Atherosclerosis is a condition of narrowing and hardening of the vessels due to plaque buildup. Plaque, also known as atheroma, is an abnormal accumulation of lipids (cholesterol), calcium, macrophages, and a certain amount of fibrous tissue. The major content of plaque is lipids.
These accumulated substances clump up in the artery walls and cause narrowing of the arteries gradually, overtime as the accumulated substances increases, the lumen of the artery becomes narrower and restricts blood flow to tissues. The restriction of blood flow leads to low oxygen to tissues, which lead to necrosis or infarction of those tissues.
What are the signs and symptoms of atherosclerosis?
Atherosclerosis is usually asymptomatic for years. Therefore, it could go undiagnosed until a complication occurs. The signs and symptoms of most complications are:
- Chest pain (angina)
- Dyspnea (difficulty in breathing)
- Muscle weakness in the legs
- Severe headache
- Difficulty speaking
- Blurred vision
- Loss of consciousness (confusion, disorientation)
- Inability to think straight
- Numbness of arms, legs or face
What are the risk factors for developing atherosclerosis?
- History of atherosclerosis in family
- High blood pressure (hypertension)
- Cigarette smoking
- Diabetes mellitus
- Unhealthy eating habits/ unhealthy diets
- Abnormally high cholesterol levels
- Inactivity (lack of exercise)
- Human immunodeficiency virus (HIV)
- Acquired immune deficiency syndrome (AIDs)
- Sex: Male
- Sleep deprivation
Complications Of Atherosclerosis
Atherosclerosis leads to so many potentially life-threatening diseases such as:
- Ischemic heart disease (coronary heart disease): is the most common cardiovascular disease, and there are four types: Stable angina, Unstable angina, Heart attack (myocardial infarction), and Sudden cardiac death (cardiac arrest).
- Heart failure
- Peripheral artery disease (PAD): is the narrowing of the arteries of the extremities. It mainly affects the legs. It is characterized by Intermittent claudication (is leg pain while walking that gets better with rest), Skin ulcers, Foot ulcer, Cold skin, Cyanosis of the skin in the affected leg, Abnormal hair and nail growth.
- Cerebrovascular disease: is a narrowing of arteries that supply the brain, and it is manifested as Mini-stroke (transient ischemic attack), Ischemic stroke, Hemorrhagic stroke, Subarachnoid hemorrhage, and Vascular dementia.
- Chronic kidney disease.
- Aneurysms is a ballooning and weakened area of an artery that can result in rupture and cause massive bleeds.
How is atherosclerosis diagnosed?
- Physical examination (BP exam, heart rate, and auscultation of the vessel)
- Biochemical blood analysis (cholesterol level, lipoproteins, glucose)
- Ankle–brachial index: is used to detect atherosclerosis of the legs and feet.
- Stress test
- Doppler ultrasound: measure blood pressure at different points of the arms and legs to detect the level of blockage of vessels.
- Cardiac catheterization and angiography.
- Chest x-ray
- CT angiography
- Echocardiogram (ECHO)
What is the best treatment for atherosclerosis?
The treatment options for atherosclerosis is aimed at reducing cholesterol levels, treatment of complications, and surgical expansion of the narrowed vessels:
- Exercise and weight loss
- A healthy diet with fruits and vegetables
- Aspirin: is usually one of the first medications given to prevent blood clot formation.
- Beta-blockers medications
- Statins: are cholesterol-lowering medications.
- ACE inhibitors.
- Niacin: increase HDL cholesterol and Lowers LDL.
- Fibrates: are cholesterol-lowering medications.
- Bile acid medications: reduce blood cholesterol levels.
- Angioplasty and stenting: This is a surgical procedure that uses a catheter and a balloon to expand the narrowed vessel.
- Endarterectomy: is a procedure that is done to remove the fatty buildup (plaque) and restore the flow of blood.
- Fibrinolytic therapy (Streptokinase, Alteplase, and Urokinase), also known as a clot-dissolving drug, is given to dissolve already formed blood clots.
Definition of terms that are usually confused with each other:
- Atherosclerosis is known as the narrowing and hardening of vessels caused by fatty buildup.
- Arteriosclerosis is a disease that is characterized by causing thickening and loss of elasticity of the arterial wall.
- Arteriolosclerosis: is known as hardening and loss of elasticity of arterioles (small arteries).
- Atherogenic: is the term used to describe the process of atheroma formation.