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Understanding the Carotid Intima-Media Thickness Test (CIMT) 

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Carotid Intima-Media Thickness Test

In healthcare, the phrase ‘first, do no harm’ can sometimes fall short. Traditional medical testing walks a fine line. It’s a balancing act—seeking life-saving information but potentially ushering in harm. 

Many cardiology tests are invasive, drenched in radiation, and can be double-edged swords. False positives are not mere statistics; they translate into real-life anxiety, leading patients through a maze of further invasive testing and treatments that carry their own set of risks. It’s a high-stakes game where the cost of information can be steep—in terms of health and peace of mind.

Amidst this backdrop, the carotid intima-media thickness test (CIMT) emerges as a promising test. This non-radiation diagnostic tool looks into the carotid arteries, offering a panoramic view of our vascular health without the collateral damage. It acts as an early detection system that sidesteps the dangers of more invasive procedures. 

Understanding CIMT: What It Is and Why It Matters

CIMT hinges on ultrasound technology. It measures the thickness of the intima and media layers of the carotid artery’s wall. The carotid arteries are large vessels in your neck that send oxygen-rich blood to your head.

Why would we need to measure the size of the carotid artery walls? Thickening can be a sign of plaque building up on those walls. This plaque build-up is called atherosclerosis and is a leading cause of heart disease and stroke. 

The subtlety of CIMT allows for the detection of arterial changes before symptoms appear, setting the stage for early intervention.

The Role of CIMT in Forecasting Cardiovascular Events

Unlike a regular ultrasound that flags larger blockages affecting circulation, CIMT provides a detailed analysis of the artery lining itself. It’s a sophisticated tool that measures the extent of inflammation and plaque accumulation, elements often invisible to less advanced scans.

This advanced imaging technique also excels in distinguishing the types of arterial plaque. The difference is critical: soft plaque, known for its potential to rupture, can lead to a heart attack or stroke without warning, while hard plaque, though less immediately dangerous, can still pose a significant risk by narrowing the arteries over time. By identifying the exact nature of the threat, CIMT allows clinicians to tailor their preventive strategies more effectively.

Essentially, CIMT can forecast potential trouble. By mapping the arterial terrain, CIMT gathers crucial data on the likelihood of atherosclerotic cardiovascular disease. It takes the abstract concept of ‘risk’ and gives it a face, a measurement, a form that clinicians and patients can confront and manage together.

What Happens During a CIMT Test? 

A CIMT test is easy and painless, taking less than 15 minutes. The patient lies back, neck extended, as gel is placed on the skin. Then, a high-resolution ultrasound transducer takes pictures. Images flash on the screen, revealing the intimate layers of the carotid arteries. 

It’s a bloodless peek into the circulatory system’s health, free from the discomfort of more invasive methods. With no downtime, patients can immediately return to their daily routines—a modern medical diagnostics marvel.

When to Retest: Timing Your Follow-Up CIMT

“See you soon” isn’t just a polite goodbye; it’s a plan. Follow-up is integral. 

Depending on initial results, a repeat CIMT scan within 6 to 12 months is often suggested. This cadence allows for monitoring the progression or regression of intima-media thickening. It’s about tracking trends, not just taking snapshots. Such vigilance is crucial for adjusting lifestyle or medical interventions, all while keeping the pharmacopeia at arm’s length whenever possible.

Understanding Your Vascular Age

When you undergo a CIMT test, the results aren’t just a set of numbers; they reflect your arteries’ condition relative to others in your age bracket. Interpreting these results is key to grasping your cardiovascular health status.

CIMT results are conveyed as a percentile rank, not to be confused with a percentage. If your results place you at the 50th percentile, it means your carotid artery thickness is at the median for your age group—essentially, it’s average. However, it’s essential to understand what these percentiles represent in terms of arterial health. A higher percentile indicates thicker-than-average artery walls, suggesting that your arteries might be “older” than what’s typical for your age group. Conversely, a lower percentile means “younger” arteries with less thickening.

But what does this thickness mean in tangible terms? A normal carotid intima-media thickness for middle-aged, healthy adults typically ranges between 0.6 and 0.7 millimeters. If the test reveals a thickness exceeding 1.0 millimeter, it’s a signal that you may be at an elevated risk for cardiovascular disease. 

