Atherosclerosis

What is an Atherosclerosis

Atherosclerosis is narrowing and hardening of the arteries. Arteries are blood vessels that carry blood from the heart to all parts of the body. This blood contains oxygen.

Arteries can become narrow or clogged with a buildup of fat, cholesterol, calcium, and other substances (plaque). Plaque decreases the amount of blood that can flow through the artery.

Atherosclerosis can affect any artery in the body, including:

  • Heart arteries (coronary artery disease). This may cause a heart attack.
  • Brain arteries. This may cause a stroke (cerebrovascular accident).
  • Leg, arm, and pelvis arteries (peripheral artery disease). This may cause pain and numbness.
  • Kidney arteries. This may cause kidney (renal) failure.

Treatment may slow the disease and prevent further damage to the heart, brain, peripheral arteries, and kidneys.

What are the causes?

Atherosclerosis develops slowly over many years. The inner layers of your arteries become damaged and allow the gradual buildup of plaque. The exact cause of atherosclerosis is not fully understood. Symptoms of atherosclerosis do not occur until the artery becomes narrow or blocked.

What increases the risk?

The following factors may make you more likely to develop this condition:

  • High blood pressure.
  • High cholesterol.
  • Being middle-aged or older.
  • Having a family history of atherosclerosis.
  • Having high blood fats (triglycerides).
  • Diabetes.
  • Being overweight.
  • Smoking tobacco.
  • Not exercising enough (sedentary lifestyle).
  • Having a substance in the blood called C-reactive protein (CRP). This is a sign of increased levels of inflammation in the body.
  • Sleep apnea.
  • Being stressed.
  • Drinking too much alcohol.

What are the signs or symptoms?

This condition may not cause any symptoms. If you have symptoms, they are caused by damage to an area of your body that is not getting enough blood.

  • Coronary artery disease may cause chest pain and shortness of breath.
  • Decreased blood supply to your brain may cause a stroke. Signs of a stroke may include sudden:
    • Weakness on one side of the body.
    • Confusion.
    • Changes in vision.
    • Inability to speak or understand speech.
    • Loss of balance, coordination, or the ability to walk.
    • Severe headache.
    • Loss of consciousness.
  • Peripheral arterial disease may cause pain and numbness, often in the legs and hips.
  • Renal failure may cause fatigue, nausea, swelling, and itchy skin.

How is this diagnosed?

This condition is diagnosed based on your medical history and a physical exam. During the exam:

  • Your health care provider will:
    • Check your pulse in different places.
    • Listen for a “whooshing” sound over your arteries (bruit).
  • You may have tests, such as:
    • Blood tests to check your levels of cholesterol, triglycerides, and CRP.
    • Electrocardiogram (ECG) to check for heart damage.
    • Chest X-ray to see if you have an enlarged heart, which is a sign of heart failure.
    • Stress test to see how your heart reacts to exercise.
    • Echocardiogram to get images of the inside of your heart.
    • Ankle-brachial index to compare blood pressure in your arms to blood pressure in your ankles.
    • Ultrasound of your peripheral arteries to check blood flow.
    • CT scan to check for damage to your heart or brain.
    • X-rays of blood vessels after dye has been injected (angiogram) to check blood flow.

How is this treated?

Treatment starts with lifestyle changes, which may include:

  • Changing your diet.
  • Losing weight.
  • Reducing stress.
  • Exercising and being physically active more regularly.
  • Not smoking.

You may also need medicine to:

  • Lower triglycerides and cholesterol.
  • Control blood pressure.
  • Prevent blood clots.
  • Lower inflammation in your body.
  • Control your blood sugar.

Sometimes, surgery is needed to:

  • Remove plaque from an artery (endarterectomy).
  • Open or widen a narrowed heart artery (angioplasty).
  • Create a new path for your blood with one of these procedures:
    • Heart (coronary) artery bypass graft surgery.
    • Peripheral artery bypass graft surgery.

Follow these instructions at home:

Eating and drinking

  • Eat a heart-healthy diet. Talk with your health care provider or a diet and nutrition specialist (dietitian) if you need help. A heart-healthy diet involves:
    • Limiting unhealthy fats and increasing healthy fats. Some examples of healthy fats are olive oil and canola oil.
    • Eating plant-based foods, such as fruits, vegetables, nuts, whole grains, and legumes (such as peas and lentils).

Limit alcohol intake to no more than 1 drink a day for nonpregnant women and 2 drinks a day for men. One drink equals 12 oz of beer, 5 oz of wine, or 1½ oz of hard liquor.

Lifestyle

  • Follow an exercise program as told by your health care provider.
  • Maintain a healthy weight. Lose weight if your health care provider says that you need to do that.
  • Rest when you are tired.
  • Learn to manage your stress.
  • Do notuse any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.
  • Do notabuse drugs.

General instructions

  • Take over-the-counter and prescription medicines only as told by your health care provider.
  • Manage other health conditions as told by your health care provider.
  • Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

  • You have chest pain or discomfort. This includes squeezing chest pain that may feel like indigestion (angina).
  • You have shortness of breath.
  • You have an irregular heartbeat.
  • You have unexplained fatigue.
  • You have unexplained pain or numbness in an arm, leg, or hip.
  • You have nausea, swelling of your hands or feet, and itchy skin.

Get help right away if:

  • You have any symptoms of a heart attack, such as:
    • Chest pain.
    • Shortness of breath.
    • Pain in your neck, jaw, arms, back, or stomach.
    • Cold sweat.
    • Nausea.
    • Light-headedness.
  • You have any symptoms of a stroke. “BE FAST”is an easy way to remember the main warning signs of a stroke:
    • B – Balance.Signs are dizziness, sudden trouble walking, or loss of balance.
    • E – Eyes.Signs are trouble seeing or a sudden change in vision.
    • F – Face.Signs are sudden weakness or numbness of the face, or the face or eyelid drooping on one side.
    • A – Arms.Signs are weakness or numbness in an arm. This happens suddenly and usually on one side of the body.
    • S – Speech.Signs are sudden trouble speaking, slurred speech, or trouble understanding what people say.
    • T – Time.Time to call emergency services. Write down what time symptoms started.
  • You have other signs of a stroke, such as:
    • A sudden, severe headache with no known cause.
    • Nausea or vomiting.
    • Seizure.

These symptoms may represent a serious problem that is an emergency. Do not wait to see if the symptoms will go away. Get medical help right away. Call your local emergency services (911 in the U.S.). Do not drive yourself to the hospital.

Summary

  • Atherosclerosis is narrowing and hardening of the arteries.
  • Arteries can become narrow or clogged with a buildup of fat, cholesterol, calcium, and other substances (plaque).
  • This condition may not cause any symptoms. If you do have symptoms, they are caused by damage to an area of your body that is not getting enough blood.
  • Treatment may include lifestyle changes and medicines. In some cases, surgery is needed.
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