Atherosclerosis is hardening of a blood vessel from a build up of plaque. Plaque is made of fatty deposits, cholesterol, and calcium. It builds on the inside lining of arteries. This causes the artery to narrow and harden. It affects large and medium-sized arteries.
As plaque builds up it can slow and even stop blood flow. This means the tissue supplied by the affected artery is cut off from its blood supply. This often leads to pain or decreased function. This condition can cause a number of serious health problems. Depending on the location of the blockage, it can cause:
In addition, a hardened artery is more likely to be damaged. Repeated damage to the inner wall of an artery causes blood clots often form. The clots are called thrombi. They can lead to a further decrease in blood flow. In some cases, a thrombus may become so large that it completely closes off the artery. It could also break into clumps, called emboli. These clumps travel through the bloodstream and lodge in smaller arteries, blocking them off. In these cases, the tissue supplied by the artery receives no oxygen. It quickly dies. When this occurs in the heart, it is called a heart attack . In the brain, it is called a stroke .
Long-term atherosclerosis can also cause arteries to weaken. In response to pressure, they may bulge. This bulge is called an aneurysm. If untreated, they can rupture and bleed.
Atherosclerosis is caused by plaque. Plaque is created by high levels of cholesterol and fat in the blood. Scar tissue and calcium from vessel injury can also add to the plaque build up.
The process leading to this may begin in childhood. It takes decades before it causes serious health problems.
There are two types of factors that increase your chance of atherosclerosis:
There are none in early atherosclerosis. As the arteries become harder and narrower, symptoms may begin to appear. If a clot blocks a blood vessel or a large embolus breaks free, symptoms can occur suddenly.
Symptoms depend on which arteries are affected. For example:
Most people are diagnosed after they develop symptoms. However, people can be screened and treated for risk factors.
If you have symptoms, your doctor will ask you questions. These will help to determine what arteries might be affected. The doctor will also need to know your full medical history. A physical exam will be done. Tests will depend on which arteries may be involved. Test will be decided based on your symptoms, physical exam, and/or risk factors. Many of these tests detect problems with the tissue that is not getting enough blood. Two common tests that directly evaluate the atherosclerotic arteries are:
An important part of treatment is reducing risk factors. To do so, see the steps in the prevention section below. Beyond that, treatment depends on the area of the body most affected.
Treatment may include:
These procedures involve a thin tube, called a catheter. It is inserted into an artery. They are most often done for arteries in the heart. They may be used to treat atherosclerosis elsewhere in the body as well. These procedures include:
Surgical options include:
There are a number of ways to prevent, as well as reverse, atherosclerosis. They include:
American Heart Association
National Heart, Lung, and Blood Institute
Canadian Cardiovascular Society
Heart and Stroke Foundation of Canada
American College of Radiology website. Available at: http://www.acr.org/ . Accessed July 7, 2009.
Beers MH, Berkow R. The Merck Manual of Diagnosis and Therapy. Whitehouse Station, NJ: Merck Research Laboratories; 1999.
Heart and stroke facts, 2003. American Heart Association website. Available at: http://www.americanheart.org/presenter.jhtml?identifier=3000333 . Accessed July 7, 2009.
Last reviewed September 2009 by David N. Smith, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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