Integrating CIMT with Other Cardiovascular Tests

Interpreting the complexities of cardiovascular health requires a multifaceted approach, as no single test can provide a complete picture. The CIMT scan is a critical component, but it truly shines when paired with Level 2 testing. This tandem approach combines the structural insight provided by CIMT with the metabolic and biological data gleaned from additional heart health markers, such as inflammation levels, cholesterol profiles, and blood glucose values.

Think of CIMT as a puzzle piece in a larger cardiovascular health puzzle. When used alone, it offers valuable information about the condition of the carotid arteries. However, it’s the combination with Level 2 testing that rounds out the assessment, offering a broader, more detailed view of heart health. This comprehensive evaluation strategy enables healthcare providers to assemble a more complete assessment of cardiovascular risk, informing more targeted and effective prevention strategies.

Next Steps

The goal of modern medicine is to treat less by preventing more. The carotid intima-media thickness test (CIMT) is a beacon in this preventive strategy. It allows for early detection and management of cardiovascular risk factors in a patient-friendly, body-friendly way. 

As a non-invasive and non-radiation test, it provides crucial information that can guide interventions, helping keep medications as a last resort. With its place firmly established in cardiovascular diagnostics, CIMT is a testament to the power of preventive medicine and the evolution of patient care.

We’re here to guide you if you’re interested in more details about CIMT testing. Please reach out to us for a complimentary 20-minute call. During this conversation, we’ll provide you with further information on securing the test and assist with scheduling so you can take that proactive step toward a clearer understanding of your heart health.


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Dr. Smigiel helps people suffering from conditions such as chronic pain and erectile dysfunction, to hair loss and weight gain. Combining treatments such as PRP Therapy, Ozone, Neural Prolotherapy, and IV Infusions with functional rehabilitation, he helps you look and feel better.

He heals the body, instead of just treating the symptoms!

With his professional qualifications as a certified family nurse practitioner, a doctor of chiropractic, and a fellow of the International Academy of Medical Acupuncture, Dr. Smigiel offers patients comprehensive care from a broad perspective of conventional and alternative medicine. He also has extensive experience in functional rehabilitation and chronic pain management.

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About Dr. James Kneller, M.D., Ph.D., FHRS

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Dr. James Kneller is one of the nation’s leading heart rhythm specialists. Dr. Kneller is certified by the American Board of Internal Medicine (ABIM) in Clinical Cardiac Electrophysiology, Cardiovascular Disease, and Internal Medicine.

As a Fellow of the Heart Rhythm Society (FHRS) and Certified Cardiac Device Specialist (CCDS), Kneller provides comprehensive patient care, combining best medical practice with invasive procedures using state-of-the-art technologies to treat heart rhythm disorders.

Beyond guideline-directed therapies, Kneller is passionate about optimized personal health. With a deep interest in complimentary alternative medicine (CAM), he strives to reduce the need for pharmaceuticals, invasive procedures, and exposure to harmful radiation. With Natural Heart Doctor, he strives to help each and every client to Live Well, Eat Well, and Think Well to attain their 100-year heart!

About Dr. Lauren Lattanza NMD, FACC

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As a Naturopathic Physician, I am trained to treat the whole person and get to the root cause of disease.

I went to Arizona State University where I graduated with a bachelor’s degree in psychology with a depth in physiology and minor in Spanish. After my undergraduate degree I was working on prerequisite classes towards medical school, which is when I came to learn that my values identified best with the principles of naturopathic medicine. I knew that I wanted to help patients identify the causes of disease and be able to offer treatments which would improve their health rather than simply treating symptoms.

I dedicated the next 4 years to the Southwest College of Naturopathic Medicine in Tempe, Arizona where I attained my Doctorate of Naturopathic Medicine. I served as Class President all 4 years, Board of Trustees – Student Trustee, spoke as the Club President for our branch of Toastmasters, and was voted by my peers and attending physicians to earn the Outstanding Leadership Award for the Class of 2020. Throughout medical school I took it upon myself to work alongside MDs, DOs, chiropractors, and functional medicine practitioners in addition to naturopathic physicians.

As a Spanish speaking student, I was able to volunteer with community clinics around Phoenix and provide free healthcare to low-income families. Due to this combined exposure, I came to find my passion in treating cardiometabolic and digestive disorders that are all too common, yet largely preventable. I took the opportunity to learn the broad spectrum of healthcare so I can ensure that I am able to provide my patients with the best options.

About Dr. Jack Wolfson DO, FACC

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Dr. Jack Wolfson is a board-certified cardiologist, Amazon best-selling author, husband, father, and the nation’s #1 Natural Heart Doctor.

