Atherosclerosis is a disease in which the wall of the artery thickens as a result of accumulation of lipids ,some cells and other particles (plaques). Atherosclerotic plaques lead to narrowing and occlusion of the arteries. Sometimes, rupture of the plaques leads to clot formation and acute occlusion of the artery (acute myocardial infarction). Sometimes, small particles might dislodge from the plaques and blocks other arteries distant from the narrowed artery ( emboli from a narrowed carotid artery blocking a small artery in the brain causing stroke).
ATHEROSCLEROSIS
Introduction
Normal Artery->Tiny Plaque->Advanced Plaque->Blocked Artery
Atherosclerosis is a chronic disease that remains asymptomatic for decades. Early detection is possible and with some preventive measures serious events such as myocardial infarction and stroke can be prevented. Atherosclerosis is responsible for 50 % of all deaths in developed countries.
Causes
1. Genetic Tendency
2. High Cholesterol
3. Hypertension
4. Smoking
5. Diabetes
2. High Cholesterol
3. Hypertension
4. Smoking
5. Diabetes
Symptoms
It causes symptoms at late stages.
Narrowing or occlusion of a heart vessel ( coronary artery) might lead to heart infarction or angina.
Small particles from an atherosclerotic narrowing in the carotid artery (main neck artery supplying brain) might travel to occlude a small artery in the brain leading to stroke.
Narrowing of the kidney arteries might lead to hypertension resistant to medical treatment and even to dialysis in advanced cases.
Arterial blockage in leg arteries can cause pain in walking (claudication), rest pain, gangrene and amputation in late stage.
Early detection of aortic aneurysm ( diameter over 3 cm) and treatment before rupture is life- saving.
Early Detection
1-Ultrasound examination (duplex scanning) of carotid, lower leg arteries, and aorta,
2-CT cardiac calcium scoring. In patients, with one or more risk factors for atherosclerosis above mentioned diagnostic tests can reveal early atherosclerosis.
2-CT cardiac calcium scoring. In patients, with one or more risk factors for atherosclerosis above mentioned diagnostic tests can reveal early atherosclerosis.
Prevention and Treatment
Eliminating (smoking and sedentary life style, unhealthy diet) and treating risk factors or associated diseases (high cholesterol, diabetes, hypertension) are crucial for prevention and treatment. Statins (cholesterol-lowering drugs), anti-platelets (like aspirin, preventing clot formation), angiotensin-converting enzyme (ACE) inhibitors and beta-blockers (mainly blood pressure-lowering drugs having some other beneficial effects on the heart and the arteries) are frequently used. Sometimes (depending on the severity of lesions and symptoms), catheter-based minimal invasive ( balloon dilatation and stent placement) or surgical intervention are needed.
Various Interventions
Coronary artery stenting Coronary artery bypass
Cardiology Cardiac Surgery
Cardiology Cardiac Surgery
Leg artery bypass Balloon dilatation of leg artery
Vascular Surgery Interventional Radiology
Vascular Surgery Interventional Radiology
Carotid artery surgery Carotid artery stenting
Vascular Surgery Interventional Radiology
Vascular Surgery Interventional Radiology