Are you at risk for diseases of the circulatory system?

Americans are routinely screened for a few conditions – blood pressure, colon cancer, breast cancer for women.

Since heart disease is the No. 1 killer in America, Dr. Edward Morrison, a vascular surgeon with East Cooper Vascular Surgery - Mount Pleasant wonders why we’re not all getting vascular screenings, sometimes called vascular check-ups. Heart disease and vascular disease are often used interchangeably to describe conditions that impact the heart and blood vessels.

We talked to Morrison about who needs to be screened, what a screening entails – it’s quick and painless – and what comes next if any findings are cause for concern.

What exactly is the vascular system?

The vascular system is the network of blood vessels that carries blood through the body. More specifically: arteries, veins and capillaries. It’s one of the largest systems in your body.

What are common vascular diseases you screen for and treat?

Common vascular diseases include:

• Carotid artery disease, which affects the artery that supplies blood to the brain
• Stroke
• Atherosclerosis, which is a buildup of fatty deposits, known as plaque, in arteries
• Blood clots
• Aneurysms, which are a bulging in the wall of a blood vessel that can be deadly if it ruptures

What are the symptoms of vascular disease?

Symptoms can include walking difficulties, foot wounds and muscle pain – often in your legs – that appears when you walk and then goes away a few minutes after you stop moving. In medical terms, it’s known as claudication.

Most of our work involves the leg arteries. Patients with issues there have pain and difficulty walking because their circulation is impaired. Often, they quit walking and become more dependent, more obese, and that worsens, of course, cholesterol management and management of diabetes.

If your doctor suspects you’ve had a mini-stroke – called transient ischemic attack, or TIA – you ought to have your carotid arteries and your neck looked at. The symptoms of TIA events can be similar to stroke.

I saw a patient recently – a lovely lady who has diabetes – and her feet were blue. Her daughter told me they’d been that way for a month and that her mom had been scared to come see me. She didn't develop this overnight; it’s been developing for a long time.

If you have diabetes or have any of the risk factors for vascular disease, ask your doctor to check your feet, if he or she isn’t already.

Who should have a vascular screening?

If it were up to me, everybody.

The problem with our nation’s health care system is its focus on the management of chronic illness rather than preventive care. Screening has variable insurance coverage based on the patient’s underlying medical conditions, symptoms and specific insurance. You may want to check your insurance plan for details.

But to answer your question about who should be screened, it’s smokers, people with diabetes, people with high blood pressure that isn’t properly controlled, those with family histories of early cardiovascular demise – dad had a heart attack at 48 or mama had a stroke at 60 – and people with elevated cholesterol. So, even though I said it jokingly a minute ago, that means nearly everybody.

The best thing you can do: Talk to your doctor about what screenings you might need and where you can go to get them. Many offices have flat rates for screening tests. And chances are good that your health records indicate the need for testing. If your doctor recommends screening, be sure to follow through and get the procedure.

What's involved in a vascular screening? Is it invasive? How long does it take?

It's not invasive and takes just 20 to 30 minutes. Often, it simply involves an ultrasound, some jelly on your belly and a probe to look at blood vessels. We’re looking at leg arteries, in particular. We’ll also get a blood pressure reading. There are no needles, no after-effects. You walk in, get it done and walk out. Common screens include the aorta, carotid and checking for peripheral artery disease.

So, in a perfect world, somebody would recognize that they fall into one or more risk categories, present themselves at your office and ask to be screened?

That works, but a primary care doctor can also do it. Ultrasounds are common in many primary care clinics.

If somebody is in one of these risk categories, but their primary care doctor hasn’t recommended a screening, what should they do?

Ask for a referral, or just contact our office directly.

How else, besides quitting smoking and starting an exercise regimen, can people reduce their risk?

Maintain a normal body weight. If you have elevated cholesterol and/or elevated blood sugar, get them treated. Changing old habits isn’t easy, but it’s necessary.

If somebody comes for a screening and you discover something worrisome, what’s the next step? Is it surgery?

Most patients we see don't need intervention – at least not yet. If you can get them to understand they have plaque in a carotid artery or in their leg artery and that it’s eventually going to cause problems – and you can get them to quit smoking, manage their cholesterol and begin exercising, most of them don't need an intervention.

And once they understand the importance of making these lifestyle changes, most are compliant with those and with keeping up with regular screenings.

I’d always rather prevent a disease instead of treating it. Today, I saw 10 people in clinic, and two or three of them are long-term vascular patients who are checked every three to six months. They don't need intervention.

If someone does need intervention, we do everything from surgical bypasses to angioplasty. When you get to be my age, you’re likely to become very conservative in your practice, because the stakes are high. We are very delicate about who we intervene on.