ATHEROSCLEROSIS: CAUSES, SYMPTOMS AND RISK FACTORS

What is arteriosclerosis?

Before knowing atherosclerosis, we will first discuss the arteries and arteriosclerosis.

Arteries are the blood vessels that deliver oxygen-rich blood from our heart to the rest of our bodies. Each artery has three layers:

1. The intima or the inner layer
2. The media or the middle layer
3. The adventitia or the outermost layer

Healthy arteries are elastic and flexible, but with time, the walls in the arteries may become thick and stiff, causing narrowing and hardening of arteries. It causes a restriction in the flow of blood to your tissues and organs. This condition is called arteriosclerosis.

Arteriosclerosis is a chronic disease. The intima is most affected by arteriosclerosis.

How is atherosclerosis different from arteriosclerosis?

Atherosclerosis is a type of arteriosclerosis. It happens when there is a build-up of sticky substance (plaque) mostly made up of calcium, cholesterol, and fat. More is the plaque build-up; more is the narrowing of the artery and restriction in blood flow. Contrary to the belief that atherosclerosis is a heart problem, it can occur in arteries anywhere in the body.

Why is atherosclerosis a serious health issue?

The development of plaque may begin in childhood and may get worse over time. The hardening and narrowing of the arteries may cause several health problems. A narrowed or blocked artery can not deliver enough oxygen-rich blood and nutrients to the tissue or the organ. Severe blockages may cause the death of the tissues or infections in the affected parts of the body.

Sometimes a piece of plaque can burst, leading to a clot. This clot can move with the blood circulation and get stuck anywhere in the body.

Atherosclerosis can cause serious health problems including but not limited to:

• Carotid artery disease
• Blood clots.
• Coronary artery disease.
• Chronic kidney disease.
• Peripheral artery disease
• Heart attack.
• Stroke or even death in extreme cases

Am I at a risk of developing atherosclerosis?

Atherosclerosis can happen in anyone and at any age. The condition may begin with damage to the artery’s inner lining. The deposition of plaque occurs where the damage has occurred. Certain risk factors can stimulate arterial damage and plaque deposition.

These risk factors include:

• Family history of heart diseases
• Diabetes mellitus.
• High cholesterol.
• High blood pressure
• Smoking
• Sedentary lifestyle
• Male
• Obesity
• Older age
• Unhealthy dietary habits (diet high in cholesterol, sugar, salt, saturated and trans fats)
• Diseases such as lupus, arthritis, inflammatory bowel disease, and psoriasis

What are the most common signs and symptoms of atherosclerosis?

Mild atherosclerosis often does not cause any symptoms. The symptoms only appear after an artery becomes narrow enough or gets entirely blocked. Many people are not aware of the condition until a medical emergency such as a heart attack or stroke happens.

Symptoms of atherosclerosis depend on the arteries that are affected:

1. Atherosclerosis in heart arteries may cause chest pain or pressure (angina).
2. Atherosclerosis in the arteries leading to your brain may cause:

• Sudden numbness or weakness in the arms or legs
• Difficulty speaking
• Temporary loss of vision in one eye,
• Drooping muscles in your face

3. Atherosclerosis in the arteries in the arms and legs may cause pain and decreased blood pressure in the affected limb.
4. Atherosclerosis in the arteries leading to your kidneys may cause high blood pressure or kidney failure.

What tests are done to diagnose atherosclerosis?

The diagnosis of atherosclerosis starts with the doctor asking your family medical history and personal medical history. The doctor may lookout for an abnormal sound, absent pulse, or weak pulse during examination with a stethoscope.

The doctor may suggest further tests to confirm the diagnosis:

• Blood tests- Blood sugar, Blood cholesterol, fat, and protein levels in the blood
• Electrocardiogram or ECG – to determine heart rhythm
• Exercise stress test – If signs and symptoms occur most often during physical activities
• Angiography – to locate and measure blockages. The doctor inserts a catheter into an artery in the arm or groin. A contrast dye is injected through the catheter into the arteries. The blockages, if any, show up on the X-rays.
• Ankle-brachial index- to measure blood flow in the arms or legs.
• Chest X-ray
• CT scan to see hardening and narrowing of large arteries.
• Echocardiogram (echo) to evaluate heart valves and chambers and measures pumping action.

What are the different ways of treating atherosclerosis?

The goals for any treatment modality are :

Preventive care

• Prevent complications related to atherosclerosis
• Lower the risk of blood clots.
• Prevent other heart or vascular conditions

Symptomatic relief

• Stop plaque build-up.
• Widen or bypass the blocked arteries.

Depending on the severity, treatment of atherosclerosis may involve:

• Lifestyle changes
• Medications
• Surgical procedures.

A doctor may prescribe the following lifestyle changes

• Quit smoking
• Eat healthy foods
• Exercise regularly
• Maintain a healthy weight
• Manage blood pressure
• Control cholesterol and blood sugar levels
• Regular health check-ups

A doctor may prescribe medicine to:

• Control blood pressure
• Lower cholesterol
• Manage blood glucose levels
• Prevent blood clots

Advanced atherosclerosis may need aggressive treatment options such as:

• Coronary angioplasty: Through a catheter inserted into a groin artery, a doctor places a stent (small tube) to open narrow or blocked coronary (heart) arteries.
• Coronary artery bypass surgery: Placement of arteries or veins from other areas in the body to bypass a narrowed artery.
• Carotid endarterectomy to remove plaque from the neck arteries to prevent a stroke.