Doctors use ultrasound scanner in office to reveal artery plaque

The small machines offer a cheap, painless way to check for hidden trouble.

MADISON, Wis. (AP) — What if your doctor could swipe a wand over your neck and reveal whether you have hidden heart disease?

That is now possible in places other than the sickbay of the starship Enterprise.

Miniature ultrasound machines are starting to make their way into ordinary doctors’ offices, where they may someday be as common as stethoscopes and EKGs. A pocket-sized one weighing less than 2 pounds hit the market last week.

Some of these devices can make images of neck arteries, which offer a “window” to heart arteries that cannot easily be seen. If the neck vessels are clogged, doctors know that those around the heart probably are, too, and that treatment or more testing is needed.

The new ultrasound machines offer a relatively cheap, painless way to screen people with no symptoms of heart problems for signs of hidden trouble.

Is that a good thing?

Many doctors say yes, because for one-third of heart disease sufferers, the first symptom is dropping dead of a heart attack. Finding these people early and treating them could save lives. The test may be especially good for women, who often have few traditional signs.

Lisa Rosenstock of Madison, Wis., is an example. At age 41, this trim, athletic mom had normal cholesterol and blood pressure but a troubling family history of heart attacks. Ultrasound revealed a big clog in the main artery from her heart to her head.

Her cardiologist, Dr. James Stein of the University of Wisconsin-Madison, put her on medicines to lower her risk of a heart attack or stroke. He also is leading a study aimed at making ultrasound testing more common.

“There’s a great need for a noninvasive and safe way to identify people who don’t have signs but have risk” of heart disease, he said.

But there are potential downsides to more people doing this testing without extensive training. Suddenly, small-town family doctors could see scary-looking artery buildups and rush to treat some that might never be life-threatening.

And though patients who see the pictures may be motivated to quit smoking, lose weight or go on cholesterol drugs, some might suffer side effects from unnecessary treatment.

Ultrasounds also are being advertised directly to consumers — the latest “peace of mind” test such as whole-body CT scans and MRIs. Some drugmakers are promoting wider testing because it could boost cholesterol pill sales.

The American Heart Association says testing with traditional ultrasound machines can help certain patients, but does not endorse widespread screening with the small devices because proof of benefit is lacking.

Guidelines from several groups suggesting who should use the small ultrasound devices, and on which patients, are expected next spring, said Stein, who heads a panel writing the advice.

On balance, many doctors see more promise than peril.

“It’s equivalent to a mammogram of the heart,” said Dr. Christopher Rembold, a cardiologist at the University of Virginia. If doctors see something suspicious, they can refer patients to specialists for more extensive tests before deciding whether or how to treat it, he said.

Screening involves checking for buildups called plaque and measuring the thickness of the wall of the main neck artery. Normal thickness varies by age, race and sex, and charts give doctors detailed guidance. Too-thick arteries are a sign of higher risk for heart attack.

Until recently, only ultrasound specialists did these tests, which were analyzed by a radiologist. That often meant patients needed another appointment at a hospital or ultrasound center, and a return trip to their primary doctor for results.

The portable ultrasound devices are changing that. SonoSite Inc. of Bothell, Wash., came out with one in 1999. It was followed by GE Healthcare, a suburban Milwaukee unit of General Electric.