Atherosclerosis
Narrowing Of The Arteries

blocked arteries Pictures of Blocked Arteries

Plaque Buildup
Left: Healthy artery
Middle: Atherosclerosis
Right: Severe atherosclerosis

Atherosclerosis

Contents

What Is Atherosclerosis?
What Happens If An Artery Becomes Blocked?
What Are The Causes?
What Are The Symptoms?
How Is It Diagnosed?
How Is It Treated?
Can It Be Cured?
How Can I Prevent It?


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Heart Disease in Women

What Is Atherosclerosis?

Atherosclerosis is a common but dangerous disorder which results in the buildup of fatty deposits (cholesterol/atheroma and fibrosis/sclerosis) in the walls of the arteries, causing them to narrow. The arteries are the main vessels in the body which supply vital blood supplies to all our organs. Atherosclerosis can develop in any of the arteries of the body and is the leading cause of poor leg circulation, heart attacks and stroke in women. These build ups can start as early as your 20s, and over time can cause symptoms to occur throughout the body. As we age, symptoms tend to develop not only because the arteries become more clogged, but also because the artery walls naturally become thicker and stiffer as part of the aging process (it is the main cause of high blood pressure in older people).

Atherosclerosis causes the inner walls of arteries to become inflamed and irregular. This causes fat and other debris floating by in the blood to start sticking to the wall forming yellow deposits known as atheromatous plaque. These deposits build up, gradually restricting blood flow and ultimately shutting it off completely. Sometimes the blockage may be sudden if a blood clot, which is traveling down the artery, lodges on the accumulation of plaque.

What Happens If An Artery Becomes Blocked?

If a coronary artery (an artery which supplies blood to the heart) becomes temporarily blocked it will starve a portion of the heart muscle of oxygen and nutrients (which are transported by blood around the body). This causes a condition known as myocardial ischemia which means reduced blood supply. If the artery remains blocked for any prolonged period of time it can result in a heart attack and death. The longer any part if the heart muscle is starved of oxygen, the more likely the tissue is to die (necrosis). So although a patient may receive emergency treatment and their life is saved, necrosis of any heart tissue can cause permanent disability. If a clot moves into an artery in the lungs, it can cause a pulmonary embolism which may result in sudden death. If blood supply to the legs or arms is stopped it can cause movement problems and eventually gangrene.

What Are The Causes?

Previously, atherosclerosis was considered a cholesterol storage disease. Now however it is regarded as a complex process which involves interaction between the artery walls and blood components with inflammation playing a major role. Although atherosclerosis is not yet fully understood the following are considered risk factors:

Age
The risk increases as we become older. Do be sure to check out books on heart disease if you are worried about your risk factors.


Genetics

Those with a close family history of coronary heart disease (CHD) are more at risk, as well as those with an inherited lipid disorder (hyperlipidaemias). Also, certain races are more prone to the disease, such as Asians.

Lifestyle Factors

Smoking, obesity and a diet high in fat are known risk factors. Lack of exercise can worsen the effects which is why cardiac patients are often recommended a heart rehab exercise program.

Diabetes

Diabetes can be associated with high cholesterol levels regardless of the type of diet eaten.

High Blood Pressure
Prolonged hypertension and high blood cholesterol levels can cause narrowing of the arteries, even in younger people.

Inflammation
Scientists now know that inflammation plays a major role in the process of atherosclerosis. Just as inflammation of the bone and joints over time is a cause of arthritis, inflammation of the arteries can cause stroke or CHD. Researchers do not know what causes the inflammation but suspect it may be an (as yet) unidentified bacteria or viral infection. Eventually CHD treatment may include an antimicrobial or antiviral agent, just as stomach ulcers are now treated with antibiotics since they were linked to a specific bacterial cause. See also: Risk factors for heart disease.

What Are The Symptoms?

In the early stages, atherosclerosis usually does not produce any symptoms. As the condition progresses, symptoms usually occur as a result of restricted blood flow to the organ affected. A partial blockage in the coronary arteries which supply the heart can result in chest pain, shortness of breath and angina attacks. Blockages in the arteries which supply blood to the brain can cause episodes of dizziness and transient ischemic attacks (symptoms of stroke which last for less than 24 hours, also known as mini stroke). A cramping pain in the leg while walking (intermittent claudication) is usually the first sign of a blocked artery in the leg. See also symptoms of coronary heart disease for more details on blockages in the arteries which supply the heart.

How Is It Diagnosed?

Patients who have no symptoms may choose to have a cholesterol screening test from the age of 35 in men and from 45 in women. If a patient is experiencing symptoms, a doctor will carry out a physical examination and listen to the heart and lungs with a stethoscope. Atherosclerosis tends to make whooshing or blowing sounds over an artery where it has developed. The doctor may then order more diagnostic tests such as:

Exercise Stress Test or Chemical Stress Test
Electrocardiogram (ECG/EKG)
Echocardiogram (Echo)
Nuclear Heart Scan

Holter Monitor or Event Monitor

More invasive heart disease testing procedures like heart catheterization or coronary angiography are only recommended in patients who display symptoms and have a positive result from an ECG or stress test. An angiogram allows the doctor to visually see inside the arteries by inserting a long tube called a catheter inside the veins.

How Is It Treated?

The optimal treatment for atherosclerosis is to prevent it from developing in the first place. That means integrating coronary heart disease prevention techniques into your lifestyle, such eating eating a balanced diet and maintaining a healthy body weight. If you are diagnosed with high cholesterol levels, but are otherwise in good health, you may be recommended a cholesterol lowering diet or given some cholesterol drugs to lower lipid levels. Those who have had a heart attack may benefit from taking the same medications, even if their cholesterol levels are normal. People with high blood pressure should work on managing their levels with diet, exercise and medications if necessary. Those with diabetes can reduce their risk factors of developing atherosclerosis by careful control of their blood glucose levels. Those already diagnosed with atherosclerosis may be prescribed a daily dose of aspirin therapy or another drug called clopidogrel (Plavix) to help prevent blood clots forming. These drugs are called antiplatelets. Alternatively surgical treatments such as coronary angioplasty may be recommended to people considered at high risk of complications such as a complete blockage and heart attack. They may benefit from a stent being put in place to keep the artery permanently widened, or if the obstruction is very severe, a coronary heart bypass surgery may be performed to resume blood flow.

Can It Be Cured?

No. Once the arteries have hardened the clock cannot be turned back. However, by turning to a healthier lifestyle you can slow down or even halt the progression of the disease. Evidence also shows that people who enter a cardiac rehabilitation program after surgery or a heart attack may slow the progression of atherosclerosis. It is also worth reading our article: Natural Remedies for Heart Disease.

How Can I Prevent It?

To help prevent the development of atherosclerosis you should:

1. Follow a balanced diet, one which is low in 'bad' fats and cholesterol and high in fresh fruit, vegetables and servings of lean protein (fish and chicken).
2. Exercise for at least 30 minutes a day, a brisk walk or swim is ideal.
3. Quit smoking, if you smoke and limit your alcohol intake to one drink a day (2 for men).
4. Have your blood pressure checked every year after the age of 50, or twice a year if you already have high blood pressure. If you do have high blood pressure, it is important to keep it under control. Ideally everyone should keep their pressure below 140/90 mmHg.
5. Have your cholesterol levels checked annually, especially after the age of 45.

  Related Articles on Cardiovascular Disease

For more advice see the following:

Heart Disease Statistics
Living With Heart Disease
Congestive Heart Failure
Heart Disease in Pregnancy

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