Atherosclerosis is a disease in which plaque builds up inside your arteries. Plaque is a sticky substance made up of fat, cholesterol, calcium, and other substances found in the blood. Over time, plaque hardens and narrows your arteries. That limits the flow of oxygen-rich blood to your body and can lead to serious problems, including: - Coronary artery disease. These arteries supply blood to your heart. When they are blocked, you can suffer angina or a heart attack. - Carotid artery disease. These arteries supply blood to your brain. When they are blocked you can suffer a stroke. - Peripheral arterial disease. These arteries are in your arms, legs and pelvis. When they are blocked, you can suffer from numbness, pain and sometimes infections. Atherosclerosis usually doesn't cause symptoms until it severely narrows or totally blocks an artery. Many people don't know they have the disease until they have a medical emergency. A physical examination, imaging and other diagnostic tests can tell if you have it. Treatments include medicines, and medical procedures or surgery. Lifestyle changes can also help. These include following a healthy diet, getting regular exercise, maintaining a healthy weight, quitting smoking, and managing stress.
INTRODUCTION
Atherosclerosis is a disease in which plaque builds up inside certain blood vessels called arteries. Plaque is a sticky substance made up of fat, cholesterol, calcium, and other substances found in the blood. Over time, plaque hardens and narrows your arteries. This limits the flow of oxygen-rich blood to your body and can lead to serious, life threatening problems. This program will help you better understand atherosclerosis, its causes, complications, diagnosis and how it is treated. Healthy lifestyle changes are also discussed.
ATHEROSCLEROSIS
Atherosclerosis is a disease in which plaque builds up inside your arteries. Arteries are blood vessels that carry blood away from the heart to the different organs of the body, the heart itself, the brain and the limbs of the body just to name a few. Healthy arteries have smooth linings, allowing blood to flow smoothly. This is a normal artery. Damage to the lining of the arteries makes them rough. Fatty substances, such as cholesterol, can stick to the rough lining and collect in the arteries. As a result, plaque forms on the inner walls of the arteries. Plaque is made up of fat, cholesterol, calcium, and other substances found in the blood. Over time, plaque hardens and narrows your arteries. When plaque causes artery walls to narrow, it is called atherosclerosis. Atherosclerosis limits the flow of oxygen-rich blood to your organs and other parts of your body. This can lead to serious problems, including heart attack, stroke, or even death. Another way atherosclerosis affects blood flow is by causing blood to clot inside the artery. This is known as a thrombus. A thrombus can limit blood flow to important organs or detach itself from the plaque site, flow upstream in the artery and plug smaller arteries. When a thrombus detaches itself it is called an embolism.
SYMPTOMS
Atherosclerosis usually does not cause symptoms until it severely narrows or totally blocks an artery. Many people don't know they have the disease until they have a medical emergency, such as a heart attack or stroke. Some people may have symptoms of the disease. Symptoms will depend on which arteries are affected. The following section explains the symptoms that may happen when atherosclerosis affects different arteries in the body. The coronary arteries supply oxygen-rich blood to your heart. If plaque narrows or blocks these arteries it causes a disease called coronary heart disease, or CHD. Common symptoms include: • Chest pain or discomfort called angina • Shortness of breath • Abnormal heart beat Plaque also can form in the heart's smallest arteries. This disease is called coronary microvascular disease, or MVD. Symptoms of coronary MVD include angina, shortness of breath, sleep problems, extreme tiredness, and lack of energy. The carotid arteries supply oxygen-rich blood to your brain. When plague narrows or blocks these arteries, it is known as carotid artery disease. It may cause a stroke. Strokes happen when blood flow to the brain stops and brain cells die. Symptoms of a stroke may include: • Confusion • Dizziness, loss of balance or coordination • Inability to move • Loss of consciousness • Numbness of the face, arms, or legs, especially on one side of the body • Problems breathing • Sudden and severe headache • Sudden weakness • Trouble seeing • Trouble speaking or understanding speech Plaque also can build up in the major arteries that supply oxygen-rich blood to the legs, arms, and pelvis. This disease is called peripheral arterial disease. If these major arteries are narrowed or blocked, you may get numbness, pain, and dangerous infections.
