ATHEROSCLEROSIS

Atherosclerosis is a type of arteriosclerosis in which there is buildup of fats, cholesterol and other substances in and on the artery walls. This buildup is called “plaque”. The plaque can cause arteries to narrow, blocking blood flow. The plaque also can burst, leading to a blood clot. It can affect arteries anywhere in the body. 

In America, about half of people age 45 to 84 have atherosclerosis but aren’t aware of it, according to the U.S. National Institutes of Health. Diseases linked to atherosclerosis are the leading cause of death in the United States and the world. 

What are the symptoms of atherosclerosis?

Atherosclerosis symptoms often don’t start until an artery is very narrow or blocked. Many people don’t know they have plaque buildup until they have a medical emergency like a heart attack or stroke. Symptoms of atherosclerosis depend on the organs or tissues affected by the blocked arteries. 

• Shortness of breath (dyspnea) during light physical activity.
• Chest pain or discomfort (angina).
• Pain in your back, shoulders, neck, arms or belly.
• Feeling dizzy or lightheaded.
• Palpitation in the chest.
• Fatigue. 
• Nausea or vomiting that may feel like indigestion. 
• DIGESTIVE SYSTEM – Lack of blood flow in parts of the digestive system leads to mesenteric ischemia. Symptoms may include: 
  • Pain or cramping in the abdomen after eating.
  • Bloating nausea or vomiting.
  • Diarrhea.
  • Unintentional weight loss due to “food fear” (fear of pain after eating).
• LEGS & FEET – peripheral artery diseases (PAD) refer to poor blood flow in the arteries in your limbs. Symptoms may include:
  • Muscle pain (intermittent claudication).
  • Burning or aching pain in your feet and toes when you rest, especially when lying flat.
  • Changes in skin colour (like redness).
  • Cool skin on your feet.
  • Frequent skin and soft tissue infections, often in your legs or feet.
  • Sores on your feet or toes that don’t heal.
• KIDNEYS – with Renal artery stenosis (RAS), symptoms may include:
  • Markedly elevated blood pressure that doesn’t respond to multiple medications.
  • Changes in urination frequency.
  • Swelling (edema). 
  • Feeling drowsy or tired.
  • Skin that feels dry, itchy or numb.
  • Headaches.
  • Unexplained weight loss.
  • Nausea, vomiting or loss of appetite.
  • Dizziness.
  • Drooping on one side of your face.
  • Loss of feeling, loss of muscle strength or weakness on one side of your body.
  • Severe headache.
  • Slurred speech or difficulty forming words.
  • Blurring or loss of vision unilaterally. (https://my.clevelandclinic.org/health/diseases/16753-atherosclerosis-arterial-disease) 

BRAIN – with CAROTID artery disease, the first symptoms are usually a transient ischemic attack (TIA) or stroke. Symptoms may include: 

HEART – coronary artery disease (CAD) happens in the arteries that supply blood to your heart. Symptoms may include: 

What causes atherosclerosis? 

Atherosclerosis is a disease that slowly gets worse. It may begin as early as childhood. The exact cause is not known. It may start with damage or injury to the inner layer of an artery. Artery damage may be caused by:

• High blood pressure.
• High cholesterol.
• High triglycerides, a type of fat in the blood.
• Smoking or other tobacco use.
• Diabetes.
• Insulin resistance.
• Obesity.
• Inflammation from an unknown cause or from diseases such as arthritis, lupus, psoriasis or inflammatory bowel disease. 

Once the inner wall of an artery is damaged, blood cells and other substances may collect at the injury site. These substances build up in the inner lining of the artery. Over time, fats, cholesterol and other substances also collect on and in the walls of the heart arteries. This buildup is called “plaque”. Plaque can cause the arteries to narrow. Narrowed arteries can block blood flow. The plaque also can burst, leading to a blood clot. 

What are the risk factors to develop atherosclerosis? 

(https://www.mayoclinic.org/diseases-conditions/arteriosclerosis-atherosclerosis/symptoms-causes/syc-20350569) 

What are the stages of atherosclerosis? 

• Fatty streak formation. This is the first visible sign of atherosclerosis. It’s a yellow streak or patch of dead foam cells at the site of endothelial damage. In this case, foam cells are white blood cells that consume cholesterol to try to get rid of it. Continued foam cell activity causes further damage to your endothelium.
• Plaque growth. Dead foam cells and other debris keep building up, turning a fatty streak into a larger piece of plaque. A fibrous cap (made of smooth muscle cells) forms over the plaque. This cap prevents bits of plaque from breaking off into your bloodstream. As the plaque grows, it gradually narrows your artery’s opening (lumen), so there’s less room for blood to flow through.
• Plaque rupture or erosion. In this stage, a blood clot forms in your artery due to plaque rupture or plaque erosion. Plaque rupture happens when the fibrous cap that covers the plaque breaks open. With plaque erosion, the fibrous cap stays intact, but endothelial cells around the plaque get worn away. Both events lead to the formation of a blood clot. The clot blocks blood flow and can lead to a heart attack or stroke. (https://my.clevelandclinic.org/health/diseases/16753-atherosclerosis-arterial-disease) 

Endothelial damage and immune response. Damage to your endothelium triggers chemical processes that cause white blood cells to travel to the injury site. These cells gather and lead to inflammation within your artery.