Narrowing and thickening of the arteries (atherosclerosis)

Atherosclerosis is narrowing and thickening of the arteries due to the buildup of plaque on the artery walls. Plaque buildup occurs because the lining of the inner wall cells of the artery (endothelium) is damaged. Endothelium functions to maintain the smooth flow of blood.

Plaque that causes atherosclerosis :

• Cholesterol.
• Fat.
• Calcium.
• Fibrin (substance in the blood).

Plaque can be carried by the bloodstream causing blockages or forming blood clots on the surface of the plaque. This condition causes the circulation of blood and oxygen from the arteries to the organs of the body to be obstructed. Atherosclerosis can occur in any part of the body, such as :

• Brain.
• Kidney.
• Feet.

Symptoms.

Symptoms of atherosclerosis will be felt when the arteries are severely narrowed and block blood circulation to the tissues or organs of the body.

• Symptoms of atherosclerosis in the hands and feet : causing pain when walking (claudication).
• Symptoms of atherosclerosis in the kidneys : causing kidney failure and high blood pressure.
• Symptoms of atherosclerosis of the heart : causing chest pain (angina).
• Symptoms of atherosclerosis in the brain : resulting in weak or stiff hands and feet, difficulty speaking, weakened facial muscles, loss of vison in one eye.

Cause.

The cause of atherosclerosis is unknown, this disease occurs due to damage or injury to the inner lining of the arteries (endothelium). Damage caused :

• Cholesterol levels.
• Triglycerides.
• High blood pressure.
• Diabetes.
• Insulin resistance.
• Arthritis.
• Infection.
• Lupus disease.
• Smoke.
• Obesity.
• A person who has a family member with a history of atherosclerosis is at high risk of suffering from the same disease.

Diagnosis.

• Physical examination.
• Blood test to find out cholesterol and blood sugar levels.
• Comparison of the blood pressure index of the legs and arms to check for clogged arteries in the hands and feet.
• Electrocardiogram (EKG) to check heart activity.
• Doppler ultrasound to view blocked arteries with sound waves.
• Stress test or treadmill check to check the electrical activity of the heart and blood pressure during physical activity.
• Magnetic Resonance Angiogram (MRA) and CT scan to check the condition of the arteries.

Treatment.

Lifestyle changes, medications, and surgical procedures.

Lifestyle changes :

• Exercise often to improve heart and blood vessel health.
• Reducing the consumption of foods with high levels of fat and cholesterol.

Drug administration :

• Medicines to prevent blood clots that block the arteries (antiplatelet and anticoagulants, such as aspirin).
• Blood pressure-lowering drugs (beta blockers, calcium channel blockers and diuretics to increase urine production).
• Medicines to lower bad cholesterol (LDL) levels, such as statins and fibric acid.
• Angiostensin enzyme inhibitor drugs (ACEinhibitors) to lower blood pressure and prevent narrowing of the arteries.
• Other drugs to control medical conditions, for example diabetes drugs.

In cases of severe atherosclerosis, surgical procedures need to be performed :

• Bypass surgery to treat blockages or narrowing of the arteries.
• Fibrinolytic therapy to treat clogged arteries due to blood clots.
• Tube insertion (stent) and angioplasty to treat narrowed or blocked arteries.
• Endarterectomy to remove fat deposits in the narrowed artery walls.
• Arterectomy to remove plaque and arteries.

Complications.

• Transient ischemic attack (mild stroke and stroke) when atherosclerosis occurs in an artery near the brain.
• Gangrene (dead tissue), when atherosclerosis occurs in the hands and feet which results in impaired blood circulation.
• Chronic kidney disease, when atherosclerosis occurs in the arteries that lead to the kidneys.
• Aneurysms or dilation of blood vessels in the artery walls.
• Heart attack, heart failure, when atherosclerosis occurs in the heart arteries.