Atherosclerosis

Atherosclerosis

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Overview

Atherosclerosis is a medical term given to a condition when there is a deposition of cholesterol or plaques inside the blood vessels causing hindrance to blood flow in extreme cases. It is also sometimes used as a synonym with arteriosclerosis, though there is a marked difference between them. 

What is Atherosclerosis?

Arteriosclerosis is a condition in which initially soft & flexible arteries that supply blood to all the parts and organs of the body become thick, hard and stiff. Arteriosclerosis can occur in a variety of ailments, and atherosclerosis is one of them.

What are the symptoms of atherosclerosis?

There may be no signs or symptoms until your arteries are narrowed to an extent to cause a stroke or a heart attack. The signs and symptoms will also depend on the location of the artery that has been affected:

  • Heart: If the arteries of your heart (coronary arteries) are blocked with plaque deposition, then you may experience the symptoms of:
    • Pain & pressure in the chest, jaw, shoulders, and neck (angina)
    • Increase or decrease in the heart rate (Arrhythmia)
    • Breathlessness
  • Brain: If the arteries of your brain are obstructed due to excessive lipid deposition, then you may feel:
    • Headache
    • Problem while speaking or hearing
    • Weakness, numbness or loss of sensation in facial muscles
    • Vision loss with either or both eyes
  • Arms and Legs: If the arteries of your arms or legs are narrowed or constricted, then there might be an occurrence of:
    • Pain in arms or legs while walking
    • Numbness
  • Kidneys: If the blood flow of the kidneys is affected, then you may have:
    • High Blood Pressure
    • Kidney Failure

What are the causes of atherosclerosis?

Atherosclerosis is a gradual process that mainly occurs due to plaque deposition in the arterial wall. The inner wall of these arteries is called the endothelium. The endothelial cells can get damaged due to certain factors such as:

  • High Blood Pressure
  • High Cholesterol
  • Diabetes
  • Addiction to tobacco or alcohol
  • Chronic inflammatory diseases like lupus or arthritis

These chronic ailments can damage the endothelium, and when the endothelial cells become damaged, blood cells start depositing near the damaged area. Gradually, there is a deposition of cholesterol in the inner wall. Slowly, with this constant building up of matter inside the artery, the artery is narrowing. It also becomes thickened and hardened, impacting the blood flow.

Sometimes, the plaque deposits may rupture and sail free in the blood, leading to blood clots. These blood clots can be extremely harmful when they obstruct the blood to an organ or a body part, leading to the deprivation of oxygen and nutrients. These blood clots can travel to multiple sites in the body and can be fatal.

There are no definite causes for atherosclerosis, though certain risk factors may predispose you to this condition.

  • Obesity
  • Smoking
  • Lack of physical activity
  • Unhealthy eating habits
  • Family history of heart disease/atherosclerosis
  • Diabetes
  • Chronic inflammation with high C- reactive protein
  • High blood pressure
  • High Cholesterol

Of all the risk factors, the major one is high cholesterol or imbalance in the cholesterol in your body. Our blood consists of lipoproteins that aid in transporting water-insoluble lipids or fats in the blood. These lipoproteins are divided into five types - High-density Lipoproteins (HDL), Low-density lipoproteins (LDL), Very Low-density lipoproteins (VLDL). The high-density lipoprotein is referred to as good cholesterol as it prevents plaque build-up inside the artery. In contrast, the low and very low lipoproteins are considered bad cholesterol as they promote atherosclerosis.

What are the complications of atherosclerosis?

  • Coronary Artery Disease: Coronary arteries are one of the most commonly affected arteries with atherosclerosis. When the blood clots formation occurs inside a coronary artery causing blockage of blood supply to the heart, it may lead to angina, heart attack or heart failure.
  • Carotid Artery Disease: The plaque formation and subsequent obstruction in the blood flow of the brain's artery can lead to both temporary or permanent damage. When the blood clot blocks a brain artery temporarily, it may lead to transient ischemic attack (TIA) or stroke, as it is commonly called. But these plaque deposits inside the brain arteries can also cause severe brain injury leading to permanent damage.
  • Peripheral Artery Disease: When the artery supplying blood to arms or legs is affected, there might be symptoms like leg pain, especially on walking. The poor blood flow resulting from blockage of the artery can impede wound healing, increase sensitivity to heat & cold, or lead to burn, frostbite or gangrene in severe cases.
  • Aneurysms: As the inner wall of the arteries are damaged due to plaque deposition, it may become weak and may bulge out a little; this condition is known as an aneurysm. There may be the absence of any symptoms in mild cases, or there may be slight pain or feeling of pulsation on the affected area. However, in severe cases, the aneurysm may burst and lead to internal bleeding. Chronic Kidney disease: Like other organs, impaired blood flow to the kidneys can affect its normal functioning and lead to toxic waste matter in the body.

How is atherosclerosis treated?

You had a blockage because you have an underlying chronic condition most probably associated with your faulty lifestyle. Once the doctors know your condition, the blockage will be managed with medication or even surgery if required.

The surgical medical interventions which may be required are as follows:

  • Angiography and stenting: A catheter with a balloon tip will be inserted into your artery with the help of a live x-ray machine. Sometimes along with angiography, stent placement is done to keep the artery from narrowing again.
  • Bypass Surgery: In this procedure, a new pathway is created for blood flow by connecting a new artery below the blockage area. The new artery is taken from the chest or leg.
  • Endarterectomy: The doctors remove the plaque from inside the arteries to restore the blood flow.
  • Fibrinolytic therapy: This technique employs drugs that can dissolve the blood clot to remove the blockage.

Medications: It is worth noting that the surgical procedures are meant to relieve the obstruction but do not guarantee that blockage will not occur again. The doctors may prescribe you certain medications to optimise your cholesterol levels, blood pressure, diabetes, or other related disorders.

Lifestyle Modifications: A sedentary lifestyle coupled with a diet rich in fats is the primary factor for atherosclerosis. If one needs to avoid this condition altogether, adequate lifestyle changes are highly essential. One needs to be physically active and exercise once or twice daily without fail.

Diet: Our eating habits decide the course of our lives in future. So, eating seasonal fruits & vegetables, nuts, whole grains, and keeping the minimum intake of artificial sweeteners, aerated drinks, and junk food will help us avoid atherosclerosis.

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