider can guide you on this).
  • Stop using tobacco products (or don’t start using them in the first place).
  • Use alcohol only in moderation and avoid nonmedical drug use.
  • Take prescription medications exactly as instructed.
  • Manage any chronic conditions you have (such as high blood pressure, Type 2 diabetes and high cholesterol).

What can I expect if I have a transient ischemic attack?

Having a TIA is like having a temporary stroke. If they happen while you’re active, the symptoms may stop or lessen if you rest because you don’t feel well. However, the symptoms can return quickly once you resume whatever you were doing.

Because a TIA and a stroke have the same possible symptoms, you should always call 911 (or your local emergency services number) immediately. There’s no way to tell if what you’re experiencing is a stroke or a TIA while it’s happening.

How long do transient ischemic attacks last?

How long TIAs last can vary. By definition, TIAs last less than 24 hours. But it’s rare for a TIA to last even that long. Most TIAs last for only minutes.

What’s the outlook for transient ischemic attack?

The outlook for a TIA depends strongly on what’s causing it and what you do about it. Without treatment, your stroke risk within the next 90 days — especially the first two days after the TIA — can be very high.

The outlook is best when you get immediate emergency medical care. Healthcare providers can make sure that what you had was a TIA and not a stroke, and they can find out what’s causing or contributing to your TIA. That can also determine how to treat the underlying issue and what you can do to prevent further issues.

How do I take care of myself after a TIA?

Once you receive care, it’s essential for you to follow your healthcare provider’s guidance. The closer you follow it, the better the odds that you won’t have another TIA or stroke. Because TIAs can happen for different reasons, what you should do to take care of yourself may vary.

In general, the same actions or precautions that prevent TIAs or lower your risk of having one are also what you should do after you have a TIA. Your healthcare provider can also guide you specifically on what you can and should do.

When should I see my healthcare provider?

After emergency treatment for a TIA, you should see a provider for follow-up care. They can recommend a schedule for follow-up visits as needed and help you monitor for any changes in symptoms and how well treatment is working.

When should I go to the emergency room?

You should immediately call 911 (or your local emergency services number) and go to the nearest emergency room if you have any stroke-like symptoms. If you previously had a TIA, you should call 911 (or your local emergency number) and go to the nearest ER if any of the symptoms return.

Several other conditions are possible if you recently had a TIA. You should get emergency care if you experience symptoms of any of the following conditions:

What questions should I ask my doctor?

  • Did I have a TIA or a stroke?
  • What were the underlying causes or factors that contributed to my TIA?
  • What kind of changes can or should I make to prevent another TIA or a stroke?
  • What treatments are available to prevent another TIA or a stroke?
  • What are the possible side effects of medications or treatments that I should watch for?
  • What are the symptoms that mean I need to go to the ER?

How common are transient ischemic attacks?

TIAs are very common. Experts estimate there are about 500,000 per year. However, there’s evidence that estimate is too low. The reasons for that include:

  • TIAs are temporary. People may not realize what they’re experiencing. If the symptoms go away quickly, they may not go to the hospital or get medical attention.
  • TIAs don’t leave behind evidence. Imaging scans can’t detect a TIA after it ends. If there are visible changes left behind, it was a stroke, not a TIA.
  • TIAs often precede strokes. People may have a stroke shortly after a TIA, but not realize what the TIA was.
  • There are many TIA mimics. Many conditions can cause stroke-like symptoms but aren’t actually strokes. By the time a person gets to the hospital, it may not be possible to tell what caused their symptoms.

A note from QBan Health Care Services

A transient ischemic attack (TIA) can happen suddenly and be gone in minutes, leaving behind confusion and worry. If you experience stroke symptoms that only last minutes, don’t ignore them! They’re still a sign that you need medical attention right away.

A TIA greatly increases your risk of having a stroke in the next 90 days, and half of the strokes that do follow a TIA happen within the next two days. Getting immediate care can help you avoid a much more serious stroke, potentially saving your life and preventing permanent damage and loss of abilities.

CAROTID ARTERY ANEURYSM

A carotid artery aneurysm is a bulge in one of the arteries supplying blood to your brain and nearby structures. Atherosclerosis is a common cause. Some people have no symptoms, but others have facial swelling, hoarseness or a throbbing lump they can feel in their neck. A carotid artery aneurysm may lead to a TIA (mini stroke) or stroke.

What is a carotid artery aneurysm?

A carotid artery aneurysm is a bulge in one of your carotid arteries. These arteries supply blood to your brain, head, face and neck. You have a common carotid artery on each side of your upper chest. As it travels up your neck, each common carotid artery divides into two branches. These are your internal carotid artery and external carotid artery. Aneurysms may affect any of your carotid arteries. But they usually develop in one of your internal carotid arteries.

An aneurysm happens when part of an artery wall weakens. As the aneurysm grows bigger, your artery wall grows thinner. There’s an increased risk that the aneurysm will burst. You can compare this to a balloon filling up with air. As the balloon gets bigger, its walls get thinner and may pop. So, the larger an aneurysm grows, the more dangerous it can be.

How serious is a carotid artery aneurysm?

Carotid artery aneurysms affect blood vessels that send blood to your brain. These aneurysms may be small and cause no complications. But blood clots can sometimes form in the aneurysm and block blood flow to your brain. This can lead to a transient ischemic attack (TIA) (mini stroke) or ischemic stroke. Large aneurysms may rupture (burst), leading to a hemorrhagic stroke and life-threatening bleeding.

What is a true vs. false carotid artery aneurysm?

Like other aneurysms, carotid artery aneurysms can be either true or false. These are medical terms that describe how the bulge forms in your artery. A true carotid artery aneurysm affects all three layers of your artery wall. These three layers (intima, media and adventitia) all bulge outward and form the aneurysm’s wall. Atherosclerosis is the most common cause of a true aneurysm.

A false carotid artery aneurysm is also called a pseudoaneurysm. A pseudoaneurysm only affects one or two layers of your artery wall. It usually looks like a round sac that sticks out of your artery on a narrow “neck.” Trauma, infection and complications from medical procedures are typical causes of a pseudoaneurysm.

Both true and false aneurysms can lead to complications and may require treatment.

Who do carotid artery aneurysms affect?

Carotid artery aneurysms can affect adults of any age and, rarely, children. But they usually affect people in their 50s or 60s.

Are carotid artery aneurysms common?

Carotid artery aneurysms are rare. Fewer than 1 in 100 aneurysms are carotid artery aneurysms.

What are the symptoms of a carotid artery aneurysm?

Some people with carotid artery aneurysms have no symptoms. Of those who do, symptoms of a transient ischemic attack (TIA) or stroke are most common. A TIA is also called a “mini stroke,” and it may be a warning sign that a stroke may happen in the next few days or weeks. Both TIAs and strokes happen when blood flow to your brain is interrupted.

TIAs and strokes are medical emergencies that need immediate care. Call 911 or your local emergency number if you have any of the following symptoms:

  • Difficulty seeing from one or both eyes.
  • Difficulty walking.
  • Dizziness, loss of coordination or feeling off-balance.
  • Numbness or weakness in your face, arms or legs, especially on one side of your body.
  • Sudden, severe headache.
  • Trouble speaking or understanding others’ speech. Your speech may be slurred or confused.

You may not be able to call 911 if you’re experiencing severe symptoms. So, it’s important to educate your loved ones about TIA and stroke symptoms so they know when to call for help. If you live alone, it’s a good idea to get a medical alert system that requires simply pushing a button to seek help.

Aside from TIAs and strokes, the aneurysm may cause you to feel other symptoms if it puts pressure on nearby structures. If the aneurysm presses on veins or nerves in your neck or head, you may experience:

Call your healthcare provider if you have any of these symptoms.

What causes carotid artery aneurysms?

There are many possible causes of carotid artery aneurysms, including:

What are the risk factors for carotid artery aneurysms?

Carotid artery aneurysms happen when your artery’s walls become weak. Many factors can raise your risk of weakened arterial walls, including:

How is a carotid artery aneurysm diagnosed?

Healthcare providers diagnose carotid artery aneurysms through:

  • A physical exam. This includes using a stethoscope to hear blood flow through your carotid artery. A whooshing sound (carotid bruit) is sometimes a sign of a carotid artery aneurysm.
  • Family history. Your provider will ask about medical conditions that have affected your biological family. People with a family history of aneurysms often face a higher risk.
  • Medical history. Your provider will learn about your medical history and associated conditions. This helps your provider identify possible causes of an aneurysm.
  • Imaging tests. Imaging tests show what’s happening inside of your carotid artery and the surrounding areas. They confirm the diagnosis of a carotid artery aneurysm and help your provider determine the best treatment.

