Atherosclerosis - narrowing of the blood vessels caused by seals of the walls of arteries and vessels, due to accumulation of cholesterol deposits on them, which leads to deformation and blockage of blood vessels.
As a result, the blood supply to the organ or tissue that vessels is affected by atherosclerosis can completely stop.
Atherosclerotic plaques, detached from the walls of vessels, can wander with bleeding and clog vessels and arteries, resulting in a sharp complete cessation of blood supply to a single organ or tissue.
In modern economically developed countries, in recent years, atherosclerosis is the most common cause of overall mortality and morbidity. According to statistics, the disease is much more common in people living in larger cities than those living in rural areas. Women suffer from atherosclerosis four times less often than men. Most often this disease occurs in people after fifty years.
Causes of atherosclerosis
To date, there are five main factors that contribute to the development and further progression of atherosclerosis:
- Sedentary lifestyle;
- Metabolic and endocrine disorders (are precursors of the disease);
- Nutrition factor (with food in the body a large amount of fat, protein products and cholesterol is received);
- Nerve disorders (change lipid-protein equilibrium);
The main cause of atherosclerosis is the surplus in human cholesterol, which is deposited in the form of plaques on the walls of the arteries, thereby reducing their lumen and preventing normal bleeding. Reduced blood entering a specific organ leads to its oxygen starvation, a violation of adequate functioning and eventually a heart attack, a stroke or a heart attack.
Unfortunately, some risk factors for developing atherosclerosis are irreversible, which is: sexual attachment, heredity and age, while others are quite realistic to eliminate: obesity, arterial hypertension, and smoking. In addition, there is a group of risk factors that can only be eliminated in part: diabetes mellitus, various types of hyperlipidemia, and others.
As a result of the compensatory response of the artery to the cholesterol deposits, its walls explode externally, so that there is no obvious symptomatology of atherosclerosis for a rather long period of time. As the disease progresses, under the influence of various systemic factors (heart rhythm disturbances, arterial hypertension, emotional stress, and physical activity), the atherosclerotic plaque is transformed from stable to unstable, often resulting in cracks or plaque rupture. The surface of an unstable plaque is prone to formation of blood clots (atherothrombosis), which leads to a progressive narrowing of the vascular lumen. In tissues and organs there is a violation of blood circulation, there are noticeable clinical symptoms for the patient.
Depending on the place of localization in the human vascular system, atherosclerosis can be a harbinger of the following diseases:
- Cerebrovascular diseases (ischemic stroke, transient ischemic attack);
- Ischemic heart disease (heart failure, sudden cardiac death, arrhythmias, myocardial infarction, angina pectoris);
- Atherosclerosis of mesenteric arteries;
- Atherosclerosis of the renal arteries;
- Atherosclerosis of the arteries of the lower extremities (gangrene of the legs and feet, intermittent lameness);
- Atherosclerotic aterosclerosis.
Atherosclerotic process affects several vascular pools. In people who have suffered a stroke, the risk of developing myocardial infarction is increased three times. In the case of peripheral arterial disease, the risk of developing myocardial infarction is increased fourfold.
Atherosclerosis of the coronary arteries is characterized by a multitude of symptoms and, depending on the severity, manifested by acute coronary insufficiency or angina, characterized by the development of heart failure or myocardial infarction. On the background of atherosclerosis, all forms of coronary heart disease occur.
Atherosclerosis aterosclerosis in most cases occurs after sixty years. In the case of aterosclerosis defeat of the thoracic aorta, the patient is concerned with burning intense chest pain that leads to the upper abdomen, back and neck. Against the background of stress and physical activity, the pain is intensified. Painful manifestations may not dip within a few days (unlike angina pectoris), periodically decreasing and increasing.
In some cases, the following symptoms may appear: swallowing disorder, unconsciousness, dizziness, tingling. In atherosclerosis of the abdominal aorta, constipation, bloating, abdominal pain are most often observed.
If atherosclerosis affects the bifurcation of the aorta, Lerys's syndrome develops, which is characterized by the following manifestations: ulcers of the fingers of the feet, impotence, cold appetite of the lower extremities, intermittent lameness. The rupture and aneurysm (stratification) of the aorta are the most serious complications of atherosclerosis of the aorta.
Atherosclerosis of the renal arteries is manifested by changes in urine tests and a steady increase in blood pressure.
Atherosclerosis of mesenteric vessels is manifested by the cutting of burning pain in the abdomen, which manifests itself during meals and then lasts from two to three hours, stomach upset and abdominal distension.
The atherosclerosis of the peripheral arteries is most often manifested by increased fatigue and weakness of the leg muscles, a feeling of frostiness in them, which is interspersed with lameness (while walking, pain in the limbs causes the patient to stop).
Diagnosis of atherosclerosis
The primary diagnosis of this disease is carried out by a family doctor or therapist during an annual preventive examination. The body mass index is determined, arterial pressure is measured, risk factors are identified (obesity, diabetes, hypertonic disease).
In case of suspicion of atherosclerotic changes, consultations are carried out by narrow specialists: a vascular surgeon (with atherosclerosis of the aorta and/or vessels of the lower extremities), a nephrologist (with atherosclerosis of the renal arteries), a neurologist (with cerebral atherosclerosis), an ophthalmologist (with atherosclerosis of the fundus vessels) and a cardiologist (With ischemic heart disease).
In order to specify the degree of damage shows the implementation of additional instrumental methods of examination:
- Intravascular ultrasound examination;
- Coronary angiography;
- Ultrasound of the aorta and heart;
- Electrocardiography with loading tests;
- Triplex and duplex scanning;
Atherosclerosis - treatment
Treatment of atherosclerosis is complex, painful and long lasting. For the patient, the most difficult test is the mandatory refusal of established for many years habits and inclinations. The patient must abandon the usual diet, change the general regime and diet, constantly carry out treatment prescribed by the doctor, strengthen motor activity, normalize the conditions of life and work, and timely take measures that slow down the progression of the disease.
It is imperative to get rid of such a harmful habit as smoking, as in smokers, the vessels disappear at a much faster pace. It is also necessary to completely abandon the use of alcohol and to strictly adhere to the anti-atelesclerotic diet.
The medication for atherosclerosis is the use of four groups of drugs that lower the level of lipids: statins, nicotinic acid, fibrates, sequestrants of bile acids. These preparations make stabilizing effect on the atherosclerotic plaque, improve the function of the inner shell (endothelium) of vessels and inhibit the development of atherosclerosis.
Surgical treatment of atherosclerosis is indicated in the case of the threat of development of complications and is aimed at restoring the patency of the arteries. In coronary artery disease, bypass grafting or stenting of the coronary arteries is performed to prevent the possible development of myocardial infarction. To prevent the possible development of lower limb gangrene, prosthetics of the main arteries is performed. To prevent stroke (cerebral atherosclerosis) stenting of carotid arteries is performed.