Calcified carotid atheroma (calcified carotid artery plaque) AND aortic arch calcification
Did you know that atherosclerosis of the coronary and carotid arteries resulting in MI and stroke is the leading cause of death amongst postmenopausal women in most of the industrialized world? Unfortunately, 60% of these people get the initial indication of the disease as a fatal event. That’s because these diseases lack traditional risk factors and do not have recognized symptoms. We end up with 700,000 yearly deaths in the US from people without previously recognized symptoms. Gibbons 2008 As dentists we can help!!!!!
Dentists can spot calcified carotid arteries on a fairly regular basis while taking panoramic images and CBCT images, 24% of implant patients with mean age of 63 in Pette 2012 CBCT study. These incidental findings are indicative of significant risk of a future vascular event. Friedlander 2007 Prabhakaran 2007 Research shows that calcified carotid arteries are associated with calcifications in the aortic arch of postmenopausal women. Friedlander 2014 Another study shows that the severity of the intracranial artery calcification was significantly correlated to coronary artery calcification Agatson score. Ahn 2013 The Agaston score is a risk factor for cardiovascular events. Budhoff 2013 Autopsy studies confirm that the extent and severity of atherosclerosis in intra-cranial arteries are associated with the extent and severity of coronary artery atherosclerosis. Gongora-Rivera 2007
This all makes sense since the process causing these calcified plaques would be the same. In the past we have referred patients to their MD for follow up on the extent and size of the plaque. Typically the MD will do some form of doppler testing to check the amount of blood flow still present through the carotid. Then based on a risk-benefit ratio decide if anything should be done. I do not believe that any images of any sort are done on the heart. From now on I will be recommending that they look into having a chest x-ray done to check for aortic arch calcifications too and talk to their MD about this being a risk factor.
Below is a video from our iCAT showing some calcification
Bryan Bauer, DDS, FAGD