Atherosclerosis

Atherosclerosis usually doesn’t cause signs and symptoms until it severely narrows or totally blocks an artery. Many people don’t know they have the disease until they have a medical emergency, such as   heart attack or stroke.

Some people may have signs and symptoms of the disease. Signs and symptoms will depend on which arteries are affected.

Coronary Arteries

The coronary arteries supply oxygen-rich blood to   heart. If plaque narrows or blocks these arteries (a disease called coronary heart disease, or CHD), it may lead to   angina. Angina is chest pain or discomfort that occurs when   heart muscle doesn’t get enough oxygen-rich blood.

Angina may feel like pressure or squeezing in   chest. Pain may also be felt in shoulders, arms, neck, jaw, or back. Angina pain may even feel like indigestion. The pain tends to get worse with activity and go away with rest. Emotional stress also can trigger the pain.

Other symptoms of CHD are shortness of breath and arrhythmias Arrhythmias are problems with the rate or rhythm of the heartbeat.

Plaque also can form in the heart’s smallest arteries. This disease is called coronary microvascular disease (MVD). Symptoms of coronary MVD include angina, shortness of breath, sleep problems, fatigue (tiredness), and lack of energy.

Carotid Arteries

The carotid arteries supply oxygen-rich blood to   brain. If plaque narrows or blocks these arteries (a disease called carotid artery disease), one may have symptoms of   stroke. These symptoms may include:

• Sudden weakness
• Paralysis (an inability to move) or numbness of the face, arms, or legs, especially on one side of the body
• Confusion
• Trouble speaking or understanding speech
• Trouble seeing in one or both eyes
• Difficulty in breathing
• Dizziness, trouble walking, loss of balance or coordination, and unexplained falls
• Loss of consciousness
• Sudden and severe headache

Peripheral Arteries

Plaque also can build up in the major arteries that supply oxygen-rich blood to the legs, arms, and pelvis (a disease called peripheral artery disease).

If these major arteries are narrowed or blocked, you may have numbness, pain, and sometimes dangerous infections.

Renal Arteries

The renal arteries supply oxygen-rich blood to   kidneys. If plaque builds up in these arteries, one may develop chronic kidney disease. Over time, chronic kidney disease causes a slow loss of kidney function.

Early kidney disease often has no signs or symptoms. As the disease gets worse, it can cause tiredness, changes in how you urinate (more often or less often), loss of appetite, nausea (feeling sick to the stomach), swelling in the hands or feet, itchiness or numbness and trouble concentrating.

The exact cause of atherosclerosis isn’t known. However, studies show that atherosclerosis is a slow, complex disease that may start in childhood. It develops faster as you age.

Atherosclerosis may start when certain factors damage the inner layers of the arteries. These factors include:

• Smoking
• High amounts of certain fats and cholesterol in the blood
• High blood pressure
• High amounts of sugar in the blood due to insulin resistance or diabetes

Risk Factors

The exact cause of atherosclerosis is not clear but certain traits, conditions, or habits may raise   risk for the disease. These conditions are known as risk factors. The more risk factors you have, the more likely it is that you’ll develop atherosclerosis.

Major Risk Factors

• Unhealthy blood cholesterol levels. This includes high LDL cholesterol (sometimes called “bad” cholesterol) and low HDL cholesterol (sometimes called “good” cholesterol).
• High blood pressure. Blood pressure is considered high if it stays at or above 140/90 mmHg over time. If you have diabetes or chronic kidney disease, high blood pressure is defined as 130/80 mmHg or higher. (The mmHg is millimeters of mercury—the units used to measure blood pressure.)
• Smoking. Smoking can damage and tighten blood vessels, raise cholesterol levels, and raise blood pressure. Smoking also doesn’t allow enough oxygen to reach body tissues.
• Insulin resistance. This condition occurs if the body can’t use its insulin properly. Insulin is a hormone that helps move blood sugar into cells where it’s used as an energy source. Insulin resistance may lead to diabetes.
• Diabetes. With this disease, the body’s blood sugar level is too high because the body doesn’t make enough insulin or doesn’t use its insulin properly.
• Overweight or obesity. The terms “overweight” and “obesity” refer to body weight that’s greater than what is considered healthy for a certain height.
• Lack of physical activity. A lack of physical activity can worsen other risk factors for atherosclerosis, such as unhealthy blood cholesterol levels, high blood pressure, diabetes, and overweight and obesity.
• Unhealthy diet. An unhealthy diet can raise your risk for atherosclerosis. Foods that are high in saturated and trans fats, cholesterol, sodium (salt), and sugar can worsen other atherosclerosis risk factors.
• Older age. As one gets older,   risk for atherosclerosis increases. Genetic or lifestyle factors cause plaque to build up in   arteries with ageing. By the time you’re middle-aged or older, enough plaque has built up to cause signs or symptoms. In men, the risk increases after the age of 45. In women, the risk increases after the age of 55.
• Family history of early heart disease. Your risk for atherosclerosis increases if your father or a brother was diagnosed with heart disease before 55 years of age, or if your mother or a sister was diagnosed with heart disease before 65 years of age.