Sometimes, providers diagnose aneurysms after suspecting a person has one. Other times, they diagnose them through imaging tests done for other reasons. This is called an incidental diagnosis.

What tests diagnose carotid artery aneurysms?

Imaging tests that diagnose carotid artery aneurysms include:

Your provider may also recommend:

  • Brain imaging to check blood flow through your brain and look for additional aneurysms.
  • Genetic testing to check for underlying genetic conditions.
  • Imaging tests to check your aorta or other arteries for additional aneurysms.

What is the treatment for carotid artery aneurysms?

Carotid artery aneurysm treatment includes:

  • Surveillance.
  • Open surgery.
  • Endovascular stent grafting.

The goals of treatment are to reduce symptoms and lower your risk of complications. You may need surgical or endovascular repair if you face a high risk of complications like aneurysm rupture or stroke. Your surgeon takes into account many factors to determine your risk, including:

  • Aneurysm size.
  • How quickly the aneurysm is growing.
  • Whether or not you have symptoms.

Surveillance

Also called “watchful waiting,” surveillance means your provider monitors your aneurysm. You’ll have imaging testing (ultrasound, CT or MRI scans) every six to 12 months. Your provider will look for any changes. This is often an option for small aneurysms that aren’t causing any symptoms.

If you have high blood pressure, your provider may prescribe blood pressure medication. This can help lower pressure on the aneurysm. Your provider may also prescribe a cholesterol-lowering medication.

Open surgery

Surgical repair is the traditional treatment method. Your surgeon removes the damaged part of your carotid artery. Then, they create a new path for your blood to flow from the normal artery below the aneurysm to the normal artery above it. This is called bypass grafting.

Your surgeon may use part of a blood vessel taken from somewhere else in your body to create the new blood vessel (graft). Or they may use an artificial material like GORE-TEX®.

Endovascular stent grafting

Endovascular repair is a less invasive option compared to open surgery. You may be eligible for endovascular stent grafting depending on the size of the aneurysm and its location in your carotid artery.

Endovascular means that surgery is performed inside of your artery using long, thin tubes (catheters). Your surgeon makes a small puncture in an artery in your groin. Then, they use catheters to guide a stent graft through your blood vessels until it reaches the aneurysm site. Under X-ray guidance, your surgeon positions the graft in the area of the aneurysm. They expand the graft inside of your artery, where metallic hooks hold it in place. The graft functions as a new path for your blood to flow.

Which treatment is right for me?

Your healthcare provider will tailor treatment to your situation and needs. Before any procedure or surgery, your provider will talk with you about its benefits, risks and side effects. Your provider will also give you detailed guidelines for your preparation and recovery.

How can I reduce my risk of a carotid artery aneurysm?

Some risk factors (like biological family history) are out of your control. But you can take some steps to keep your arteries healthy and lower your risk of an aneurysm. These include:

  • Don’t smoke, vape or use tobacco products. Ask your provider for resources to help you quit.
  • Eat a heart-healthy diet low in saturated fat, sodium and sugar.
  • Exercise regularly, according to your healthcare provider’s guidance.
  • Limit your alcohol intake.
  • Manage risk factors like high blood pressure.
  • Take your medications as prescribed.
  • Visit your provider for yearly check-ups and keep all of your follow-up appointments.

What can I expect if I have a carotid artery aneurysm?

The outlook for people with carotid artery aneurysms can vary widely. Some people have a small aneurysm that their provider monitors for many years. Others have an aneurysm that grows quickly and needs treatment. Surgeries and endovascular procedures can treat your aneurysm but carry some risks. Talk with your provider about your condition and what you can expect going forward.

How do I take care of myself?

Follow your healthcare provider’s guidance on lifestyle changes that can help you manage your condition. Also, ask your provider about any activity restrictions. You may need to avoid some activities that cause you to overexert yourself.

When should I see my healthcare provider?

Your provider will tell you how often you need to come in for appointments or testing. Be sure to go to all of your appointments.

Call your provider if you have:

  • New or changing symptoms.
  • Side effects from any of your medications.
  • Any questions or concerns about your aneurysm or your treatment plan.

When should I go to the emergency room?

Call 911 or your local emergency number immediately if you have symptoms of a:

What questions should I ask my doctor?

If you’ve been diagnosed with a carotid artery aneurysm, you probably have many questions. But you might not know where to start. Some questions to begin the conversation include:

  • Where’s the aneurysm located? Is it in my neck or skull?
  • How big is the aneurysm?
  • Will I need treatment? If so, when?
  • What are my treatment options?
  • What are the benefits and risks of each treatment option?
  • What can I expect as I recover?
  • What lifestyle changes should I make?
  • Do I have any activity restrictions?
  • Do I need additional testing? If so, how often?

What is the difference between an extracranial carotid artery aneurysm and an intracranial carotid artery aneurysm?

Both terms refer to an aneurysm that affects one of your carotid arteries. But they each describe a different location for where the aneurysm forms. Extracranial means the aneurysm is outside of your skull, in your neck. Intracranial means the aneurysm is within your skull.

Researchers use these two terms because your internal carotid artery travels both outside and within your skull. So, it’s helpful to take a closer look at this artery’s path.

Anatomy of your internal carotid artery

Your internal carotid arteries (one on each side of your neck) branch from your common carotid arteries in your neck. They then travel straight upward through your neck until they reach the base of your skull. This extracranial part of each internal carotid artery is called the C1 or cervical segment. “Cervical” in this context means something related to your neck.

Each internal carotid artery then passes through an opening in your skull called the carotid canal. This is the dividing point between the extracranial and intracranial parts of your artery. After this point, your internal carotid artery is within your skull (intracranial). It continues on a winding path to join up with other blood vessels in your brain. Scientists further divide the intracranial part into six segments:

  • C2: Petrous segment.
  • C3: Lacerum segment.
  • C4: Cavernous segment.
  • C5: Clinoid segment.
  • C6: Ophthalmic segment.
  • C7: Communicating segment.

There’s no need to memorize these terms, but knowing this anatomy can help you talk with your provider about your condition. Your provider may say you have an aneurysm in your “left internal carotid artery, cervical segment.” This refers to the internal carotid artery on the left side of your body, but specifically, a segment outside of your skull.

Ask your provider about any terms you don’t understand. They can help you understand what’s going on inside of your body and where it’s happening.

A note from QBan Health Care Services

Learning you have an aneurysm can feel frightening. You might wonder what caused this to happen and whether your daily life will change. You might also fear complications. But thanks to imaging technologies and treatments, many people can go on with life as normal.

If you’ve been diagnosed with a carotid artery aneurysm, talk with your healthcare provider about next steps for treatment. They may recommend a period of surveillance (keeping an eye on the aneurysm) if the aneurysm is small. Be sure to keep all of your appointments for imaging and follow-ups. And let your provider know if you have any questions or concerns along the way.

AORTIC ANEURYSM

An aortic aneurysm is a bulge in the wall of your aorta, the main artery from your heart. Aortic aneurysms form in a weak area in your artery wall. They may rupture (burst) or split (dissect), which can cause life-threatening internal bleeding or block the flow of blood from your heart to various organs.

What is an aortic aneurysm?

Your aorta is the largest artery in your body. It carries blood and oxygen from your heart to other parts of your body. It’s shaped like a curved candy cane. Your ascending aorta leads up from your heart. Your descending aorta travels back down into your abdomen (belly).

An aneurysm can develop in any artery. An aortic aneurysm develops when there’s a weakness in the wall of your aorta. The pressure of blood pumping through the artery causes a balloon-like bulge in the weak area of your aorta. This bulge is called an aortic aneurysm.

What are the different types?

There are two different types of aortic aneurysms. They affect different parts of your body:

  • Abdominal aortic aneurysm (AAA): An abdominal aortic aneurysm develops in the “handle” of your aorta that points down.
  • Thoracic aortic aneurysm (TAA): A thoracic aortic aneurysm (heart aneurysm) occurs in the section that’s shaped like an upside-down U at the top of your aorta. In people with Marfan syndrome (a connective tissue disorder), a TAA may occur in the ascending aorta.

How common are they?

Abdominal aortic aneurysms are 4 to 6 times more common in men and people assigned male at birth than women and people assigned female at birth. They affect only about 1% of men aged 55 to 64. They become more common with every decade of age. The likelihood increases by up to 4% every 10 years of life.

