Atherosclerotic

Atherosclerosis
Specialty	Cardiology
Symptoms	Chest pain, shortness of breath, fatigue
Complications	Heart attack, stroke, peripheral artery disease
Usual onset	Gradual
Duration	Long-term
Causes	High cholesterol, hypertension, smoking, diabetes
Risk factors	Age, family history, obesity, sedentary lifestyle
Diagnostic method	Blood tests, angiography, ultrasound
Treatment	Lifestyle changes, medications, surgery
Prognosis	Variable
Frequency	Common

Atherosclerosis is a condition characterized by the buildup of plaque inside the arteries, which can lead to serious cardiovascular complications. It is a major underlying cause of heart disease and stroke, two of the leading causes of death worldwide.

Pathophysiology

Atherosclerosis begins with damage to the endothelium, the inner lining of the arteries. This damage can be caused by factors such as high blood pressure, high cholesterol, smoking, and diabetes. Once the endothelium is damaged, low-density lipoprotein (LDL) cholesterol can penetrate the arterial wall.

The immune system responds by sending white blood cells to digest the LDL cholesterol, but over time, these cells become engorged and form foam cells. These foam cells accumulate to form fatty streaks, which are the earliest visible signs of atherosclerosis.

As the process continues, the fatty streaks develop into atheromatous plaques, which consist of a core of lipids and a fibrous cap. These plaques can narrow the arteries, reducing blood flow. If a plaque ruptures, it can lead to the formation of a blood clot (thrombus), which can completely block the artery and cause a heart attack or stroke.

Risk Factors

Several risk factors contribute to the development of atherosclerosis:

• Age: The risk increases with age.
• Family history: A family history of heart disease can increase risk.
• Smoking: Tobacco use damages the endothelium and accelerates plaque formation.
• High blood pressure: Hypertension can damage arteries over time.
• High cholesterol: Elevated levels of LDL cholesterol contribute to plaque buildup.
• Diabetes: High blood sugar can damage the endothelium.
• Obesity: Excess weight is associated with increased risk.
• Sedentary lifestyle: Lack of physical activity can contribute to risk.

Diagnosis

Atherosclerosis is often diagnosed through a combination of:

• Blood tests: To check cholesterol levels and other markers.
• Electrocardiogram (ECG): To detect heart abnormalities.
• Echocardiogram: To visualize the heart and blood flow.
• Angiography: To view blood flow through the arteries.
• Ultrasound: To assess blood flow and detect blockages.

Treatment

Treatment for atherosclerosis focuses on lifestyle changes, medications, and sometimes surgical interventions:

• Lifestyle changes: These include adopting a heart-healthy diet, regular exercise, quitting smoking, and maintaining a healthy weight.
• Medications: These may include statins to lower cholesterol, antihypertensives to control blood pressure, and antiplatelet drugs to prevent clot formation.
• Surgical procedures: In severe cases, procedures such as angioplasty or coronary artery bypass grafting (CABG) may be necessary to restore blood flow.

Prognosis

The prognosis for individuals with atherosclerosis varies depending on the severity of the disease and the effectiveness of treatment. Early detection and management can significantly improve outcomes and reduce the risk of complications such as heart attack and stroke.

Prevention

Preventive measures include:

• Maintaining a healthy diet low in saturated fats and cholesterol.
• Engaging in regular physical activity.
• Avoiding tobacco use.
• Managing stress effectively.
• Regular health screenings to monitor blood pressure, cholesterol, and blood sugar levels.

See also

• Coronary artery disease
• Peripheral artery disease
• Stroke