How Vascular Screenings Can Save Your Life

Did you know that an estimated 20 to 30 million Americans are a risk for vascular disease? These include stroke, peripheral artery disease, carotid artery disease, aortic aneurysms and others. In most cases, with early detection, vascular disease can be treated effectively.

In this podcast, Deidre Smith, a Vascular Surgery Nurse Practitioner at UM Baltimore Washington Medical Center, tells us about vascular screenings and how they can save your life!
How Vascular Screenings Can Save Your Life
Featured Speaker:
Deidre Smith, BSN, MS, AGNP-BC
Deidre Smith received her Bachelor of Science in Nursing and Master of Science in Adult/Gerontology Primary Care Nurse Practitioner at the University of Maryland School of Nursing. She has over ten years of experience in cardiovascular care and joined UM BWMC’s Vascular Center in 2017. She coordinates the outpatient management of our patients and facilitates their continued non-invasive surveillance. She has a particular interest in prevention, screening, and education of patients and their families about peripheral arterial and venous disease.
Transcription:
How Vascular Screenings Can Save Your Life

Cheryl Martin: It's estimated that 20 to 30 million Americans are at risk for vascular disease. It includes any condition that affects your circulatory system or system of blood vessels from diseases of your arteries, veins and lymph vessels to blood disorders that affect circulation. The good news is with early detection, vascular disease can be treated effectively.

Welcome to the Live Greater podcast series, information for a Healthier You from the University of Maryland Medical System. I'm Cheryl Martin. And joining me today to talk about vascular screenings and how they can save your life is Deidre Smith, a vascular surgery nurse practitioner at the University of Maryland Baltimore Washington Medical Center. Glad to have you on, Deidre.

Deirdre Smith: Thank you so much for having me, Cheryl. I'm glad to be here.

Cheryl Martin: Tell us about the symptoms of vascular disease.

Deirdre Smith: Sure. So, vascular disease can present in many different ways. Namely, there are three major areas, where we expect vascular disease to manifest. One could be signs or symptoms of a stroke. And so, that would indicates possibly some level of carotid artery disease, which are the arteries in your neck that take blood flow up to the head and the brain area.

Another symptom could be unrelenting abdominal or back pain. And this would raise suspicion for a possible abdominal aortic aneurysm, which is an enlarging or ballooning out of the aorta, which is the main artery that runs down the center of the chest into the abdomen.

And then lastly, leg pain. Leg pain or wounds on the feet that won't heal are usually indicative of some type of vascular component of peripheral artery disease where there's buildup of plaque in the arteries that supply the legs, causing what we call claudication or cramping of the muscles during activity or wounds on the feet that cause prolonged or delayed healing.

Cheryl Martin: So, tell us about a vascular screening and how that can make a difference.

Deirdre Smith: Sure. Vascular screenings can make a great difference, especially for our older patients that have multiple chronic conditions or a very strong family history of vascular disease. Early detection is key in order for us to restore blood flow to pertinent areas and organs of the body, of course, which will decrease long-term morbidity and ultimate mortality.

Cheryl Martin: Are there different types of screenings?

Deirdre Smith: Yes, there are different types of vascular screenings that we conduct. We do carotid artery screenings, which again are the arteries in the neck that take blood flow up to the head and the brain. This is done simply by ultrasound surveillance as well as ultrasound of the abdomen to detect any type of aneurysm that may or may not be present. And then also, a doppler ultrasound of the legs to evaluate blood flow, the percentage of blood flow that you're receiving to the legs and to the feet. So, those are the three main areas of vascular screening that we offer.

Cheryl Martin: Now, Deidre, you mentioned the elderly are prime candidates for this. Should a person ask for a vascular screening without having any of these symptoms?

Deirdre Smith: So, I would say that anyone over the age of 60 years old, especially those with chronic conditions such as diabetes, hypertension, high cholesterol, any history of smoking, tobacco, or any strong family history of arterial disease or vascular disease should request screening. Those would be the people who would be at highest risk for detecting any vascular concerns that may not present any symptoms.

Cheryl Martin: Do you find that a lot of people know to ask for this screening, especially those at risk?

Deirdre Smith: So, actually no. I would say unless someone has a strong family history and has dealt with these vascular concerns with their family members or loved ones before, normally their primary care doctor is the first person that they would go to with any issues, and then we would normally see a referral for a vascular screening from their primary care provider. But it is usually unlikely that people would normally request a vascular screening on their own.