CAUSES
Atherosclerosis can be caused by many factors. Atherosclerosis may start when the inner layers of the arteries become damaged. Arteries may become damaged through: • Smoking. • High amounts of certain fats and cholesterol in the blood. • High blood pressure. • High amounts of sugar in the blood . Plaque may begin to build up where the arteries are damaged. Over time, plaque hardens and narrows the arteries. Eventually, an area of plaque can rupture, or break open. When this happens, blood cell fragments called platelets stick to the site of the injury. They may clump together to form blood clots. Clots narrow the arteries even more, limiting the flow of oxygen-rich blood to your body.
RISK FACTORS
Certain traits, conditions, or habits may raise your risk for the disease. These conditions are known as risk factors. The more risk factors you have, the more likely it is that you'll develop atherosclerosis. Having a risk factor for a disease or medical condition does not mean that you will develop it. You can control many risk factors and help prevent or delay atherosclerosis. Risk factors that you can control and manage include: • Unhealthy blood cholesterol levels • High blood pressure • Smoking • Diabetes • Being overweight or obese • Lack of physical activity • Poor diet Some risk factors you cannot control. Risk factors you cannot control include: • Old age • Family history
DIAGNOSIS
Your doctor will diagnose atherosclerosis based on your medical and family histories, a physical exam, and test results. Your doctor also may check to see whether any of your pulses, such as a pulse in the leg or foot, are weak or absent. A weak or absent pulse can be a sign of a blocked artery. Your doctor may recommend one or more blood and imaging tests to diagnose atherosclerosis. Imaging tests may include CT scans, MRIs, ultrasounds, and echocardiograms. Your healthcare provider may also have you do a stress test. During stress testing, you exercise to make your heart work hard and beat fast while heart tests are done. If you can't exercise, you may be given medicine to make your heart work hard and beat fast. As part of some stress tests, pictures are taken of your heart while you exercise and while you rest. These imaging stress tests can show how well blood is flowing in various parts of your heart. They also can show how well your heart pumps blood when it beats. An angiography may also be done. For this test, dye that can be seen on x-rays is injected into the arteries using a thin, flexible tube called a catheter. This test can show whether plaque is blocking your arteries and how severe the blockage is.
TREATMENT OPTIONS
Treatments for atherosclerosis may include lifestyle changes, medicines, and medical procedures or surgery. Lifestyle changes may include: • A healthy diet, including a variety of fruits and vegetables, whole grains, lean meats, and fat-free or low-fat milk and dairy products. A healthy diet is low in sodium, added sugar, solid fats, and refined grains. • Losing weight if you are overweight or obese • Being as physically active as you can. Physical activity can improve your health. Ask your doctor what types and amounts of activity are safe for you. • Quitting smoking. Smoking can damage blood vessels, raising your risk for atherosclerosis. Talk with your doctor about programs and products that can help you quit. To slow the progress of plaque buildup, your doctor may prescribe medicines to help lower your cholesterol level, blood pressure or blood sugar if they are elevated. He or she also may prescribe medicines to prevent blood clots from forming. For successful treatment, take all medicines as your doctor prescribes. If you have severe atherosclerosis, your doctor may recommend a medical procedure or surgery, such as angioplasty. Angioplasty is used to open blocked or narrowed arteries of the heart. Sometimes a small mesh tube called a stent is placed in the artery to keep it open after the procedure. Coronary artery bypass grafting, or CABG, is a type of surgery sometimes used to treat atherosclerosis. In CABG, arteries or veins from other areas in your body are used to bypass, or go around, your narrowed coronary arteries. It can improve blood flow to your heart and possibly prevent a heart attack. Bypass grafting can also be used for leg arteries. For this surgery, a healthy blood vessel or a synthetic graft is used to bypass a narrowed or blocked artery in one of the legs. The healthy blood vessel or synthetic graft redirects blood around the blocked artery, improving blood flow to the leg. Carotid endarterectomy is surgery to remove plaque buildup from the carotid arteries in the neck. This procedure restores blood flow to the brain, which can help prevent a stroke.
SUMMARY
Atherosclerosis is a disease in which plaque builds up inside your arteries. Over time, plaque hardens and narrows your arteries, limiting the flow of oxygen-rich blood. This can lead to serious problems. Atherosclerosis usually doesn't cause symptoms until it severely narrows or totally blocks an artery. Many people don't know they have the disease until they have a medical emergency. When symptoms do happen, they are specific to the arteries affected by atherosclerosis. A physical examination, imaging, and other diagnostic tests can tell if you have the disease. Treatments include medicines, and medical procedures or surgery. Lifestyle changes can also help. These include following a healthy diet, getting regular exercise, maintaining a healthy weight, and quitting smoking
