We’re all too familiar with the following scenario:

Fit male in his early 40’s who exercises 5 times a week, eats healthy, drinks plenty of water, doesn’t consume alcohol and suddenly dies of a heart attack. He had his annual physical a month prior and was given an A+ by his primary care doctor.

Unfortunately, the leading diagnostic tests don’t do a good job of detecting atherosclerosis and risk of sudden cardiac death until it’s too late. Having a late diagnosis of atherosclerosis and cardiovascular disease is often frustrating. If only there was a diagnostic test to determine risk earlier in the progression of disease so that preventative measures could have been taken sooner.

Early Identification = Easier Management

The Soterogram is a non-invasive method designed to identify signs of early-onset atherosclerosis. This state-of-the-art procedure is FDA-registered and cleared, has a clinical accuracy rate of 97 percent. Best of all, it takes only 15 minute, doesn’t involve a needle-stick and is performed in a relaxing environment. Furthermore, it is covered by most major medical insurance plans.

Soterogram Benefits

  • Early detection
  • Non-invasive – no radiation. No needles. No hospital admission.
  • Examination is less than 20 minutes
  • Immediate test results with report
  • Recommendations to reduce risk
  • Covered by most major insurances


Atherosclerosis is responsible for more than half of all deaths in the developed world. Over a million deaths annually are due to atherosclerosis.

Atherosclerosis is a hardening of the arteries. Put another way, it decreases arterial compliance to stretch. This decreased elasticity has the consequence of decreasing blood flow from plaque build-up and therefore restricting essential oxygen and nutrients to target tissues and organs.

Since low elasticity is correlated to atherosclerosis, a test that can determine elasticity has a high probability of detecting atherosclerosis. This is exactly what the Soterogram does.

Atherosclerosis is really an intelligent adaptive response of the body to chronic inflammation such as environmental toxins, smoking, high blood pressure, hormonal imbalance, obesity, blood sugar dysregulation, stress and certain types of dyslipidemia.

“The Soterogram measures very accurately how stiff the arterial wall is. The engineering term for that is compliance, which is change in volume divided by change in internal pressure.”

– Jeffrey Raines, MD

What Other Options Exist?

CT Calcium Score

This test uses a CT scan, usually in a hospital, to measure the amount of calcified plaque in your coronary arteries. The test measures your “calcium score, which helps your doctor calculate your risk of developing coronary artery disease (CAD)-related events such as a heart attack or a stroke. This test requires exposure to radiation and does not effectively prevent calcium deposition as the test can only determine injury to the vessels after it has occurred.

Stress Test

A stress test shows how your heart performs during physical activity. Because exercise makes your heart pump harder and faster, an exercise stress test can reveal problems with blood flow within your heart. This test is usually performed on a treadmill or stationary bike while you are hooked up to the EKG monitor. You blood pressure and heart rate are also monitored. This test is usually only performed if you currently have symptoms of coronary heart disease and is not a standard screening test.


The EKG, or electrocardiogram is used to assess your heart rhythm, detect ischemia and abnormalities of the heart. It does not detect endothelial dysfunction.


Uses upper extremity only, which is not a coronary risk equivalent. Finger-tip temperature measurement can be influenced by a variety of factors such as patient medications, Reynaud’s, nailpolish, thyroid disorders, menstrual cycle, clinical setting, anxiety.

Carotid Ultrasonography

The Carotid Intima Media Thickness Test (CIMT) is a test using ultrasound (sound waves) to determine the amount of atherosclerosis in the carotid arteries in the neck. Carotid arty disease is not a coronary risk equivalent as opposed peripheral arterial disease (2).

How Does The Soterogram Work?

The test uses pressure cuffs on the patient’s arm, calf and thigh to measure volume changes in order to measure compliance of the artery wall.

Multiple blood pressure cuffs with sensors create stress to the arteries when inflated. This simulates exercise. After releasing the pressure of the cuffs, normal functioning arteries should expand back to normal (elastic). If there is a disease process, then the arteries are not as flexible and act more like a rigid pipe.

Blood flow depends on endothelial cells (inner lining of blood vessel). When these cells are healthy, they readily expand as the heart beats, leveling out blood pressure. One of the earliest signs of heart disease is endothelial dysfunction, which causes blood vessels to lose their distensibility.

The Soterogram focuses on the disease state of the arterial wall, and a wealth of practical information can be obtained, including brachial systolic pressure, diastolic pressure and heart rate, which are obtained twice over approximately 10 minutes. Arterial volume expansion is accurately measured at the calf and thigh levels.

What is Endothelial Function?

Endothelial cells have multiple functions.

  • regulates fluid and molecule traffic between blood and tissues
  • Serves as an anti-coagulant (anti-clotting) surface
  • Contributes to vascular homeostasis and repair
  • Plays a central role in angiogenesis and tissue wound healing
  • Plays a vital role in vascular tones and blood flow regulation (measured with Soterogram).

Reactive Hyperemia

This is phenomenon following increased resistance to a blood vessel (adenosine induce or pressure induced from a cuff). Following the decrease in resistance, there is a brief period that blood flow increases.

The healthier the artery, the larger reactive hyperemia response.

What to do with Abnormal Results?

Based upon your results, we have devised a proprietary algorithm that restores the compliance of the vasculature system in combination with exercise and diet.

If you smoke, smoking cessation is the single most important action you can take.

Where Can I Find This Test?

We now offer this incredible screening test in our Brickell, Miami clinic. In addition, here are a few other clinics that offer the Soterogram:

  1. Dr. Christopher Davis (https://www.revealvitality.com/)
  2. Dr. Christopher Coretes (https://cortesfamilyphysicians.com/)
  3. Dr. Jeffrey Draesel Jr (https://drdraesel.com/)

Is It Covered By Insurance?

Yes it is! If you have qualifying insurance then this cardiovascular screening test is covered by insurance. In most cases, insurance carriers allow one visit per year as a preventative health screen. If your results are abnormal, then a follow-up test post-intervention is typically also covered.

If your insurance does not cover the test, the cash fee is $149.00 and is also included in our full annual preventative wellness check-up with PhysioAge.


  1. Blessing EM, Steenkamp MM, Manzanares J, Marmar CR. Cannabidiol as a Potential Treatment for Anxiety Disorders. Current neurology and neuroscience reports. https://www.ncbi.nlm.nih.gov/pubmed/26341731. Published October 2015.
  2. https://www.acc.org/guidelines