Physical Exam

 Physical examination may show weak or absent pulse (e.g. in leg or foot). A weak or absent pulse can be a sign of   blocked artery.

Diagnostic Tests

One or more tests may be required to diagnose atherosclerosis.  Extent of disease so determined by tests, helps in planning the treatment.

Blood Tests

Blood tests check the levels of certain fats, cholesterol, sugar, and proteins in   blood. Abnormal levels may be a sign that you’re at risk for atherosclerosis.

ECG (Electrocardiogram)

An ECG can show signs of heart damage caused by CHD. The test also can show signs of a previous or current heart attack.

Chest x- Ray

A chest x- ray takes pictures of the organs and structures inside your chest, such as your heart, lungs, and blood vessels. A chest x ray can reveal signs of heart failure.

Ankle/Brachial Index

This test compares the blood pressure in your ankle with the blood pressure in your arm to see how well your blood is flowing. This test can help diagnose P.A.D (Peripheral Arterial Disease).

Other Tests

Other tests are being studied to see whether they can give a better view of plaque build up in the arteries. Examples of these tests include magnetic resonance imaging (MRI) and positron emission tomography (PET).

aking action to control risk factors can help prevent or delay atherosclerosis and   related diseases. Risk for atherosclerosis increases with the number of risk factors you have.

Doctor may recommend medical advice along with heart-healthy lifestyle changes if you have atherosclerosis. Heart-healthy lifestyle changes include heart-healthy eating, maintaining a healthy weight, managing stress, physical activity and quitting smoking.

Heart-Healthy Eating

Doctor may recommend heart-healthy eating, which   includes:

• Fat-free or low-fat dairy products, such as skimmed milk
• Fish high in omega-3 fatty acids, such as salmon, tuna, and trout, about twice a week
• Fruits, such as apples, bananas, oranges, pears, and prunes
• Legumes, such as kidney beans, lentils, chickpeas, black-eyed peas, and lima beans
• Vegetables, such as broccoli, cabbage, and carrots
• Whole grains, such as oatmeal, brown rice, and corn tortillas

Maintaining a Healthy Weight

Maintaining a healthy weight is important for overall health and can lower   risk for coronary heart disease. Knowing   body mass index (BMI) helps in finding out   a healthy weight in relation to   height and give an estimate of   total body fat. 

A BMI:

• Below 18.5 is considered underweight.
• Between 18.5 and 22.9 is in the normal range.
• Between 23.0 and 24.9 is considered overweight.
• A BMI of 25.0 or higher is considered obese.

A general goal is to aim for   a BMI of less than 25.   Doctor or health care provider can help   set an appropriate BMI goal.

Managing Stress

Learning how to manage stress, relax, and cope with problems can improve   emotional and physical health. Consider healthy stress-reducing activities, such as:

• A stress management program
• Meditation
• Physical activity
• Relaxation therapy
• Talking things out with friends or family

Physical Activity

Regular physical activity can lower many atherosclerosis risk factors, including LDL or “bad” cholesterol, high blood pressure, and excess weight. Physical activity also can lower   risk for diabetes and raise  HDL or “good” cholesterol, which helps prevent atherosclerosis.

Quitting Smoking

If you smoke or use tobacco, quit. Smoking can damage and tighten blood vessels and raise   risk for atherosclerosis. Take advice of doctor about programs and products that   help in quitting. Also, try to avoid passive smoking. If you have trouble quitting smoking on your own, consider joining a support group. Many hospitals, workplaces, and community groups offer classes to help people quit smoking.