Atherosclerosis - Causes, Symptoms, Diagnosis, Prevention and Treatment

Atherosclerosis

Authored by Dr.Mohan Rao on 24 Dec 2014 - 16:11

Arteries are the blood vessels which carry the blood from the heart to all the parts of the body. Normal and healthy arteries are elastic and flexible, but over time, the walls of the arteries become thick and stiff making the arteries hard which causes a restriction in the blood flow to the various organs and tissues. This condition of the arteries is called arteriosclerosis.

A specific type of arteriosclerosis is atherosclerosis. In atherosclerosis plaques are formed inside the blood vessels. Plaques are a result of building up of cholesterol and fats on the artery walls which keep on increasing in size over time resulting in restriction of blood flow.

The plaques can eventually burst into smaller parts and cause blood clots. Atherosclerosis is a heart problem but can affect arteries in any part of the body.

It is just an ageing process. The internal wall of arteries is known as intima. It is a thin single endothelial layer and is easily injured by blood flow. These are covered by clot (by platelets and clotting factors) which acts as a seed for atherosclerosis or thickening.

The exact cause is not known, but atherosclerosis starts when the inner layer of the blood vessel is damages or injured. This damage can be caused by the following:

  • High blood pressure
  • High cholesterol in diet
  • High triglycerides levels in the blood
  • Smoking
  • Diabetes
  • Inflammation from some diseases like arthritis, lupus or infections.

No symptoms are usually observed in mild atherosclerosis. The symptoms appear when the artery becomes so narrow that it completely blocks the blood supply to the organs and tissues. The complete blockage of the coronary artery can trigger a heart attack.

The symptoms of moderate to severe atherosclerosis vary according to the artery affected. These include:

  • When atherosclerosis is present in the coronary (heart) arteries, symptoms such as chest pain or angina are seen.
  • When atherosclerosis is present in the arteries of the brain, then symptoms include sudden numbness in the arms or legs, difficulty in speaking. These are the symptoms of transient ischemic attack which if left untreated can lead to stroke.
  • If atherosclerosis is present in the arteries of the arms and legs then symptoms of peripheral artery disease such as leg pain while walking are seen.
  • If atherosclerosis is present in the renal arteries then the person may develop hypertension or even kidney failure.

First a physical examination is done by the physician to check for the signs of narrowed and hardened arteries which include:

  • Decreased blood pressure in an affected limb
  • A weak or absent pulse below the narrowed area of your artery
  • Signs of a pulsating bulge (aneurysm) in your abdomen or behind your knee
  • Whooshing sounds (bruits) over your arteries, heard using a stethoscope
  • Evidence of poor wound healing in the area where your blood flow is restricted

When atherosclerosis is suspected upon carrying out physical examination, further confirmation is done by carrying out one or more diagnostic tests from among the following:

  • Blood tests: Blood tests are done to check the levels of blood sugar and cholesterol on the blood.
  • Doppler ultrasound: This is a special ultrasound test carried out on various points of the arms and legs to measure the blood pressure at those points. This helps the doctor to study the pattern of blood flow in the arteries.
  • Ankle-brachial index test: This test is done to detect the presence of atherosclerosis in legs and feet.
  • Electrocardiogram (ECG): It is done to detect any abnormalities in the pattern of heart beat caused due to improper blood supply to the heart.
  • Exercise stress test: This test is done to see the working of heart during physical activity.
  • Cardiac catheterization and angiogram: This test helps to view the blockage or narrowing of the arteries of the heart.
  • Other tests: Other tests such as ultrasound, computerized tomography (CT) scan and magnetic resonance angiography (MRA) can be done to study the hardening and narrowing of the arteries.

The hardening of arteries occurs over time as age progresses, but the following factors are also responsible for increasing the risk of atherosclerosis:

  • High blood pressure
  • High cholesterol
  • Obesity
  • Diabetes
  • A family history of early heart disease
  • Smoking and other tobacco use
  • Lack of exercise

Atherosclerosis can be treated by doing some lifestyle modifications such as eating healthy diet and exercising regularly. But in moderate to severe cases medication or surgical treatment is required.

The medications which can be used for the treatment of atherosclerosis include:

  • Cholesterol lowering medications: Statins and fibrates are two type of drugs used to lower the low density lipoprotein (LDL) in the blood which helps to reverse the building up of the cholesterol on the inner walls of the arteries.
  • Anti-platelet medications: Anti-platelet drugs such as aspirin can be used to reduce the clot formation in the arteries and prevent blockage.
  • Beta blockers: These drugs are commonly used in coronary heart disease. They are used to reduce the demand of the heart by reducing the heart rate and blood pressure. They are also useful in reducing the risk of heart attacks and heart rhythm abnormalities.
  • Angiotensin-converting enzyme (ACE) inhibitors: These drugs slow the progression of atherosclerosis by decreasing the blood pressure. They also can help reduce the risk of heart attacks.
  • Calcium channel blockers:These drugs are used to reduce the work load on the heart by reducing the blood pressure.

In severe cases where the drugs cannot treat the atherosclerosis, surgical intervention may be required. The following surgical procedures are carried out to treat atherosclerosis:

  • Angioplasty and stent placement
  • Endarterectomy
  • Thromboltytic therapy
  • Bypass surgery

The following lifestyle changes are recommended to prevent atherosclerosis:

  • Quit smoking
  • Eat healthy food
  • Exercise regularly
  • Maintain a healthy weight
*Disclaimer This is not medical advice. The content is for educational purposes only. Please contact your doctor for any health care issues.