Atherosclerosis is a complicated process in which the walls of the arteries thicken and harden due to a build-up of plaque within them. This plaque is made up of fat, cholesterol, and some dead cells, all covered by a hard layer called a fibrous cap. The fibrous cap on the plaque can rupture, causing the formation of a blood clot – called a thrombus. This clot can grow over time, and eventually block the lumen (the passageway) of the blood vessel. This leads to cell injury and death, as some parts of the body are no longer able to get blood flow. The symptoms of cell death depend on the location of the clot, and they vary in their severity.
The symptoms of atherosclerosis depend on its location. The most common site of atherosclerosis is the coronary arteries, which are the arteries of the heart. The symptoms of coronary atherosclerosis include:
Atherosclerosis can lead to heart attacks, which have these same symptoms except more severe.
The cause of atherosclerosis is not perfectly understood. Still, we know that factors like smoking and a poor diet can cause irritation of the blood vessels, leading to the accumulation of plaques and the symptoms of atherosclerosis.
Risk factors for atherosclerosis include:
The diagnosis of atherosclerosis usually starts with a discussion, where the doctor listens carefully to an explanation of all the symptoms that you’ve been having, such as pain or weakness. Then the doctor will listen carefully to your blood vessels with a stethoscope. If your pulse is weak in a certain area, or there’s an abnormal whooshing sound (called a bruit), that may be hint that atherosclerosis is occurring nearby.
For a deeper investigation, your doctor might do an imaging study where dye is injected into your arteries and pictures are taken of them. This is called angiography, and it helps your doctor to see exactly which blood vessels are being blocked by a plaque, and how thick the plaque is.
In atherosclerosis, some of the most important treatments are lifestyle changes. These include eating a healthier diet with less processed sugars and fats, and more green vegetables. It also includes increasing exercise, limiting alcohol consumption, and quitting smoking. Your doctor will likely recommend all of these to you.
Medications are also a helpful treatment in atherosclerosis, including blood-pressure medicines, cholesterol lowering medicines, and medicines such as aspirin that reduce blood clots.
Surgeries and procedures can be used as a treatment for atherosclerosis, especially when it is very advanced and severe. Angioplasty is one of these procedures, where a small balloon is pushed into a blocked artery and then expanded, which pushes away the plaque and unblocks the artery. Another procedure that can be done is a graft, where a blocked artery is removed and replaced with a different artery that does not have plaque in it.