Abdominal aortic aneurysms occur more frequently than thoracic aortic aneurysms. This may be because the wall of your thoracic aorta is thicker and stronger than the wall of your abdominal aorta.

What are the risk factors for aortic aneurysm?

Both your family history and your lifestyle can play a role in your risk of developing an aortic aneurysm. Aortic aneurysms occur most often in people who:

  • Smoke.
  • Are over age 65.
  • Were assigned male at birth.
  • Have a family history of aortic aneurysms.
  • Have high blood pressure (hypertension).

What causes aortic aneurysm?

The causes of an aortic aneurysm are often unknown, but can include:

What are the symptoms of an aortic aneurysm?

In many cases, people don’t know they have an aortic aneurysm. An aneurysm often doesn’t cause any symptoms until it ruptures (bursts).

If an aneurysm ruptures, it’s a medical emergency that requires immediate treatment. Call 911 if you or someone you are with has a ruptured aneurysm.

Symptoms of a ruptured aneurysm come on suddenly and can include:

Finding an aortic aneurysm before it ruptures offers your best chance of recovery. As an aortic aneurysm grows, you might notice symptoms including:

  • Difficulty breathing or shortness of breath.
  • Feeling full even after a small meal.
  • Pain wherever the aneurysm is growing (could be in your neck, back, chest or abdomen).
  • Painful or difficult swallowing.
  • Swelling of your arms, neck or face.

What are the complications of an aortic aneurysm?

If an aortic aneurysm ruptures, it causes internal bleeding. Depending on the location of the aneurysm, a rupture can be very dangerous — even life-threatening. With immediate treatment, many people can recover from a ruptured aneurysm.

A growing aortic aneurysm can also lead to a tear (aortic dissection) in your artery wall. A dissection allows blood to leak in between the walls of your artery. This causes a narrowing of your artery. The narrowed artery reduces or blocks blood flow from your heart to other areas. The pressure of blood building up in your artery walls can also cause the aneurysm to rupture.

How is aortic aneurysm diagnosed?

Many aneurysms develop without causing symptoms. Providers often discover these aneurysms during a routine checkup or screening.

If you’re at high risk of developing an aortic aneurysm — or have any aneurysm symptoms — your provider will do imaging tests. Imaging tests that can find and help diagnose an aortic aneurysm include:

How is an unruptured aortic aneurysm treated?

If you have an unruptured aortic aneurysm, your provider will monitor your condition closely. If you have risk factors for developing an aortic aneurysm, your provider may also recommend regular screenings.

Treatment aims to prevent the aneurysm from growing large enough to tear the artery or burst. For smaller, unruptured aneurysms, your provider may prescribe medications to improve blood flow, lower blood pressure or manage cholesterol. All can help slow aneurysm growth and reduce pressure on the artery wall.

What are the types of aortic aneurysm surgery?

Large aneurysms at risk of dissecting or rupturing may require surgery. Your provider might use one of these types of surgical procedures to treat an aortic aneurysm:

  • Open aneurysm repair: Your provider removes the aneurysm and sews a graft (a section of specialized tubing) in place to repair the artery. Open aneurysm repair surgery may also be necessary if an aneurysm bursts.
  • Endovascular aneurysm repair (EVAR): Endovascular surgery is a minimally invasive procedure to fix aortic aneurysms. During the procedure, your provider uses a catheter (thin tube) to insert a graft to reinforce or repair the artery. This procedure is also called thoracic endovascular aneurysm repair (TEVAR) or fenestrated endovascular aneurysm repair (FEVAR).

What can I expect after aortic aneurysm surgery?

Recovery after aneurysm surgery takes a month or longer. Your provider will continue to monitor you for changes to the aneurysm, growth or complications. Most people have positive outcomes after surgery.

All surgery has risks. Possible complications after surgery include:

  • Leaking blood around the graft (called endoleak).
  • Movement of the graft away from where it was placed.
  • Formation of blood clots.
  • Infection.

Can I prevent an aortic aneurysm?

Having high blood pressure, high cholesterol or using tobacco products increases your risk of developing an aortic aneurysm. You can reduce your risk by maintaining a healthy lifestyle. This includes:

What is the prognosis (outlook) for people with an aortic aneurysm?

With careful monitoring and treatment, your provider can help you manage an aortic aneurysm. Ideally, your healthcare team can identify and care for an aortic aneurysm before it ruptures.

If an aortic aneurysm ruptures, seek medical care immediately. Without prompt treatment, a ruptured aortic aneurysm can be fatal. Both open and endovascular surgery can successfully treat a ruptured aortic aneurysm.

When should I call the doctor?

You should call your healthcare provider if you experience:

  • Loss of consciousness (syncope, fainting or passing out).
  • Low blood pressure.
  • Rapid heart rate.
  • Sudden, severe pain in your chest, abdomen or back.

What questions should I ask my doctor?

You may want to ask your healthcare provider:

  • Am I at risk of developing an aortic aneurysm?
  • How will I know if I have an aortic aneurysm?
  • What steps can I take to prevent an aortic aneurysm from dissecting or rupturing?
  • What lifestyle changes will help reduce my risk of an aortic aneurysm?

A note from QBan Health Care Services

Taking steps to improve your heart health can help prevent aortic aneurysms from developing or getting worse. Talk to your doctor about lifestyle changes you can make. If you’re at risk for an aortic aneurysm, be sure to get regular screenings. Finding and treating an aneurysm early greatly reduces the risk of rupture or other complications.

VASCULAR DISEASE

Vascular disease (vasculopathy) affects the blood vessels that carry oxygen and nutrients throughout your body and remove waste from your tissues. Common vascular problems happen because plaque (made of fat and cholesterol) slows down or blocks blood flow inside your arteries or veins. Lifestyle changes often help, but some people need medication or surgery.

What is vascular disease?

Vascular disease includes any condition that affects your circulatory system, or system of blood vessels. This ranges from diseases of your arteries, veins and lymph vessels to blood disorders that affect circulation.

Blood vessels are elastic-like tubes that carry blood to every part of your body. Blood vessels include:

  • Arteries that carry blood away from your heart.
  • Veins that return blood back to your heart.
  • Capillaries, your tiniest blood vessels, which link your small veins and arteries, deliver oxygen and nutrients to your tissues and take away their waste.

Types of Vascular Disease

Some vascular diseases affect your arteries, while others occur in your veins. They can also happen only in specific parts of your body.

Peripheral artery disease

Like the blood vessels of your heart (coronary arteries), your peripheral arteries (blood vessels outside your heart) also may develop atherosclerosis, the buildup of plaque (fat and cholesterol deposits), inside them. Over time, the buildup narrows the artery. Eventually, the narrowed artery causes less blood to flow, which may lead to ischemia, or inadequate blood flow to your body’s tissue. Types of peripheral arterial disease include:

  • Peripheral artery disease: A blockage in your legs. Total loss of circulation can lead to gangrene and loss of a limb.
  • Intestinal ischemic syndrome: A blockage in the blood vessels leading to your gastrointestinal system.
  • Renal artery disease: A blockage in your renal arteries can cause renal artery disease and kidney failure.
  • Popliteal Entrapment Syndrome: A rare vascular disease that affects the legs of some young athletes. The muscle and tendons near the knee compress the popliteal artery, restricting blood flow to the lower leg and possibly damaging the artery.
  • Raynaud’s Phenomenon: Consists of spasms of the small arteries of your fingers, and sometimes toes, from exposure to cold or stress.
  • Buerger’s Disease: Most commonly affects the small and medium-sized arteries, veins and nerves. Although the cause is unknown, there is a strong association with tobacco use or exposure. The arteries of your arms and legs become narrowed or blocked, causing lack of blood supply (ischemia) to your fingers, hands, toes and feet. With severe blockages, the tissue may die (gangrene), making it necessary to amputate affected fingers and toes. Superficial vein inflammation and symptoms of Raynaud’s can occur as well.

Carotid artery issues

These happen in the two main carotid arteries in your neck.

  • Carotid artery disease: A blockage or narrowing in the arteries supplying your brain. This can lead to a transient ischemic attack (TIA) or stroke.
  • Carotid artery dissection: Begins as a tear in one layer of your artery wall. Blood leaks through this tear and spreads between the wall layers.
  • Carotid body tumors: Growths within the nervous tissue around your carotid artery.
  • Carotid artery aneurysm: A bulge in your artery wall that weakens the wall and may cause a rupture.

