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:
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
. In the brain, it is called a
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:
Risk factors you cannot control:
Father or brother who developed complications of atherosclerosis before age 55 or mother or sister who developed complications of atherosclerosis before age 65
Age: 45 and older for men; 55 and older for women
Sex: men have a greater risk of heart attack than women
Risk factors you can control:
—especially LDL ("bad") cholesterol and low HDL (“good”) cholesterol
—a combination of three out of the following five findings:
Low HDL-cholesterol—also called good cholesterol
Elevated blood sugar
Elevated blood pressure
Increased waist circumference (greater than 40 inches in men and 35 inches in women)
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:
Coronary (heart) arteries—may cause symptoms of heart disease, such as chest pain
Arteries in the brain—may cause symptoms of a stroke such as weakness or dizziness
Arteries in the lower extremities—may cause pain in the legs or feet and trouble walking
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:
—a tube-like instrument is inserted into an artery. Dye is injected into the vessel to help determine the degree of blood flow. When done in the heart, this test is called
—a test that uses sound waves to examine the inside of the body. In this case, the test examines the size and shape of arteries.
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:
Drugs to interfere with the formation of blood clots, such as
Drugs that improve the flow of blood through narrowed arteries, such as
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:
—a balloon-tipped catheter is used to press plaque against the walls of the arteries. This increases the amount of space for the blood to flow.
Stenting—usually done after angioplasty. A wire mesh tube is placed in a damaged artery. It will support the arterial walls and keep them open.
—instruments are inserted via a catheter. They are used to cut away and remove plaque so that blood can flow more easily. This procedure is not done often these days.
Surgical options include:
—removal of the lining of an artery obstructed with large plaques. This is often done in carotid arteries of the neck. These arteries bring blood to the brain.
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