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Atherosclerosis Causes and Risks:
Atherosclerosis is a common disorder of the arteries. Fat , cholesterol , and other substances collect in the walls of arteries. Larger accumulations are called atheromas or plaques. Eventually, the fatty tissue can erode the wall of the artery, diminish the elasticity (stretchiness) of the artery, and interfere with the blood flow. Clots may form around the plaque deposits, further interfering with blood flow. Severely restricted blood flow in the heart muscle leads to symptoms such as chest pain .
Risk factors include smoking , diabetes , obesity , high blood cholesterol , a diet high in fats , and having a personal or family history of heart disease . Cerebrovascular disease , peripheral vascular disease , high blood pressure , and kidney disease involving dialysis are also disorders that may also be associated with atherosclerosis.
Arteriosclerosis means hardening of the arteries. It accompanies atherosclerosis and is not clearly separated from it. It involves deposits along the arteries, which often contain calcium.
Prevention:
See treatment.
Symptoms:
Atherosclerosis shows no symptoms until a complication occurs.
Signs and Tests:
Atherosclerosis may not be diagnosed until complications occur. Prior to complications, atherosclerosis may be noted by the presence of a vascular (blood vessel) bruit (whooshing or blowing sound heard over the artery with a stethoscope). Pulses may be decreased in the affected area.
Tests that indicate atherosclerosis (or complications) include: - an ultrasound of affected area
- a CT scan of affected area
- an arteriography of affected area
Treatment:
To some extent, the body will protect itself by forming new blood vessels (collateral circulation) around the affected area.
Medications may be recommended to reduce blood fats / cholesterol . These include medications such as cholestyramine, colestipol, nicotinic acid , gemfibrozil, probucol, lovastatin, and others. Aspirin (which inhibits platelet clumping) or anticoagulants may be used to reduce risk of clot formation.
Balloon angioplasty uses a balloon-tipped catheter to flatten plaque and increase blood flow past the occlusion. The technique is similar to that used to open the arteries of the heart, but it can be applied to many other arteries in the body. Surgical removal of deposits (endarterectomy) may be recommended in some cases (example--carotid endarterectomy).
Treat or control risk factors:
Diet recommendations may include low-fat , low-cholesterol, and low-salt diet. Follow the health care provider's recommendations for treatment and control of hypertension , diabetes , and other diseases. Reduce body weight if overweight and stop smoking if a smoker. Get regular exercise to improve the fitness of the heart and circulation.
Prognosis:
The outcome varies. Atherosclerosis is usually progressive and frequently leads to complications.
Complications:
Call Your Healthcare Provider:
Call for an appointment with the health care provider if you are at risk for atherosclerosis, particularly if symptoms of complications occur.
This picture shows gangrene (necrosis/ tissue death) of the 4th and 5th toe in a patient with severe arteriosclerosis. When arteriosclerosis or other diseases cause interruption of the blood supply to tissue, the tissue dies. The feet are a common area to suffer from lack of blood supply due to damaged vessels and decreased circulation.
A carotid arteriogram is an X-ray study designed to determine if there is narrowing or other abnormality in the carotid artery, a main artery to the brain. This is an angiogram of the left common carotid artery (both front-to-back and side views) showing a severe narrowing (stenosis) of the internal carotid artery just beyond the division of the common carotid artery into the internal and external branches .
This is an angiogram of the right carotid artery showing a severe narrowing (stenosis) of the internal carotid artery just past the carotid fork. There is enlargement of the vein or ulceration in the area after the stenosis in this close-up film. Note the narrowed segment toward the bottom of the picture.
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