Venous disease

Veins are flexible, hollow tubes with flaps inside, called valves. When your muscles contract, these one-way valves open, and blood moves through your veins. When your muscles relax, the valves close, keeping blood flowing in one direction through your veins.

If the valves inside your veins become damaged, the valves may not close completely. This allows blood to flow in both directions. When your muscles relax, the valves inside the damaged vein(s) will not be able to hold the blood. This can cause pooling of blood or swelling in your veins. The veins bulge and look like ropes under the skin. The blood begins to move more slowly through your veins and may stick to the sides of your vessel walls. Symptoms include heaviness, aching, swelling, throbbing or itching. Blood clots can form.

  • Varicose veins: Bulging, swollen, purple, ropy veins, seen just under your skin. Damaged valves within the veins cause this.
  • Spider veins: Small red or purple bursts on your knees, calves, or thighs. Swollen capillaries (small blood vessels) cause this.
  • Klippel-Trenaunay syndrome (KTS): A rare congenital (present at birth) vascular disorder.
  • May-Thurner syndrome (MTS): Your right iliac artery compresses your left iliac vein, which increases the risk of deep vein thrombosis (DVT) in your left extremity.
  • Thoracic outlet syndrome (TOS): A group of disorders that happen with compression, injury or irritation of the nerves and/or blood vessels (arteries and veins) in your lower neck, armpit and upper chest area.
  • Chronic venous insufficiency (CVI): A condition that happens when the venous wall and/or valves in your leg veins are not working effectively, making it difficult for blood to return to your heart from your legs.

Blood clots

A clot forms when clotting factors in your blood make it coagulate or become a solid, jelly-like mass. When a blood clot forms inside a blood vessel (a thrombus), it can come loose and travel through your bloodstream, causing a deep vein thrombosis, pulmonary embolism, heart attack or stroke.

Blood clots in your arteries can increase the risk for stroke, heart attack, severe leg pain, difficulty walking or even the loss of a limb.

  • Hypercoagulable states or blood clotting disorders: Conditions that put people at increased risk for developing blood clots because they make blood more likely to form blood clots (hypercoagulable) in the arteries and veins. You can inherit these conditions (congenital, occurring at birth) or acquire them. These disorders include high levels of factors in your blood that cause blood to clot (fibrinogen, factor 8, prothrombin) or not enough natural anticoagulant (blood-thinning) proteins (antithrombin, protein C, protein S). The most aggressive disorders include circulating antiphospholipid antibodies, which can cause clots in both arteries and veins.
  • Deep vein thrombosis (DVT): A blood clot occurring in a deep vein.
  • Pulmonary embolism: A blood clot that breaks loose from a vein and travels to your lungs.
  • Axillo-subclavian vein thrombosis, also called Paget-Schroetter Syndrome: Most common vascular condition to affect young, competitive athletes. The condition develops when your collarbone (clavicle), first rib or the surrounding muscle compresses a vein in your armpit (axilla) or in front of your shoulder (the subclavian vein). This increases your risk of blood clots.
  • Superficial thrombophlebitis: A blood clot in a vein just under your skin.

Aortic aneurysm

An aneurysm is an abnormal bulge in a blood vessel wall. Aneurysms can form in any blood vessel, but they occur most commonly in the aorta (aortic aneurysm) which is the main blood vessel leaving the heart:

Fibromuscular dysplasia (FMD)

Fibromuscular dysplasia (FMD): A rare medical condition in which people have abnormal cellular growth in the walls of their medium and large arteries. This can cause the arteries with abnormal growth to look beaded and become narrow. This can cause issues with the arteries, including aneurysms and dissection.

Lymphedema

The lymphatic system includes an extensive network of lymph vessels and lymph nodes that helps coordinate your immune system’s function to protect your body from foreign substances. Lymphedema, an abnormal buildup of fluid, develops when lymph vessels or lymph nodes are missing, impaired, damaged or removed.

  • Primary lymphedema (rare): Some people are born without certain lymph vessels or have abnormalities in them.
  • Secondary lymphedema: Happens as a result of a blockage or interruption that alters the lymphatic system. Causes of this include: infection, malignancy, surgery, scar tissue formation, trauma, deep vein thrombosis (DVT), radiation or other cancer treatment.

Vasculitis

Your blood vessels can get inflamed because of a medicine, an infection or an unknown cause. This can make it hard for blood to travel through your blood vessels. This is sometimes associated with rheumatological conditions or connective tissue disease. Vasculitis can also cause an aneurysm.

Who does vasculopathy affect?

Some people are born with vascular diseases they inherit from their parents. In these cases, such as blood clotting disorders, they start dealing with this issue at a younger age. However, many vascular diseases develop over time because of an accumulation of plaque (fat and cholesterol) in the arteries, such as peripheral artery disease or carotid artery disease. Atherosclerosis, the hardening of the arteries, can start when you’re a teen and cause problems in middle age or later.

How common is vascular disease?

Vascular diseases are very common in America, partly because so many people weigh too much and have diabetes. The most common vascular diseases include peripheral artery disease (PAD) and carotid artery disease.

What are the vascular disease symptoms?

Symptoms vary depending on the type of vascular disease.

Peripheral artery disease symptoms

  • Peripheral artery disease: Leg pain or cramps with activity but improve with rest; changes in skin color; sores or ulcers and tired legs.
  • Intestinal ischemic (or mesenteric ischemia) syndrome: Severe stomach pain, nausea, throwing up, diarrhea, food fear and weight loss.
  • Renal artery disease: Uncontrolled hypertension (high blood pressure), congestive heart failure and abnormal kidney function.
  • Popliteal entrapment syndrome: Leg and foot cramps, numbness, tingling, discoloration.
  • Raynaud’s phenomenon: Fingers and toes that look red, blue or white, throbbing, tingling, redness.
  • Buerger’s disease: Pain in your arms, hands, legs and feet, even at rest. Blue or pale fingers or toes.

Symptoms of carotid artery issues

  • Carotid artery disease: Usually no symptoms until having a stroke or transient ischemic attack (TIA or mini-stroke). Symptoms of these include trouble with vision or speech, confusion and difficulty with memory.
  • Carotid artery dissection: Headache, neck pain and eye or facial pain.
  • Carotid body tumors: Palpitations, high blood pressure, sweating and headaches.
  • Carotid artery aneurysm: Stroke or transient ischemic attack (TIA or mini-stroke).

Venous disease symptoms

  • Varicose veins and spider veins: Swelling, pain, blue or red veins visible on legs.
  • Klippel-Trenaunay syndrome (KTS): Pain or heaviness in your leg or arm.
  • May-Thurner syndrome (MTS): Swelling, tenderness, pain in your leg, red or discolored skin.
  • Thoracic outlet syndrome (TOS): Neck, arm and shoulder pain, tingling and numbness in your arm or hand.
  • Chronic venous insufficiency (CVI): Leg cramps, heavy or achy legs, swelling or pain in your legs.

Blood clots

  • Blood clotting disorders: Deep vein thrombosis, pulmonary embolism.
  • Deep vein thrombosis (DVT): Pain, swelling, warmth in your leg, red skin.
  • Pulmonary embolism: Coughing up blood, chest pain, shortness of breath.
  • Axillo-subclavian vein thrombosis: Swelling, heaviness or pain in your arm or hand, skin that looks blue.
  • Superficial thrombophlebitis: Inflammation, pain, warmth around your vein, red skin.

Aortic aneurysm symptoms

  • Thoracic aortic aneurysm: Chest pain, fast heart rate, trouble swallowing, swollen neck.
  • Abdominal aortic aneurysm: Abdominal or back pain, dizziness, nausea and throwing up, fast heart rate (if the aneurysm ruptures).

Fibromuscular Dysplasia (FMD) symptoms

Fibromuscular dysplasia (FMD): Neck pain, vision changes, high blood pressure, dizziness, hearing a “whooshing sensation” or hearing your heartbeat in your ears.

Lymphedema symptoms

Swelling, most often in your arms or legs.

Vasculitis symptoms

Not feeling well, fever, swelling.

What causes vascular disease?

For some vascular problems, the cause isn’t known. Vascular disease causes include:

How is vascular disease diagnosed?

Your healthcare provider will want to do a physical exam and get your medical history, as well as a history of which diseases are in your family. It helps your healthcare provider look for vascular disease when you take your shoes and socks off before they examine you.

Depending on the type of vascular disease your provider suspects, they may do blood tests and imaging.