Cheryl Martin: But it is a good idea based on what you're saying. So, what diseases can the screening catch? You'd mentioned some of them.

Deirdre Smith: Absolutely. It's a great idea to get a vascular screening. So, carotid artery disease again would detect any type of plaque buildup or cholesterol accumulation in the arteries that take blood flow up to the head and the brain. When this perpetuates or worsens, this can cause or put you at risk for stroke. And of course, with stroke, we know that that can cause several different disabilities depending on the severity of the stroke.

Also for abdominal aortic aneurysms, as I mentioned before, those have the propensity to enlarge over time, and eventually rupture if they're not caught in a timely manner and repaired. Likewise with the lower extremities, plaque buildup on the inside of the arteries that take blood flow down to the legs and feet can cause wounds that won't heal, that would sometimes eventually progress to gangrene. And then, we are looking at the possibility of someone becoming at risk for amputation. So, a vascular screening can be the first step in life-sustaining repair of these conditions.

Cheryl Martin: What happens during the screening?

Deirdre Smith: So, the screening is totally painless. And during the screening, someone would meet with our vascular technologists who would go through a host of questions just to evaluate the patient a little bit more, ask a few questions about their lifestyle, whether or not they've experienced or exhibiting any of the symptoms that we previously discussed in order to get just a better idea of any concerns that they may have or any further testing that may need to be done. And an ultrasound screening is performed. As I said, it's totally painless. And an ultrasound probe is used on the neck, the abdomen, and the legs to detect these issues.

Cheryl Martin: How long does it take?

Deirdre Smith: A vascular screening should take about an hour. And that's the culminative time between the patient meeting with the vascular technologist, having the ultrasounds performed, as well as a short discussion with a provider, nurse practitioner or physician afterwards to review the results of their studies.

Cheryl Martin: And once you get the result, does the nurse practitioner or the physician then give an analysis of what should change, let's say, in your lifestyle?

Deirdre Smith: Sure. So, there's much discussion about smoking cessation for those who do smoke; lifestyle changes, namely diet and exercise changes as well as recommendations for followup in our office for an appointment. Sometimes if asymptomatic vascular disease is detected, we would recommend that they continue to followup with our office on a routine basis to manage these things.

Cheryl Martin: How do you request an appointment? Is it by doctor referral only, or can you schedule one on your own for a screening?

Deirdre Smith: Sure. So, doctors can definitely refer patients for a screening. But we also accept self-referrals. self-referrals. So, it can be a self-referral or a referral from another physician or provider.

Cheryl Martin: Now, does health insurance cover the screenings?

Deirdre Smith: the screenings are totally free of charge. We do not bill insurance or ask for any type of payment for these vascular screenings.

anyone can call and request a screening and come in and receive an initial screening. And then from the results of those screenings, we can further direct them in terms of followup care if needed or refer them back to their primary care physicians with a small little report sheet as to what was found or, you know, that their tests were normal, so that they can keep them on file for their records.

Cheryl Martin: That's great. Anything else you'd like us to know about vascular screenings that we didn't cover?

Deirdre Smith: So, vascular screenings, I think, again, I just wanted to drive home the point that they're imperative for patients who have a heavy smoking history or heavy family history of vascular concerns. Anyone over the age of 60, namely with multiple chronic conditions such as hypertension, high cholesterol, diabetes, those patients are usually the ones that we find either have asymptomatic disease, meaning they do have positive findings on the ultrasound, even though they don't manifest any symptoms of vascular disease. But also, those that if a situation or a complication from vascular disease would occur, that they seem to progress very fast. So, just urging everyone if any of those things apply to you that you get a vascular screening done to make sure that you're not at risk.

Cheryl Martin: Because it could save your life.

Deirdre Smith: Absolutely. Absolutely, Cheryl.

Cheryl Martin: Deidre Smith, thanks so much for talking about the importance of vascular screenings.

. . To find a location for vascular screening, visit umms.org/vascular 

That's U M ms.org/vascular. And thank you for listening to Live Greater a Health and Wellness. Brought to you by the University of Maryland Medical System. You can find more shows just like this one at umms.org/podcast and on the University of Maryland Medical System's YouTube channel. We look forward to you joining us again.