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Atherosclerosis

Overview of atherosclerosis

Atherosclerosis refers to the development of fatty deposits on the walls of the medium and large blood vessels.

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These fatty deposits commonly known as atheromas or atherosclerotic plaques obstruct the normal flow of blood through the blood vessels.

Atherosclerosis is the most common type of arteriosclerosis (thickening of blood vessels that carry oxygenated blood in the body) and is sometimes used as a synonym of arterisclerosis.

The blood vessels of the heart, brain, kidneys, legs and other vital organs may be affected either directly or indirectly. This is the most common cause of heart disorders and the associated cases of death in the developed countries.1,2

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Signs and Symptoms of atherosclerosis

The signs and symptoms involved vary based on the blood vessel that is blocked and the area or organ being supplied by the blood vessel.

Generally, atherosclerosis does not produce any features until the block results in a significant decrease in the blood flow.

Blocks in the blood vessels of the legs may be manifested as frequent cramps felt after walking while chest pain is the common symptom if blood vessels that supply the heart are involved. In case of brain, it may at times lead to stroke.

The risk of kidney failure and blood pressure are increased if the corresponding blood vessels are affected.1,2

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Causes of atherosclerosis

Atherosclerosis is now recognised as an inflammatory process, which may be triggered by various mechanisms such continued flow of blood at an increased pressure through the blood vessels (as in hypertension), presence of certain risk factors, infectious conditions and underlying disorders.

Some of the factors that have been associated with an increased risk of atherosclerosis include:

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These factors result in an inflammatory reaction in the tissues of the affected areas of the blood vessels. This results in accumulation of different types of cells over which fat cells and calcium accumulate and start forming a thickened layer progressively. This layer now known as plaque obstructs the flow of blood locally. At times the plaque gets dislodged, flows along with the blood and obstructs smaller blood vessels causing a disruption in the blood supply to that area.2,3

Diagnosis of atherosclerosis

The diagnosis of atherosclerosis is based on the clinical features observed, physical examination and appropriate investigations. The investigations that are advised include CT and MRI scanning, ultrasound examination and certain blood tests to rule out the presence of underlying conditions. 

Treatment of atherosclerosis

The treatment varies with the severity of the accumulation and the complications that may have arisen due to the blockage of the blood vessels.

In less severe-to-moderate cases, lifestyle modifications and certain medications such as blood thinners, cholesterol-lowering agents are advised.

In general, the saturated fats in the diet have to be replaced with monounsaturated fats and polyunsaturated fats.

Other changes recommended include

  • Regular exercise
  • Weight reduction
  • Cessation of smoking

Any underlying disorders such as diabetes are treated appropriately. The complications may require surgical removal of the clot or widening of the blood vessel.1,2

Complications of atherosclerosis

Atherosclerosis can lead to complications such as cardiac stroke/failure, brain stroke, kidney failure and formation of gangrene in the legs or toes.

Prevention of atherosclerosis

Formation of atherosclerotic patches can be prevented by following a healthy lifestyle with adequate exercises and control of disorders such as high blood pressure and diabetes.

References

1.Howard-Alpe GM, Sear JW, Foex P. Methods of detecting atherosclerosis in non-cardiac surgical patients; the role of biochemical markers. Br J Anaesth. 2006; 97: 758–769.

2.Merck manual online medical dictionary. Atherosclerosis. [homepage on the internet]. NJ, USA; Merck & Co., Inc. Available at: http://www.merck.com/mmhe/sec03/ch032/ch032a.html. Accessed on: 18 June 2008.

3.Madamanchi NR, Runge MS. Mitochondrial dysfunction in atherosclerosis. Circ Res. 2007; 100; 460—473.

Written by: healthplus24.com team

Date last updated: December 13, 2014