What tests will be done to diagnose vasculopathy?

Many vascular diseases involve clots or blockages in blood vessels. To diagnose these, your healthcare provider needs to be able to see inside your blood vessels using imaging methods that include:

How is vascular disease treated?

Eating healthier and exercising more can help with many vascular diseases. For others, you may need to take medicine or have a surgical procedure. Vascular disease treatments vary depending on the condition.

Peripheral artery disease treatment

  • Peripheral artery disease: Diet, exercise, medicine, surgery.
  • Intestinal ischemic syndrome: Pain medicine, clot-busting drugs, surgical removal of blood clot. Angioplasty, stenting or bypass surgery for chronic cases.
  • Renal artery disease: Low-salt, heart-healthy diet. High blood pressure medicine, statins.
  • Popliteal entrapment syndrome: Surgery to release the popliteal artery.
  • Raynaud’s phenomenon: Keep hands and feet warm. Take medicine that helps blood vessels stay open (dilated).
  • Buerger’s disease: Quit tobacco products. Warm up fingers and toes. Take medicine (vasodilators) to open blood vessels.

Treatment of carotid artery issues

  • Carotid artery disease: Healthier diet. Blood thinners and cholesterol-lowering medicine. Plaque removal (carotid endarterectomy). Angioplasty and stenting to keep the artery open.
  • Carotid artery dissection: Antiplatelets, anticoagulants, stenting.
  • Carotid body tumors: Surgical removal of the tumor.
  • Carotid artery aneurysm: Antihypertensives, cholesterol-lowering medicine, clot-busting medicine. Bypass or stent-graft surgery.

Venous disease treatment

  • Varicose veins and spider veins: Removal using heat, saltwater or laser therapy.
  • Klippel-Trenaunay syndrome (KTS): Same treatment as varicose veins.
  • May-Thurner syndrome (MTS): Same as for deep vein thrombosis.
  • Thoracic outlet syndrome (TOS): Physical therapy, medicine.
  • Chronic venous insufficiency (CVI): Move legs frequently and wear compression stockings. Vein treatment with saltwater, laser or removal through an incision.

Blood clot treatment

  • Blood clotting disorders: Same as for deep vein thrombosis and pulmonary embolism.
  • Deep vein thrombosis (DVT): Elevate your legs. Take blood thinners and medicines for pain.
  • Pulmonary embolism: Blood thinners and thrombolytics. Procedure to remove the clot.
  • Axillo-subclavian vein thrombosis: Thrombolytics, blood thinners. Removal of the clot.
  • Superficial thrombophlebitis: Raise your affected limb above your heart. Use a warm compress. Put on support stockings. Have the vein surgically removed.

Aortic aneurysm treatment

  • Thoracic aortic aneurysm: Surgery to put in a fabric graft or a stent. This can be a major surgery depending on the location and surgical method.
  • Abdominal aortic aneurysm: Surgery to put in a graft. An endovascular repair is less invasive.

Fibromuscular Dysplasia (FMD)

  • Blood thinners, medicine for pain.
  • Angioplasty. Surgery to prevent an artery rupture.

Lymphedema

  • Let your arm rest above your heart level while you lie down for 45 minutes twice daily.
  • Wear a compression sleeve.
  • Use your affected limb for daily tasks.
  • Visit a specialized lymphedema clinic if your healthcare provider recommends it.

Vasculitis

  • Your provider may prescribe medications like steroids.

Complications/side effects of the treatment

Any medicine can have side effects, but the benefits of medicines usually make them worth taking. Side effects often go away. If they don’t, you can ask your healthcare provider to switch you to a different drug.

When considering a procedure or surgery, talk to your provider about the risks and benefits. What’s right for your neighbor may not be the right treatment for you.

How can I reduce my risk of vascular disease?

You can’t do anything about your age, family history or genetics, but you can:

  • Manage your diabetes, high cholesterol and high blood pressure.
  • Exercise regularly.
  • Eat healthier foods.
  • Move around once an hour if you have to sit or stand for hours.
  • Stay at a healthy weight.
  • Reduce your stress level.
  • Avoid tobacco products.

What can I expect if I have vasculopathy?

Vascular disease can be a lifelong problem. Once your healthcare provider knows you have plaque accumulations in your blood vessels, they’ll want you to make some changes to how you live. These changes, such as exercising, not using tobacco products and choosing healthier foods, are things you’ll need to keep doing for years to come. You may also need to take medicines to decrease your risk of a heart attack or stroke.

Outlook for this condition

The outlook for many vascular conditions is good if your healthcare provider catches the problem early. Many vascular issues get harder to treat as they get worse. Some vascular conditions, such as carotid artery dissection, abdominal aortic aneurysm and pulmonary embolism, can be life-threatening.

How do I take care of myself?

In addition to the things mentioned above, you’ll also want to keep taking medicines your healthcare provider prescribes and keep going to your regular checkups.

When should I see my healthcare provider?

Contact your provider if anything changes with your vascular issue or if you have a problem with the medication they prescribed.

When should I go to the ER?

Call 911 if you have:

  • Confusion or dizziness.
  • Slurred speech.
  • A droop on one side of your face.
  • Severe chest pain.
  • Severe abdominal pain.
  • Loss of vision.
  • Weakness in an arm or leg.

What questions should I ask my doctor?

  • What’s the best treatment for my specific situation?
  • Is there anything else I should be doing to take care of my vascular condition?
  • Are there related conditions I should watch for with this vascular issue?

A note from QBan Health Care Services

With vascular disease, the best thing you can do is stay vigilant. Don’t skip any medical checkups or medicine doses. Because some vascular issues run in families, sharing health information with your family can help them prevent and be on the lookout for vascular disease. Encourage your family to get their blood pressure and cholesterol checked since high levels put them at risk for vascular diseases.

PELVIC ULTRASOUND

A pelvic ultrasound creates pictures of the organs inside your pelvis — the area between your belly and legs. The test can help a healthcare provider diagnose problems like tumors or cysts. A pelvic ultrasound is done externally (outside the body) or internally (inside the body).

What is a pelvic ultrasound?

An ultrasound is an imaging exam that uses sound waves to create detailed pictures of organs inside your body. The pictures are called sonograms. An ultrasound is a safe, fairly quick procedure that’s available at most imaging centers and some doctors’ offices.

A pelvic ultrasound looks at the organs in your pelvic area between your abdomen (belly) and legs. It may also look at your lower abdomen. The pelvic organs include:

  • Bladder, which holds urine.
  • Fallopian tubes, which carry eggs between the ovaries and uterus.
  • Ovaries, organs that make and store eggs.
  • Prostate, a gland that helps with reproduction in men.
  • Rectum, the lower part of your intestines.
  • Uterus.
  • Vagina, the canal to the uterus.

Are there different types of pelvic ultrasounds?

There are different types of pelvic ultrasounds. Each looks at different organs or serves a particular purpose:

  • Abdominal ultrasound, which examines organs from outside the belly.
  • Pregnancy ultrasound, which watches fetal development in the uterus.
  • Rectal ultrasound, which examines the inside of the rectum. A special exam called a transrectal ultrasound looks at the prostate.
  • Transvaginal ultrasound, which examines the reproductive organs from inside the vagina.

When would a healthcare provider recommend a pelvic ultrasound?

A healthcare provider may recommend a pelvic ultrasound if you have:

What conditions can a pelvic ultrasound diagnose?

A pelvic ultrasound can help diagnose a range of conditions:

All people:

In people assigned female at birth:

In people assigned male at birth:

  • Infections or cysts in seminal vesicles (glands that help produce semen).
  • Prostate cancer.
  • Testicular cancer.
  • Testicular or scrotal infection.
  • Scrotal or penile injury.

Are there other uses for a pelvic ultrasound?

A healthcare provider may use a pelvic ultrasound to perform a biopsy. A biopsy is a procedure to collect a small sample of tissue from inside your body. The ultrasound can help guide the biopsy needle to the right location.

Another use for a pelvic ultrasound is to check the positioning of an intrauterine device (IUD). An IUD is a device placed in the uterus to prevent pregnancy.

Who performs a pelvic ultrasound?

A healthcare provider who specializes in ultrasounds usually performs a pelvic ultrasound. The medical field calls these providers sonographers. In some cases, your doctor may do the exam.

How does a pelvic scan create images?

