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Atherosclerosis: Cardiovascular Disease

"Narrowing Of Arteries"

Arteries are blood vessels that circulate blood, oxygen and nutrients, from the heart to the rest of the body. Atherosclerosis is an arterial disease in which a build up of plaque occurs in the lining (intima) of the wall of an artery causing a "narrowing" effect and a consequent reduction in the flow of blood through the vessel. The consequences of an inadequate blood supply for any organ or tissue are poor function, tissue damage or death. Except in the case of patients with genetically inherited raised cholesterol (familial hypercholesterolemia) where this type of arterial disorder may occur at a relatively early age, atherosclerotic disease generally develops over many years.

What Are The Symptoms Of Atherosclerosis?

Cholesterol-induced atherosclerotic disease usually spreads to all major arterial vessels, but certain arteries can lead to specific health consequences when narrowed.

Effect Of Atherosclerosis In The Brain

Narrowed arteries in the brain can lead to a blood clot (thrombus), which might severely restrict or cut off the supply of oxygen to an area of brain tissue. The health consequences of this will depend on the area and amount of brain tissue involved. The artery may even rupture causing a leakage of blood (hemorrhage). Both these events (called strokes) may lead to significant brain damage.

Effect Of Atherosclerosis In The Heart

In the heart, it is commonly experienced in the form of angina (crushing pain or a constriction in the centre of the chest behind the breast bone or on the left side of the front of the chest, caused by the heart receiving too little oxygen), or coronary thrombosis (heart attack due to a stoppage of the heart muscles triggered by lack of oxygen) due to damage done to the heart muscle from vessel occlusion (narrowing of the arteries).

Effect Of Atherosclerosis In The Kidneys

Atherosclerotic blood vessels in the kidneys can cause hypertension (elevated blood pressure) or even renal failure.

Effect Of Atherosclerosis In The Limbs

In the lower legs, narrowed arteries can lead to extreme pain or even death of tissue due to lack of oxygen. In extreme cases, this can lead to amputation of the leg.

Risk Factors For Atherosclerosis

In the West, most men aged 40 years or over suffer from some degree of atherosclerosis, although it can affect people in their 20s, especially those suffering from genetically inherited raised cholesterol (familial hypercholesterolemia). The main risk factors for atherosclerotic disease include:

- Family history of atherosclerosis
- Hypertension (high blood pressure)
- Being male
- Smoking
- High levels of serum cholesterol
- Diabetes (Type 1 and Type 2)
- Obesity

Diagnosis Of Atherosclerotic Disease

Doctors typically diagnose atherosclerosis initially on the basis of a patient's medical history and circumstances. In addition to blood tests to measure cholesterol and other lipids, certain non-invasive imaging tests such as Doppler ultrasound or invasive tests such as angiography may be performed in hospital. If a patient has symptoms of atherosclerosis in the brain a hospital-based specialist may recommend further exploration of the condition using brain scans (CT or MRI scans).

Is There A Cure For Atherosclerosis?

No. At present there is no drug available which cures atherosclerosis. And there are no medications capable of restoring elasticity to hardened arteries.

How Is Atherosclerosis Treated?

Treatment for this disease varies according to the condition of the artery and it's effect on health. Drug therapy and surgery are the main treatment options, and both are likely to be combined with a specific diet and exercise program.

Treatment To Lower Cholesterol And/Or Reduce Blood Clots

Some patients are treated with cholesterol-lowering meds (eg. statins) that retard the progression of the disease and reduce the risk of plaque rupture. Anti-blood clotting drugs (eg. aspirin) may also prove beneficial for these patients.

Drugs To Strengthen Heart Function

Atherosclerosis in the arteries supplying blood to the heart muscle (coronary arteries) may be treated by drug therapy or surgery. Drugs can be given which reduce the amount of work that the heart performs, which may also be beneficial.

Surgery To Improve Arterial Blood Flow

Atherosclerotic arteries leading to the heart, or in the neck, or to the kidneys or the limbs may also be treated by surgical techniques involving the introduction of devices into the diseased arteries. The three basic methods include:

- Balloon dilation or PTCA (percutaneous transluminal coronary angioplasty), in which a balloon is passed through the coronary arteries to the constricted parts and then inflated to enlarge the blood vessel in order to improve blood-flow. Even better results can be achieved by utilizing a metal stent.

- Artery cleaning, or endarterectomy. The plaque deposit on the arterial wall is scraped away during surgery, thus enlarging the diameter of the artery and improving blood-flow. This procedure is typically performed only on the carotid arteries in the neck.

- Arterial bypass. If an artery is too diseased to be treated, it can be bypassed by inserting a new blood vessel or vein graft around the constricted artery from the aorta.



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