Maggie McKay (Host): Meaningful Medicine is a Novant Health podcast, bringing you access to leading doctors who answer questions they wish you would ask. From routine care to rare conditions, our physicians offer tips to navigate medical decisions and build a healthier future.

Joining us is vascular surgeon, Dr. Rebecca Kelso, to discuss diagnostic heart screenings, how they work, who can benefit from them and what they reveal. Thank you so much for making the time, Dr. Kelso.

Rebecca Kelso, MD: Thanks for having me.

Host: Absolutely. So, talk to us about your work. A lot of people hear vascular specialist and immediately think life-threatening crisis, but you are working to prevent those from happening.

Rebecca Kelso, MD: Yes, that's kind of our goal. And vascular surgery is especially looking at the blood vessels outside the heart and outside of the brain. And so, what we do is look for any conditions such as blockages or aneurysms and try to identify those. Sometimes they're also identified by a patient's primary doctor. And then, we just try to help treat those, manage those, and prevent complications or life-threatening scenarios like you mentioned.

Host: And what types of conditions can diagnostic screenings reveal?

Rebecca Kelso, MD: So, the big words that we use are peripheral artery disease, for one; neck artery disease or aneurysms. And when we talk about artery disease, what we're really meaning is something that people call hardening of the arteries. They may refer to it as PAD, PVD. The physical term for it is atherosclerosis, and that's really where the arteries become filled with things related to cholesterol, calcium, or things that lead to buildup.

Host: So, how do the screenings work? When we think diagnostic tests, typically colonoscopies come to mind, which are not especially pleasant, what can someone expect when they come to see you?

Rebecca Kelso, MD: So, the good news is that vascular surgery screenings are all painless. And so, the majority of them are all done with something that we call ultrasound. So, the most common way that people have encountered an ultrasound is that when you have your ultrasound to look for the pregnancy. And so in our case though, we use the same ultrasound machine to evaluate the blood vessels. And so, there's usually some cold gel involved to help us see through the probe. And that allows us to look at all the blood vessels.

We also do a different test, and sometimes we're looking at how good flow is, especially to the legs. And then, we use blood pressure cuffs. And so, blood pressure cuffs can be placed on the legs to then measure the blood flow all the way down into the feet. And the good news is these tests usually take anywhere from 30 to 60 minutes and then they're done, and your doctor can review the test.

Host: And what's the power of these screenings?

Rebecca Kelso, MD: So, the power of screening is just like looking for other disease. We want to try to help people identify any blood vessel diseases before they become a problem. Hopefully, we can identify sometimes even why you may be having symptoms, and then ultimately lead to the ability to monitor, to treat these things with medications, to help minimize heart and blood vessel risk, and then identify changes so that we can treat them before any of those life-threatening problems arise.

Host: Dr. Kelso, if a screening does reveal a concern, what are the next steps? Does that mean immediate surgery or are there other things that can be done before that?

Rebecca Kelso, MD: That's a great question. Because a lot of times, people think of seeing a vascular surgeon always means that there's always surgery involved. And so, one of the good things is that for the most part, if we identify something on screening, we can usually follow these every six months to a year in some circumstances and look for any changes. And only if there are changes that can lead to things like stroke or aneurysm rupture do we try to do surgery before we get to that point? So often, diseases will be monitored for quite some time before you actually even need surgery.

Host: So, who is an ideal candidate for vascular diagnostic screenings?

Rebecca Kelso, MD: Vascular disease is really common in the same population of people that have heart problems or strokes. And so when we look at screening, we like to identify people that are at risk. And when we say at risk, we mean anybody that has factors such as diabetes, high blood pressure, high cholesterol smokers, or people that have a family history of problems, so a family history of arteries that have been blocked, strokes, or even a family history of aneurysms. We also tend to screen anybody that's over the age of 65 for these conditions as well.

Host: In closing, is there anything else you'd like people to know?

Rebecca Kelso, MD: I think the other thing I'd like people to know is that to talk about these things with your provider or ask to see a vascular surgeon if you have concerns. A lot of these problems are things that are asymptomatic or what we call silent, and so you may not even know you have them, and this is why screening can be so important.

Host: Well, thank you so much for sharing your expertise. This has been so educational and helpful. We really appreciate it.

Rebecca Kelso, MD: Thank you. It was great to be here today.

Host: Again, that's Dr. Rebecca Kelso. If you found this podcast helpful, please share it on your social channels and check out our entire podcast library for topics of interest to you. To find a physician, visit novanthealth.org. For more health and wellness information from our experts, visit healthyheadlines.org.