ATHEROSCLEROSIS:
Atherosclerosis is also called as arteriosclerotic vascular disease.It is a condition where the arteries will become narrowed and hardened due to an excessive buildup Or development of plaque around the wall of artery. Plaque is made up of a cholesterol, fat, calcium, and also other components which is found in the blood. Over time, plaque will hardens and narrows the arteries. The atherosclerosis disease will disrupts the flow of blood throughout the body and causing serious cardiovascular complications. Atherosclerosis can also lead to serious health conditions, including heart attack, stroke, or it may cause even death.
Healthy arteries are very flexible and also elastic, but time passes , the walls health arteries will become harden this condition is commonly called as hardening of the arteries. The word atherosclerosis is derived from the Greek word, which means focal accumulation of lipid and thickening of arterial intima (sclerosis [hardening]). Atherosclerosis capable to affect any type artery present in the body, including arteries present in the heart, arteries in brain, arms, legs, pelvis and even in kidneys. As a result, different diseases may develop atherosclerosis based on which the arteries are affected. Arteriosclerosis is the stiffening hardening of the artery walls. Or Atherosclerosis is the narrowing of the artery because of plaque build-up. All patients with atherosclerosis will have arteriosclerosis, but those individual with arteriosclerosis might not necessarily have atherosclerosis. However, these two terms will have same meaning and frequently used.
ATHEROSCLEROSIS OF AORTA:
Atherosclerosis of the aorta is nothing but a development of the plaque in the aorta. It is a common condition that happens silently over many years.
ATHEROSCLEROSIS CAUSES:
Atherosclerosis will begin in the late teens, but it usually takes decades to show signs and symptoms. Some people may experience rapidly increased atherosclerosis during their thirties and also others may experience atherosclerosis during their ages of fifties or sixties. Certain factors that can damage the inner area of the artery (endothelium) and can trigger the atherosclerosis include:
• High blood pressure
• High cholesterol levels
• Smoking
• High blood sugar levels in blood Areas of the artery that are already damaged are more likely to have development of plaque which can eventually break open. When the plaque breaks open, blood cell fragments called thrombocytes (or platelets) accumulate at the affected area of the artery. These fragments can then stick together that leading to the formation of blood clots.
• High triglycerides: intake of more amount of fat in food and in the body will leads
to form a triglycerides. Blood triglyceride levels are above 400 mg/dL have been
linked to coronary artery disease in some people. Triglycerides, however, are not
nearly as harmful as LDL(low density Lipoprotein)cholesterol.
• Diabetes: Patients who with poorly controlled diabetes and who has frequently
have excess blood glucose levels in blood , are much more likely to develop
atherosclerosis.
• Genetics: People with a parent or sibling who has or had atherosclerosis and
cardiovascular disease have a much higher risk of developing atherosclerosis when compared to others.
• Obesity: more body weight will increases the strain on the heart which in turn
increases the risk of developing atherosclerosis due to formation of plague,even if
no other risk factors are present.
ATHEROSCLEROSIS SYMPTOMS:
Atherosclerosis usually does not produce any signs and symptoms until blood circulation becomes completely restricted or blocked, leading to cause cardiovascular disease (CVD).
The type of cardiovascular disease and its associated symptoms mainly depends on, where the blockage of arteries occurs. The first signs of atherosclerosis can begin to develop during adolescence, with streaks of white blood cells appearing on the walls of artery. The symptoms of the disease mainly depend on, which arteries are affected.
1. Carotid Arteries: These arteries provide blood circulation to the brain. When the blood supply is limited, patients can suffer from strokes and also may experience:
• Weakness
• Breathing difficulties
• Severe Headache
• Facial numbness
• Paralysis
2. Coronary Arteries: These arteries will provide blood circulation to the heart, when the blood supply to the heart is limited, it can cause angina pectoris and heart attack. Symptoms may include:
• Nausea and Vomiting
• Extreme anxiety
• Chest pain
• Coughing
• Feeling faint
3. Heart attack: If one of the plaques present in coronary arteries gets ruptures that leads to formation of blood clots. If the blood clot blocks the supply Or circulation of blood to the heart, it will cause to have a heart attack. Symptoms of a heart attack include:
• Chest pain – pain is usually located in the centre of chest and giving the
sensation of pressure,squeezing or tightness.
• Pain in other body parts is also observed that can feel as though it is
travelling from chest to arms. Usually the left arm, although both arms can be
affected, jaw, neck, back and abdomen.
• An overwhelming sense the of anxiety.
• (Similar to a panic attack), difficult to breath or Shortness of breath, feeling
sick or tired , light-headedness, coughing, nausea and vomiting, wheezing.
4. Aneurysm: If atherosclerosis weakens the walls of blood vessels, it can lead to the formation of an aneurysm means bulge in a blood vessel.
If the aneurysm grows too much, then the condition is more severe,there is a
danger. Blood vessels will rupture, which can cause potentially fatal internal
bleeding and also cause organ damage. An aortic aneurysm, which develops inside the aorta (a large blood vessel that runs down the abdomen and transports blood away from heart).If an aortic aneurysm ruptures, the person will experience a more severe and sudden pain in the middle or in side abdomen. The pain can spread down into the scrotum (the sac containing the testicles) in men.
Ruptured brain symptoms of aneurysm usually begin with a sudden and severe
headache, which has been described as like being hit on the head.
5. Renal arteries: These supply blood to the kidneys; if the blood supply becomes limited, there is serious risk of a developing chronic renal failure, and the patient
may experience:
• Loss of appetite.
• Swelling of the hands and feet.
• Difficulty in concentrating.