During a pelvic ultrasound, a sonographer uses a special tool called a transducer. This small, wand-like instrument gives off sound waves. The transducer connects to a computer and a screen. As your healthcare provider moves the transducer, the sound waves bounce off certain types of tissue. They then return to the transducer as echoes. The computer translates the echoes into images, which appear on the screen.

Sonograms are pictures in real time, meaning they show your organs’ movements as they happen. Sonograms also show blood flowing through blood vessels.

How should I prepare for a pelvic ultrasound?

Your healthcare provider may ask you to drink plenty of water before an abdominal pelvic ultrasound. A full bladder helps the transducer’s sound waves travel, creating a clearer picture of your bladder. You usually don’t need to do this for a rectal or transvaginal ultrasound.

Your healthcare provider should provide instructions before any pelvic scan. Make sure to reach out with questions you may have.

Where is a pelvic ultrasound performed?

You may need to go to a center that specializes in imaging for a pelvic ultrasound. But many healthcare providers have ultrasound equipment in their clinics. That makes it convenient for you to receive an in-office scan without going to a separate location.

How is an abdominal pelvic ultrasound done?

Your healthcare provider applies warm gel on the lower part of your belly. The gel helps the transducer glide smoothly over your skin and create clearer pictures. Your provider moves the transducer over different areas of your abdomen. You shouldn’t feel any pain.

How is a transvaginal ultrasound done?

During a transvaginal exam, your healthcare provider will insert the transducer a few inches into your vagina after covering it in a lubricating gel. It may feel a bit uncomfortable at first, like a gynecologic exam. Your provider gently moves the transducer at different angles to get clear pictures of your reproductive organs.

How is a rectal ultrasound done?

During a rectal ultrasound, you lie on your side. Your healthcare provider inserts a lubricated transducer into your rectum to examine the lining there. Your provider may also scan the prostate.

Are there side effects after a pelvic scan?

You shouldn’t experience any side effects after a pelvic scan. Contact your healthcare provider right away if you experience pain, bleeding, fever or other problems.

How are the results of a pelvic scan handled?

Your ultrasound provider sends the pictures to a radiologist (imaging specialist). The radiologist examines the images carefully and makes a diagnosis. The radiologist then shares that information with your healthcare provider. Your provider will contact you to discuss the results. In some instances, like in obstetrics and gynecology, your healthcare provider may interpret the images directly without consulting a radiologist.

What are the benefits of a pelvic scan?

Pelvic scans are widely used because they are:

  • Detailed: Pelvic scans produce high-quality images.
  • Quick: Pelvic scans take anywhere from 15 minutes to an hour.
  • Safe: Pelvic scans do not use radiation, which can occasionally cause medical problems with higher doses.

A note from QBan Health Care Services

A pelvic ultrasound is a safe, reliable imaging exam. It can detect and diagnose a range of health conditions, especially with reproductive organs. An accurate, timely scan means you may be able to get treatment sooner if there is a problem. Often, an ultrasound can rule out health conditions and confirm that you have a clean bill of health.

BREAST ULTRASOUND

If you feel a lump in your breast, or one shows up on your mammogram, your provider may recommend an ultrasound. A breast ultrasound produces detailed images of breast tissue. It can reveal if the lump is a fluid-filled cyst (usually not cancerous) or a solid mass that needs more testing.

What is breast ultrasound?

An ultrasound is an imaging test that uses high-frequency sound waves to take pictures of internal organs and tissues.

A breast ultrasound provides pictures of the insides of your breasts. This test can give more information about small areas of interest within the breast that may be difficult to see in detail on a mammogram.

When is a breast ultrasound needed?

Typically, healthcare providers don’t use breast ultrasound on its own to screen for breast cancer. More often, they recommend an ultrasound to follow up on suspicious areas seen on a mammogram. Because hand-held ultrasound uses a small probe to check the tissue, it is most useful when there is a specific targeted area of interest within the breast to examine. Mammography is still the best tool for screening the entire breast, even in dense breasts.

A healthcare provider may recommend a breast ultrasound for many different reasons. Some of the most common are:

  • Checking if a breast lump is a fluid-filled breast cyst (usually not cancerous) or a solid mass (which may require further testing).
  • Investigating a focal area in the breast that appeared abnormal on a mammogram.
  • Examining a pregnant woman’s breasts in conjunction with physical exam. Occasionally, a mammogram is also used in pregnant women because radiation doses are very low and the abdomen can be shielded if concern for breast cancer detection is high.
  • Guiding a needle into a mass to sample tissue for a biopsy. Pathologists (specialized doctors) can then evaluate the tissue under a microscope to determine if the mass is breast cancer.

How do I prepare for a breast ultrasound?

On the day of your ultrasound, you should not apply any lotion or powder to the skin on or around your breasts or wear deodorant. These substances can interfere with getting clear images from the test. You may be relieved to know that any existing hair does not interfere with the images.

What happens during a breast ultrasound?

When you arrive at your provider’s office or imaging center, you’ll undress from the waist up. You’ll change into a robe or gown that opens in the front. Your provider will ask you to remove jewelry so that it doesn’t interfere with the images.

During the ultrasound, you lie on a table — usually in an angled position to optimize positioning for the imager. The ultrasound technician or radiologist (a doctor specialized in medical imaging) applies a clear, water-based gel to a wand, called a transducer. They move the transducer over the skin on and around your breasts.

The person imaging you can see the ultrasound images on a screen during the test. Representative images are saved to share with your doctors.

When the ultrasound is complete, you or the technician wipe any remaining gel off your skin.

What happens after a breast ultrasound?

After your breast ultrasound the radiologist interprets the images and reports the results to your healthcare provider. If any additional tests are needed, or follow up is recommended, that information is shared with you at the time of the exam.

What are the risks of a breast ultrasound?

Breast ultrasound uses sound waves — not radiation — to produce images. There are no known risks of ultrasound technology.

In some cases, the interpretation of your ultrasound results may lead to additional tests or procedures (such as a biopsy). These additional procedures carry their own risks. Talk with your healthcare provider about the risks to decide which tests are right for you.

When should I call my doctor?

Call your healthcare provider if you:

  • Feel a new or changing lump, dimpling, or other changes in your breast or armpit that are unusual for you.
  • Have any nipple discharge, new inversion or skin changes of the nipple.
  • Think a breast implant has ruptured.

A note from QBan Health Care Services

A breast ultrasound is a safe, painless test to examine targeted areas of breast tissue. Breast ultrasound provides detailed images of breast tissue and can help your provider diagnose breast cysts or lumps. For women with dense breasts, mammography is still the best screening tool. If you have dense breasts or a family history of breast cancer, ask your provider about scheduling a risk assessment with a clinical breast specialists and supplemental screening tools such as MRI and tomosythesis (3D) mammography.

VASCULAR ULTRASOUND

Vascular ultrasound is a noninvasive test healthcare providers use to evaluate blood flow in the arteries and veins of the arms, neck and legs. Providers use this test to diagnose blood clots and peripheral artery disease. You may also have this test to see if you’re a good candidate for angioplasty or to check blood vessel health after bypass.

What is a vascular ultrasound?

Vascular ultrasound, also called a duplex study, is a noninvasive test. This test shows healthcare providers how blood flows in your arms, neck and legs. High-frequency sound waves create detailed images of soft tissue and blood vessels.

When is a vascular ultrasound performed?

Your healthcare provider may use vascular ultrasound to see how blood flows through your veins and arteries (blood vessels). You may have this test to help your provider diagnose:

When would I need a vascular ultrasound exam?

You may need a vascular ultrasound if you have symptoms like:

  • Burning feeling in your legs.
  • Muscle atrophy.
  • Pain in your buttocks, hips, thighs or calves.
  • Leg sores (ulcers) that don’t heal.

Healthcare providers also use vascular ultrasound to check blood flow to organs. You may have this test if you’ve received an organ transplant.

Providers may also order a vascular ultrasound exam to see if you’re a good angioplasty candidate or check blood vessel health after venous disease bypass surgery.

Who performs a vascular ultrasound exam?

An ultrasound technologist performs your vascular ultrasound exam. These technologists have special training in performing ultrasound tests.

How does vascular ultrasound work?

Vascular ultrasound uses high-frequency sound waves to create detailed images. These sound waves pass through your soft tissues and blood vessels. Sound waves create echoes as they pass through tissue and computers turn these echoes into images or videos.

How do I prepare for a vascular ultrasound?

There’s nothing special you need to do to prepare for a vascular ultrasound. Plan to arrive at the facility about 15 minutes before your vascular ultrasound appointment.