For more than two decades, more than one million people have enjoyed the warmth, compassion, and transformational power of his natural heart health courses and events.

Dr. Wolfson is the founder of Natural Heart Doctor Scottsdale, his heart health practice in Arizona, and Natural Heart Doctor, an online resource center with natural health information. Doctors from across the globe reach out to Dr. Wolfson for training and education in holistic health practices.

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Our chiropractor is an expert at adjustments and holistic chiropractic care and works closely in conjunction with the other health care experts at Natural Heart Doctor.

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IV Therapy

We use specially formulated natural vitamins and minerals that are injected into a vein to prevent or treat dehydration. Ideal for people in Arizona.

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Stimulate your body’s natural healing abilities and promote physical and emotional well-being with acupuncture at Natural Heart Doctor.

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Our health coaches use evidence based skillful conversation, clinical interventions, and strategies to engage you actively and safely in health behavior changes.

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We use the most advanced testing in the world to assess heart health and to identify the root cause of your health issues.

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Schedule an office visit with one of our cardiologists, holistic physicians, chiropractor, or health coaches.

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Frequently Asked Questions

I’d like to receive an online second opinion from Natural Heart Doctor. What do I do next?

You can initiate a second opinion online through our website at any time. To begin, select the team member you’d like to speak with and open an account.

Click here for cardiologist Dr. Jack Wolfson.

Naturopathic Medical Doctor Dr. Lauren Lattanza. Get details.

Naturopathic Medical Doctor Dr. Tonia Rainier. Get details.

Click here for  Natural Heart Doctor Health Coach.

Alternatively, you can email health@naturalheartdoctor.com. A member of our care team will help guide you through the process of starting a second opinion.

What is the cost of a Natural Heart Doctor Online Second Opinion?

The cost for most second opinions varies by team member. This fee includes information collection, a phone or video consultation, a second opinion from a Natural Heart Doctor specialist and guidance throughout the process from your personal Care Team at Natural Heart Doctor.

Cardiologist Dr. Jack Wolfson’s Second Opinion Fee is $1500.

Holistic Physician’s Dr. Lauren Lattanza’s Second Opinion Fee is $250.

Naturopathic Physician Dr. Tonia Rainier’s Second Opinion Fee is $250.

Note: We apply the Online Second Opinion Call fee as a credit to any future consultations with Natural Heart Doctor, should you choose them.

Will my insurance cover the cost of a Natural Heart Doctor Online Second Opinion?

Most likely, no. Most health plans do not cover online second opinions or consultations. You are responsible for the cost of our second opinion. Natural Heart Doctor cannot file a claim with your insurance carrier, nor can we provide a procedure (CPT) code for this service.

What is the timeline to receive an online second opinion?

We do our best to schedule your second opinion as quickly as possible. Typically, it takes 5 to 7 business days after your information has been collected to receive your phone or video online second opinion.

What information do you need in advance of our call?

Our office will send you a short questionnaire to complete and return. We DO NOT need your complete medical records.

How many questions can I ask the expert during our call?

You may ask a maximum of five questions. This is to ensure that the expert has sufficient time to devote to each question. All questions must be finalized before your online meeting.

What should I expect to receive once my second opinion is complete?

You will receive a summary of our discussion along with our second opinion. The second opinion will be in written form. After you have reviewed the second opinion, a Natural Heart Doctor clinician will follow up with you by phone to address general medical questions about the information provided in the second opinion.

What if I have follow-up questions for the expert after I have reviewed my second opinion?

If you have a clarifying question about an expert’s response to one of the questions in your second opinion, and the Natural Heart Doctor clinician is unable to address it, then you may request a follow up session for an additional fee. 

Is my medical and payment information secure?

Natural Heart Doctor is strongly committed to protecting the privacy and security of all our patients. Our website meets all federal requirements for protecting personal health information under the Health Insurance Portability and Accountability Act (HIPAA). All financial transactions are processed by Natural Heart Doctor securely using industry standard payment processing tools.

I would rather visit Natural Heart Doctor for an in-person appointment. What should I do next?

If you would prefer an in-person appointment at Natural Heart Doctor instead of an online second opinion, please call (480) 535-6844 for details and scheduling.

Can I schedule a follow up appointment with the specialist who provided my online second opinion?

Yes, we’re happy to help you on an extended basis. Our clinician can discuss options with you when presenting our second opinion summary.