6. Peripheral arterial disease: The arteries to the limbs, usually the legs, are blocked. The most common symptoms includes leg pain, either in one or both legs, usually in the calves, thighs or hips. The pain may be described as one of the heaviness, dullness or cramp in the leg muscles. Other symptoms may include:
• Hair loss on legs or feet
• Male impotence (erectile Dysfunction)
• Numbness in the legs
• Change in colour of the skin particularly on legs
• The toenails get thicker
• Weakness in the legs
DIAGNOSIS OF ATHEROSCLEROSIS:
Physicians can be able to make a diagnosis of atherosclerosis by conducting a physical exam by means of a stethoscope and gentle probing of the arteries with the hand (palpation) to find signs of narrowed, hardened arteries or enlarged arteries. Including: A absent or weak pulse below the narrowed area of artery. Decreased blood pressure in limb which is affected Whooshing sounds (bruits) over the arteries which is heard by using a stethoscope. Signs of a pulsating bulge called aneurysm in the abdomen or behind knee. Evidence of history of poor wound healing in the area where blood flow is completely restricted. Depending on the results of the physical exam, more diagnostic tests are carried out including:
• Blood tests: Blood tests can helps to detect increased levels of cholesterol and
blood sugar levels in blood that may increase the risk of atherosclerosis.
• Doppler ultrasound: It is a special ultrasound device (Doppler ultrasound) which is used to measure the blood pressure at various points along leg or arm. These measurements can help doctor to measure the degree of any artery blockages, as well as the speed of blood flow in the arteries.
• Ankle-brachial index: This test can reveal the atherosclerosis in the arteries in legs and feet. Doctor may compare the blood pressure in ankle with the blood pressure in arm. This is known as the ankle- brachial index. An abnormal difference may indicate peripheral vascular disease, which is usually caused by atherosclerosis. More definite tests are:
• (ECG)Electrocardiography: An electrocardiogram which measures the electrical activity of the heart. This test can measure the proper functioning of the heart and can often detect the presence of heart disease.
• Stress test: stress test, also known as exercise stress test. It is used to gather
information about how well heart works during any physical activity. Because
physical exercise makes the heart pump faster and harder than it does during most daily activities, an exercise stress test can reveal problems within the heart that might not be noticeable otherwise. This stress test is usually includes like riding a stationary bike or walking on a treadmill while heart rhythm, blood pressure and also rate of breathing are monitored.
• Cardiac catheterization and angiogram: this test can show if coronary arteries are narrowed or blocked. A liquid dye is injected into the arteries of heart by using a long, thin tube called as catheter,that is fed through an artery, usually in leg, to the arteries in heart. As the dye fills in arteries ,the arteries gets coloured then the
arteries become visible on X- ray, revealing areas of blockage.
• Ultrasound: An ultrasound scanner uses sound waves to build up a picture of the inside of body. This will helps to measure blood pressure at different points in body. Any variation in blood pressure could point to the site of a blockage in arteries. Ultrasound tests can also be used to study about the larger arteries.
• Computerised tomography scan: A computerised tomography (CT) scan takes a series of X-ray images and uses a computer to assemble them into a more detailed three-dimensional image. It can also detect the hardening or narrowing in the larger arteries.
ATHEROSCLEROSIS TREATMENT:
1. Lifestyle changes: The lifestyle changes will mainly focus on management of body weight, physical activity and intake of healthy diet. Doctors may recommend eating foods high in soluble fibre and limiting intake of saturated fats, sodium and alcohol.
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2. Medication: The medications may be prescribed to treat the atherosclerosis,
• To prevent the deposition or build up of plaque or formation of blood clots by using antiplatelet agents or Thrombolytic agents(helps to breakdown the blood clots).
• To lower cholesterol such as statins.
• To reduce the blood pressure, the medications like Angiotensin-converting enzyme (ACE) inhibitors, Diuretics (Water pills) are commonly employed.
3. Surgery: in Severe cases of atherosclerosis can be treated by surgical procedures, such as angioplasty or coronary artery bypass grafting (CABG).
• Angioplasty involves the expanding the artery and opening the blockage, so that the blood can flow throughout and maintain the proper functioning again. CABG is
another form of surgery that can improve the flow of blood to the heart by using
arteries from other parts of the body to bypass a narrowed coronary artery.
4. Angioplasty and stent placement: Angioplasty is nothing but a procedure in which a small device is inserted into narrowed blood vessels that supply required amount of blood to the heart. This device widens the arteries and increases flow of blood. Balloon angioplasty is also called as PTCA(coronary percutaneous transluminal angioplasty).It uses a thin small tube called as catheter and having a tiny balloon at its tip of catheter. The tube which is inserted into the blood stream by using a large vessel in the arm or leg. By watching the progress of the tiny tube on an X-ray, the cardiologist will monitor or guide the tube into the heart, where it is inserted into a narrowed coronary artery. The tiny balloon is then inflated to widen the narrowed area. During most of these procedures, cardiologists also insert a metal wire frame that serves as a scaffolding to help keep the artery open. This device is called a stent. The stent will prevent the closing of arteries when it placed . There are mainly two types of stents:
• Bare metal stents
• Drug coated stents
5. Endarterectomy: In some of the cases, the deposition of the fatty substance must be surgically removed from the walls of a narrowed artery. When the procedure is done on arteries in the neck (the carotid arteries), it is called as carotid endarterectomy.
6. Bypass surgery: In this bypass type of surgery,a graft bypass may be created by using a vessel from another part of body or a tube which is made up of synthetic fabric. This will allows complete blood flow around the narrowed or blocked artery