You should wear comfortable and loose-fitting clothing and leave any jewelry or valuables at home. Healthcare providers may ask you to change into a hospital gown.

What happens during a vascular ultrasound?

You lie on an examination table. The technologist applies a lubricating gel to your skin in the areas where they will examine your arteries and veins.

The technologist places a special probe called a transducer against your skin. You might feel a little pressure as they move the probe over the area. You may hear your blood flowing as it makes a pulsing or whooshing sound.

What should I expect after the vascular ultrasound?

When the exam is over, the technologist wipes the lubricating gel away. You can return to work or other activities immediately after your exam.

Does vascular ultrasound have any risks or side effects?

Vascular ultrasound is safe. You won’t have any side effects from the exam.

What results do healthcare providers get from vascular ultrasound?

Vascular ultrasound gives your healthcare provider information about how quickly (or slowly) blood flows through your body. This tells your provider if something is blocking a blood vessel (like a blood clot or plaque) or if blood vessels have become narrow.

How long does it take to get results from a vascular ultrasound?

A doctor who specializes in reading and interpreting radiographic images (radiologist) evaluates the images. When the radiologist has completed their review, they send the results to the doctor who ordered your vascular ultrasound.

When should I call my healthcare provider after a vascular ultrasound exam?

You shouldn’t expect any side effects from a vascular ultrasound exam. Let your healthcare provider know if you develop any new or worsening symptoms such as pain or redness in the examined area.

A note from QBan Health Care Services

Vascular ultrasound is a noninvasive test healthcare providers use to determine how blood flows in arteries and veins in your arms, neck and legs. They use this test to diagnose blood clots, narrowed blood vessels, and other vascular health conditions.

PREGNANCY ULTRASOUND

A prenatal or pregnancy ultrasound uses sound waves to create a picture of your baby on a screen. Pregnancy care providers use it to check on the health of your baby and detect certain pregnancy complications. Most people have two ultrasounds during pregnancy, but you may have more if your provider feels it’s medically necessary.

What is an ultrasound in pregnancy?

A prenatal ultrasound (or sonogram) is a test during pregnancy that checks on the health and development of your baby. An obstetrician, nurse midwife or ultrasound technician (sonographer) performs ultrasounds during pregnancy for many reasons. Sometimes ultrasounds occur to check on your baby and make sure they’re growing properly. Other times your pregnancy care provider orders an ultrasound after they detect a problem.

During an ultrasound, sound waves are sent through your abdomen or vagina by a device called a transducer. The sound waves bounce off structures inside your body, including your baby and your reproductive organs. Then, the sound waves transform into images that your provider can see on a screen. It doesn’t use radiation, like X-rays, to see your baby.

Even though prenatal ultrasounds are safe, you should only have them when it’s medically necessary. If there’s no reason for an ultrasound (for example, if you just want to see your baby), your insurance company might not pay for it.

Prenatal ultrasounds may be called fetal ultrasounds or pregnancy ultrasounds. Your provider will talk to you about when you can expect ultrasounds during pregnancy based on your health history.

Why is a fetal ultrasound important during pregnancy?

An ultrasound is one of the few ways your pregnancy care provider can see and hear your baby. It can help them determine how far along you are in pregnancy, if your baby is growing properly or if there are any potential problems with the pregnancy. Ultrasounds may occur at any time in pregnancy depending on what your provider is looking for.

What can be detected in a pregnancy ultrasound?

A prenatal ultrasound does two things:

  • Evaluates the overall health, growth and development of the fetus.
  • Detects certain complications and medical conditions related to pregnancy.

In most pregnancies, ultrasounds are positive experiences and pregnancy care providers don’t find any problems. However, there are times this isn’t the case and your provider detects birth disorders or other problems with the pregnancy.

Reasons why your provider performs a prenatal ultrasound are to:

Ultrasound is also an important tool to help providers screen for congenital conditions (conditions your baby is born with). A screening is a type of test that determines if your baby is more likely to have a specific health condition. Your provider also uses ultrasound to guide the needle during certain diagnostic procedures in pregnancy like amniocentesis or CVS (chorionic villus sampling).

An ultrasound is also part of a biophysical profile (BPP), a test that combines ultrasound with a nonstress test to evaluate if your baby is getting enough oxygen.

How many ultrasounds do you have during your pregnancy?

Most pregnant people have one or two ultrasounds during pregnancy. However, the number and timing vary depending on your pregnancy care provider and if you have any health conditions. If your pregnancy is high risk or if your provider suspects you or your baby has a health condition, they may suggest more frequent ultrasounds.

When do you have your first prenatal ultrasound?

The timing of your first ultrasound varies depending on your provider. Some people have an early ultrasound (also called a first-trimester ultrasound or dating ultrasound). This can happen as early as seven to eight weeks of pregnancy. Providers do an early ultrasound through your vagina (transvaginal ultrasound). Early ultrasounds do the following:

  • Confirm pregnancy (by detecting a heartbeat).
  • Check for multiple fetuses.
  • Measure the size of the fetus.
  • Help confirm gestational age and due date.

Some providers perform your first ultrasound closer to 12 weeks of pregnancy.

20-week ultrasound (anatomy scan)

You can expect an ultrasound around 18 to 20 weeks in pregnancy. This is known as the anatomy ultrasound or 20-week ultrasound. During this ultrasound, your pregnancy care provider can see your baby’s sex (if your baby is in a good position for viewing their genitals), detect birth disorders like cleft palate or find serious conditions related to your baby’s brain, heart, bones or kidneys. If your pregnancy is progressing well and with no complications, your 20-week ultrasound may be your last ultrasound during pregnancy. However, if your provider detects a problem during your 20-week ultrasound, they may order additional ultrasounds.

How soon can you see a baby on an ultrasound?

Pregnancy care providers can detect an embryo on an ultrasound as early as six weeks into the pregnancy. An embryo develops into a fetus around the eighth week of pregnancy.

If your last menstrual period isn’t accurate, it’s possible that it may be too early to detect a fetal heart rate.

Which ultrasound is most important during pregnancy?

All ultrasounds during pregnancy are important. Your pregnancy care provider uses ultrasound to tell them important information about your pregnancy.

What are the two main types of pregnancy ultrasounds?

The two main types of pregnancy ultrasound are transvaginal ultrasound and abdominal ultrasound. Both use the same technology to produce images of your baby. Your pregnancy care provider performs a transvaginal ultrasound by placing a wand-like device inside your vagina. They perform an abdominal ultrasound by placing a device on the skin of your belly.

Transvaginal ultrasound

During a transvaginal ultrasound, your pregnancy care provider places a device inside your vaginal canal (similar to how you place a tampon). In early pregnancy, this ultrasound helps to detect a fetal heartbeat or determine how far along you are in your pregnancy (gestational age). Images from a transvaginal ultrasound are clearer in early pregnancy as compared to abdominal ultrasound.

Abdominal ultrasound

Your pregnancy care provider performs an abdominal ultrasound by placing a transducer directly on your skin. Then, they move the transducer around your belly (abdomen) to capture images of your baby. Sometimes slight pressure has to be applied to get the best views. Providers use abdominal ultrasounds after about 12 weeks of pregnancy.

Traditional ultrasounds are 2D. More advanced technologies like 3D or 4D ultrasound can create better images. This is helpful when your provider needs to see your baby’s face or organs in greater detail. Not all providers have 3D or 4D ultrasound equipment or specialized training to conduct this type of ultrasound.

Your provider may recommend other types of ultrasounds. Examples of additional ultrasounds are:

  • Doppler ultrasound: This type of ultrasound checks how your baby’s blood flows through its blood vessels. Most Doppler ultrasounds occur later in pregnancy.
  • Fetal echocardiogram: This type of ultrasound looks at your baby’s heart size, shape, function and structure. Your provider may use it if they suspect your baby has a congenital heart condition, if you had another child that had a heart condition or if you have certain health conditions that warrant taking a closer look at the heart.

How do I prepare for the test?

There’s no special preparation for an ultrasound. Some pregnancy care providers ask that you come with a full bladder and don’t use the restroom before the test. This helps them view your baby better on the ultrasound. You can bring a support person, but bringing children is discouraged as this is an important test that requires complete focus.

You may be asked to change into a hospital gown, but this isn’t usually required for abdominal ultrasounds. If your provider is performing a transvaginal ultrasound in your first trimester, you’ll put on a hospital gown or undress from the waist down.

What should I expect during a prenatal ultrasound?

