What is atherosclerosis?
Atherosclerosis is a type of thickening or hardening of the arteries caused by a buildup of plaque in the inner lining of an artery.
Plaque is made up of deposits of fatty substances, cholesterol, cellular waste products, calcium, and fibrin, and can develop in medium or large arteries causing the artery wall to become thickened and stiff.
Atherosclerosis is a slow, progressive disease that may start as early as childhood. However, the disease has the potential to progress rapidly.
What causes atherosclerosis?
It is unknown exactly how atherosclerosis begins or what causes it. However, there is a gradual buildup of plaque or thickening of the inside of the walls of the artery. This causes a decrease in the amount of blood flow, and a decrease in the oxygen supply to the vital body organs and extremities.
What are the risk factors for atherosclerosis?
Certain risk factors are associated with atherosclerosis, including:
- Elevated cholesterol and triglyceride levels
- High blood pressure
- Type 1 diabetes
- Physical inactivity
- High saturated fat diet
What are the symptoms of atherosclerosis?
Signs and symptoms of atherosclerosis may develop gradually, and may be few, as the plaque builds up in the artery. Symptoms may also vary depending on the affected artery. However, when a major artery is blocked, signs and symptoms may be severe, such as those occurring with heart attack, stroke, aneurysm, or blood clot.
The symptoms of atherosclerosis may resemble other heart conditions. Consult your health care provider for a diagnosis.
How is atherosclerosis diagnosed?
In addition to a complete medical history and physical exam, you may have one or more of these tests:
Cardiac catheterization. With this procedure, X-rays are taken after a dye is injected into an artery to locate the narrowing, blockages, and other abnormalities of specific arteries.
Doppler sonography. A special probe is used to direct sound waves into a blood vessel to evaluate blood flow. An audio receiver amplifies the sound of the blood moving though the vessel. Faintness or absence of sound may indicate an obstruction in the blood flow.
Blood pressure comparison. Comparing blood pressure measurements in the ankles and in the arms to determine any constriction in blood flow. Significant differences may indicate a narrowing of vessels which could be caused by atherosclerosis.
MUGA/radionuclide angiography. A nuclear scan to see how the heart wall moves and how much blood is expelled with each heartbeat, while the person is at rest.
Thallium/myocardial perfusion scan. A nuclear scan given while the person is at rest or after exercise that may reveal areas of the heart muscle that are not getting enough blood.
Computerized tomography or CT. A type of X-ray test that can see if there is coronary calcification that may suggest a future heart problem.
How is atherosclerosis treated?
Specific treatment will be determined by your health care provider based on:
- Your age, overall health, and health history
- Extent of the disease
- The location of the blockage
- Your signs and symptoms
- Your tolerance for specific medicines, procedures, or therapies
- Expectations for the course of the disease
- Your opinion or preference
Treatment may include:
Risk factors that may be modified include smoking, high cholesterol levels, high blood glucose levels, lack of exercise, poor dietary habits, and high blood pressure.
Medicines that may be used to treat atherosclerosis include:
Antiplatelet medicines. Medicines used to decrease the ability of platelets in the blood to stick together and cause clots. Aspirin, clopidogrel, ticlopidine, and dipyridamole are examples of antiplatelet medicines.
Anticoagulants. Also called blood thinners, these medicines work differently from antiplatelet medicines to decrease the ability of the blood to clot. An example of an anticoagulant is warfarin.
Cholesterol-lowering medicines. Medicines used to lower lipids (fats) in the blood, particularly low density lipid (LDL) cholesterol. Statins are a group of cholesterol-lowering medicines. They include simvastatin, atorvastatin, and pravastatin. Bile acid sequestrants—colesevelam, cholestyramine and colestipol—and nicotinic acid are two other types of medicine that may be used to reduce cholesterol levels.
Blood pressure medicines. Medicines used to lower blood pressure. There are several different groups of medicines that act in different ways to lower blood pressure.
With this procedure, a balloon is used to create a bigger opening in the vessel to increase blood flow. Although angioplasty is performed in other blood vessels elsewhere in the body, percutaneous coronary intervention (PCI) refers to angioplasty in the coronary arteries to permit more blood flow into the heart.PCI is also called percutaneous coronary intervention. There are several types ofPCI procedures, including:
Balloon angioplasty. A small balloon is inflated inside the blocked artery to open the blocked area.
Atherectomy. The blocked area inside the artery is shaved away by a tiny device on the end of a catheter.
Laser angioplasty. A laser used to vaporize the blockage in the artery.
Coronary artery stent. A tiny coil is expanded inside the blocked artery to open the blocked area and is left in place to keep the artery open.
Coronary artery bypass
Most commonly referred to as bypass surgery, this surgery is often done in people who have angina (chest pain) due to coronary artery disease (where plaque has built up in the arteries). During the surgery, a bypass is created by grafting a piece of a vein above and below the blocked area of a coronary artery, enabling blood to flow around the obstruction. Veins are usually taken from the leg or from the chest wall.
What are the complications of atherosclerosis?
As a result of the plague buildup inside of the arteries, the blood flow within these arteries is reduced. A heart attack may occur if the oxygenated blood supply is reduced to the heart. A stroke may occur if the oxygenated blood supply is cut off to the brain. Severe pain and tissue death may occur if the oxygenated blood supply is reduced to the arms and legs.
Can atherosclerosis be prevented?
Atherosclerosis may be prevented or delayed by reducing risk factors. This includes adopting a healthy lifestyle. A healthy diet, losing weight, being physically active, and not smoking can help reduce your risk of atherosclerosis. A healthy diet includes fruits, vegetables, whole grains, lean meats, skinless chicken, seafood, and fat-free or low-fat dairy products. A healthy diet also limits sodium, refined sugars and grains, and solid fats.
If you are at risk for atherosclerosis because of family history, or high cholesterol, it is important that you take medications as directed by your health care provider.
When should I call my health care provider?
If your symptoms get worse or you have new symptoms, let your health care provider know.
- Atherosclerosis is a type of thickening or hardening of the arteries caused by a buildup of plaque in the inner lining of an artery.
- Risk factors may include high cholesterol and triglyceride levels, high blood pressure, smoking, diabetes, obesity, physical activity, and eating saturated fats.
- Atherosclerosis can cause a heart attack, stroke, aneurysm, or blood clot.
- Medications, treatments, and surgery may be needed to reduce the potential complications of atherosclerosis.
Tips to help you get the most from a visit to your health care provider:
- Before your visit, write down questions you want answered.
- Bring someone with you to help you ask questions and remember what your provider tells you.
- At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you.
- If you have a follow-up appointment, write down the date, time, and purpose for that visit.
- Know how you can contact your provider if you have questions.