Do I Need a Carotid Ultrasound?
The carotid arteries run up each side of your neck and carry blood to your brain. A carotid ultrasound uses sound waves to look at them. It is non-invasive, painless, and typically completed in under an hour.
What it checks
- Plaque: fatty deposits inside the artery wall.
- Narrowing: how much a plaque limits blood flow.
- Wall thickness (CIMT): the thickness of the inner layers of the artery wall. Walls thicker than expected for your age and sex can be an early sign that arteries are changing.
Why knowing your results is worth it
Most heart and artery problems build quietly for years. Blood pressure and cholesterol numbers tell you about risk. A carotid scan shows you what is actually happening in your arteries. That can help in four ways:
- It can settle a "maybe." If your risk is borderline, finding plaque often tips the decision toward treatment. Finding none can give you and your doctor reason to take a lighter approach.
- It makes the risk visible. Many people change their habits when they see an image of plaque in their own artery, in a way a lab value does not prompt.
- It gives you a baseline. A repeat scan in a year or two can show whether things are staying steady, so you can tell if your treatment and lifestyle changes are working.
- It helps you ask better questions. You walk into your next visit with something specific: "My scan showed mild plaque. Should my cholesterol goal change?"
What your results can look like
| What the scan shows | What it means | What people often do next |
|---|---|---|
| No plaque, typical wall thickness | No visible artery changes right now | Keep up regular checks of blood pressure, cholesterol and blood sugar |
| Thicker walls than typical | Arteries may be starting to change | Talk with your doctor about risk factors; tighten diet, exercise and sleep |
| Mild plaque (under 50% narrowing) | Artery disease is present, with blood flow still fine | Review cholesterol and blood pressure treatment with your doctor |
| Moderate narrowing (50-69%) | Plaque is limiting blood flow | Follow up with your doctor within weeks |
| Significant narrowing (70% or more) | Needs prompt attention | Contact your doctor right away |
Who may benefit
- People with a family history of early heart disease or stroke
- People with several risk factors, such as high blood pressure, high cholesterol, diabetes, or a history of smoking
- People over 50 who want a clearer picture of their risk
- People whose doctor heard a whooshing sound over an artery in the neck
- People with "borderline" risk who want more information before deciding on treatment
An honest note
A carotid ultrasound is not a complete heart check, and a normal result does not rule out heart disease. For people with no symptoms and average risk, major guidelines do not recommend routine carotid screening. It is most useful when your risk is unclear, or when you want more information to guide decisions with your doctor.
Why get it with ImagineEcho
- We come to you. A sonographer visits your home or facility. No driving, no parking, no waiting room.
- Non-invasive and painless. The scan is typically completed in under an hour.
- Cardiologist or vascular specialist review. Your images are reviewed by a specialist, and your results are delivered to you.
- Book exactly what you need. Need more than one exam? They can be combined into a single visit. Just let us know when booking.
- Part of a full picture. If your results suggest looking further, we also offer heart and vascular exams, including echocardiograms, so you do not have to start over with a new provider.
- We serve San Francisco, Marin, Santa Clara, Alameda, San Mateo and Contra Costa counties.
When to get emergency care instead
Sudden weakness or numbness on one side of the body, trouble speaking, loss of vision in one eye, or a sudden severe headache can be signs of a stroke. Call 911. Do not wait for a scan.
Frequently asked questions
Do I need a doctor's referral?
You can book your exam directly online.
Will insurance cover it?
This is a self-pay exam. HSA and FSA funds are accepted.
How should I prepare?
No special preparation is needed.
How often should it be repeated?
It depends on your results. A common range is every 1-2 years if plaque or narrowing was found. Your doctor can advise.
Ready to know where your arteries stand?
Looking for other heart tests? See our guide to echocardiogram options in the San Francisco Bay Area.