You’ll lie on a padded examining table during the test. Most ultrasounds occur in a dimly lit room, which helps your ultrasound technician (or sonographer) see the screen. Your sonographer applies a small amount of water-soluble gel to the skin of your belly. The gel doesn’t harm your skin or stain your clothes, but it may feel cold. This gel helps transmit sound waves more efficiently.

Next, the sonographer places a transducer on the skin of your abdomen. The transducer sends sound waves into your body, which reflect off internal structures, including your baby. The sound waves that reflect back create pictures on a screen. Your sonographer uses these images to take important measurements such as your baby’s head circumference and length. You may see them making lines on the screen or clicking a button to “freeze” certain angles.

There’s virtually no discomfort during a prenatal ultrasound. You may feel mild discomfort if you have to pee. The ultrasound test takes about 30 minutes to complete.

If you have a transvaginal ultrasound, the process is only different in that the transducer is inside your vagina and not on your belly.

What should I expect after a pregnancy ultrasound?

If you had an abdominal ultrasound, your sonographer wipes the gel off your belly. They may print off some ultrasound pictures for you to take home with you.

In most cases, your sonographer won’t discuss the results of your test with you. If your obstetrician performs your ultrasound, they may discuss what they see as they go along.

If a sonographer performs your ultrasound, an obstetrician will look at the images, then discuss their findings with you at your next appointment. Most practices schedule your appointment right after your ultrasound so you get your results the same day.

What are the risks of prenatal ultrasounds?

Studies have shown ultrasounds are safe during pregnancy. There are no harmful side effects to you or your baby.

Is it safe to do an ultrasound every month during pregnancy?

While ultrasounds are safe for you and your baby, most major medical associations recommend that pregnancy care providers should only do ultrasounds when the tests are medically necessary. If your ultrasounds are normal and your pregnancy is uncomplicated or low risk, repeat ultrasounds aren’t necessary.

What results do you get on a pregnancy ultrasound?

Your ultrasound results will be normal or abnormal. A normal result means your pregnancy care provider didn’t find any problems and that your baby is growing and developing normally. An abnormal result means your provider noticed something irregular. If they do, your provider will order additional ultrasounds or diagnostic tests to determine if something is wrong.

Occasionally, the ultrasound is incomplete if there’s difficulty seeing all the structures needed for that particular ultrasound. Your baby’s position or movement sometimes makes it difficult to see everything your provider needs to see. If this is the case, you’ll need a repeat ultrasound and they’ll try again.

There are some limitations to ultrasounds, so your provider may not find certain abnormalities until after birth.

What are reasons you need more ultrasounds during pregnancy?

There are several reasons your pregnancy care provider may order additional ultrasounds during your pregnancy. Some of these reasons include:

  • Problems with your ovaries, uterus, cervix or other pelvic organs.
  • Your baby is measuring small for their gestational age or your provider suspects IUGR (intrauterine growth restriction).
  • Problems with the placenta like placenta previa or placental abruption.
  • You’re pregnant with twins, triplets or more.
  • Your baby is breech.
  • You have too much amniotic fluid (polyhydramnios).
  • You have too little amniotic fluid (oligohydramnios).
  • You have a condition like gestational diabetes or preeclampsia.
  • Your baby has a congenital disorder.

Normal results on pregnancy ultrasounds can vary. Generally, a normal result means your baby appears healthy and your provider didn’t find any issues.

Why do some pregnancy providers schedule ultrasounds differently?

The number of ultrasounds you’ll have and when you have them can vary between providers. Every practice operates differently and some providers do things differently based on your health history or symptoms.

When does a pregnancy ultrasound determine sex?

Your baby’s sex isn’t visible on an ultrasound until about 18 to 20 weeks. Be sure to tell your pregnancy care provider whether or not you want to know the sex of your baby before your ultrasound.

A note from QBan Health Care Services

An ultrasound during pregnancy can be both exciting and terrifying. Your pregnancy care provider uses ultrasound to get a better idea of how your baby is growing and developing. There are different types of ultrasounds, and the exact timing may vary depending on your provider. Most pregnant people have two ultrasounds — one in the first trimester and one in the second trimester. However, if there’s a potential complication or medical reason for more ultrasounds, your provider will order more as a precaution. Talk to your provider about the ultrasound schedule during pregnancy and what you can expect.

ABDOMINAL ULTRASOUND

An abdominal ultrasound uses high-frequency sound waves to see structures inside your belly. This test checks the health of your abdominal organs — like your liver, gallbladder and kidneys — and the blood vessels that lead to them.

What is an abdominal ultrasound?

An abdominal ultrasound is a type of imaging test. It uses high-frequency sound waves to create pictures of the organs and blood vessels in your belly (abdomen).

You might hear healthcare providers use the term sonogram. Generally, “ultrasound” refers to the test, and “sonogram” refers to the image the test produces.

Why would a doctor order an abdominal ultrasound?

There are several reasons why a healthcare provider may recommend an abdominal ultrasound. One of the most common is to check on a developing fetus throughout pregnancy. Providers often call this test a prenatal ultrasound.

Ultrasound can also check parts of your digestive system, including your:

A complete abdominal ultrasound examines those three organs, as well as your:

What can an abdominal ultrasound detect?

Abdominal ultrasound may also help pinpoint the cause of unexplained abdomen (stomach) pain. It can help diagnose conditions, as well, like:

How does an abdominal ultrasound work?

Ultrasound uses sound waves you can’t hear to take pictures of soft tissues inside your body. To capture these images, a provider glides a handheld wand (transducer) over your abdomen.

The ultrasound machine sends out high-frequency sound waves that bounce off structures like organs, blood vessels and other soft tissues. A computer receives these signals and uses them to create pictures.

Abdominal ultrasound preparation

Your healthcare provider will give you complete instructions before your ultrasound. Follow their guidelines to ensure the most accurate test results.

Your provider may ask you to stop eating or drinking some hours before your test. In some cases, you may need to drink a specific amount of water right before your test. Or you may not need to prepare at all.

Abdominal ultrasound fasting

Depending on your situation, you might need to fast before your abdominal ultrasound. Having a full (or empty) bladder or stomach can sometimes lead to blurry images. Ask your provider if you should fast before your appointment.

What to expect during the test

For an abdominal ultrasound, you’ll lie on your back on a comfortable table. You’ll need to pull up or remove your shirt or put on a hospital gown.

During the test, a healthcare provider:

  1. Applies gel to your abdomen. This gel may feel cold, but it won’t hurt you or damage your clothes.
  2. Moves the probe over your skin. Your provider gently moves the handheld ultrasound wand over your skin, on top of the gel. They’ll move the wand back and forth until they clearly see the areas in question.
  3. Gives you instructions. The provider performing this test may ask you to turn to one side or hold your breath for a few seconds.
  4. Cleans your skin. They’ll wipe off any remaining gel on your skin.

If your provider wants to study your blood vessels, your test may include Doppler ultrasound. Doppler sound waves detect details of how blood flows inside your blood vessels.

How long do abdominal ultrasounds take?

On average, an abdominal ultrasound usually takes 30 minutes to complete. But it could take more or less time depending on your situation.

Are ultrasounds safe?

Yes, ultrasound is a safe and accurate imaging test. Unlike X-ray imaging, ultrasound doesn’t use radiation (which can cause health issues at high doses). Ultrasound has no known side effects.

When should I know the results?

After your test, a radiologist (doctor who specializes in reading medical images) will review your ultrasound pictures. Then they’ll write a report of their findings and send it to your primary care physician (PCP). In most cases, this takes about one week or less.

Providers sometimes use ultrasound to diagnose potentially life-threatening conditions in an emergency. If your provider suspects an urgent concern, you’ll get results right away.

What should I ask my healthcare provider?

If you need an abdominal ultrasound, here are some questions you may want to ask your provider:

  • What type of ultrasound do I need?
  • Will I need any other tests?
  • How do I need to prepare for my abdominal ultrasound?
  • When can I expect to get my results?

Can you drink water before an ultrasound of the abdomen?

It depends. Drinking small amounts of water with daily medication is usually OK. But your provider might need you to fast for eight hours before your exam. If you’re not sure, ask your healthcare provider what you need to do in the hours leading up to your appointment.

A note from QBan Health Care Services

If you need an abdominal ultrasound, it’s normal to wonder what to expect the day of your test. Ultrasound imaging is safe and noninvasive. In most cases, it only takes about 30 minutes. Your healthcare provider can talk to you about why you need an ultrasound and what you can expect once you get your results.