Atherosclerosis is an insidious disease. Usually it begins innocently: we get tired faster, our legs often hurt, we have trouble concentrating and remembering. But untreated arteriosclerosis can result in a heart attack, stroke, or leg amputation. That is why it is so important to prevent atherosclerosis and control cholesterol levels.

Atherosclerosis (arteriosclerosis)begins in adolescents. Each of our organs is entwined with a network of blood vessels. It is them that the life-giving blood that carries nutrients that ensure the proper functioning of the whole organism reaches all tissues. He althy arteries resemble smooth flexible tubes. They contract and expand, which allows blood to flow freely. Unfortunately, the vessels harden with age. Fat particles, proteins and calcium s alts build up on the walls of your arteries. This process begins at the age of a dozen or so years.

Deceptive atherosclerotic plaque

Cholesterol particles circulate in our blood. It is a fatty compound that resembles a soft wax. The liver produces about 2 grams of it a day. We deliver much larger amounts to the body with food. We need cholesterol, among others for good digestion, for the secretion of hormones (mainly sex) and for the production and absorption of vitamin D.

If there is too much cholesterol in the blood (especially low-density cholesterol, or LDL), it builds up in the walls of the arteries in the form of the so-called plaque, or plaque. They narrow and stiffen the vessels. This process is called atherosclerosis (arteriosclerosis). While cholesterol can appear in any artery, it is most often formed in the coronary heart, carotid, which supply the brain with blood, and in the arteries that supply blood to the legs.

Symptoms of atherosclerosis

An increase in the amount of cholesterol in the blood or an incorrect proportion of its fractions usually does not cause any disturbing symptoms for a long time. It is only when our arteries are narrowed by at least half that we notice that something is wrong: we tire more easily, we may have difficulty concentrating and remembering.

In very rare cases, cholesterol builds up in the skin and can be seen as yellow lumps, usually around the eyelids, at the elbow, under the breasts. They can also form nodules on the tendons of the wrists and the Achilles tendon.

Important

Blood vessels, depending onfunctions have different sizes. The largest, or arteries, may be the thickness of your thumb. Those that reach the heart are called coronary because they surround our most important muscle like a wreath. The arteries branch into arterioles and these turn into capillaries (also known as capillaries or capillaries) - the thinnest and most numerous of the blood vessels. From the capillaries, blood flows into slightly wider vessels called veins. They pass into the veins that lead blood to the heart. So the blood from the heart flows out through the arteries and returns through the veins. Blood pressure in veins is lower than in arteries.

The effects of atherosclerosis

Due to the build-up of atherosclerotic plaque, the blood vessels narrow and it is more and more difficult for the blood to squeeze through them. The heart, which works like a pump, makes it faster and the blood flows faster. Thanks to this, as much blood as it takes to the individual organs, but at the same time it is an excessive effort for the heart itself.

The muscle grows to cope with the task and … it requires a larger portion of oxygenated, nutritious blood. Meanwhile, the coronary arteries narrowed with atherosclerotic plaque are too narrow for the overgrown muscle to receive as much blood as it needs. The heart becomes hypoxic. This causes a chest pain called coronary (called angina). Over time, such pain occurs even after slight exertion.

In advanced atherosclerosis, cholesterol deposits may occupy more than half of the vessel's cross-section. Under the influence of e.g. increased pressure, the inner wall of the vessel may crack. Platelets that quickly stick together at the rupture form a clot that can break away from the wall at any moment and flow with the blood, for example, towards the heart (then a heart attack occurs), the brain (a stroke occurs), lungs (an embolism occurs). Often there is significant ischemia in the legs. This can lead to necrosis of some tissues. Then, non-healing ulcers develop, which in extreme cases may lead to leg amputation.

Atherosclerosis: research

Unfortunately, there is no one specialized study that would allow for the confirmation of atherosclerosis. When there is a lot of plaque in the arteries, it can be detected by ultrasound. The monitor shows the widening and thickening of the walls of the vessels. Ultrasound examination with a Doppler attachment is useful, thanks to which the doctor can assess disorders of blood flow through the vessels.

The condition of the coronary arteries allows you to evaluate computed tomography and coronary angiography. The risk of atherosclerosis can also be estimated by examining the level of total cholesterol and its fractionsLDL (bad) and HDL (good) and blood triglyceride levels.

Drugs and treatments for atherosclerosis

Doctors recommend medications to lower cholesterol. Among the newer generation preparations, they have fibrates at their disposal, which increase the level of good cholesterol (e.g. lipanthyl, lipostat, bezamidin) and statins (e.g. vasilip, zocor), which lower the level of bad cholesterol and triglycerides, and increase the concentration of good cholesterol.

Statins help to slow down or even regress atherosclerotic changes in the coronary arteries. Sometimes, however, drugs are not enough to save us, for example, from a heart attack or stroke. Sometimes doctors have to take radical measures:

  • Ballooning. A catheter is inserted into the artery through a small incision (most often in the groin). The doctor follows his movements on the monitor. When the catheter reaches the site of the greatest narrowing, a special balloon inserted through the catheter increases its volume and thus crushes cholesterol deposits. The crumb is pulled out through the catheter and the artery dilated.
  • Stents. So that the artery does not overgrow with the atherosclerotic plaque, the so-called stent. It is a short tube made of fine mesh. Often, stents are soaked in special substances (e.g. rapamycin) to prevent plaque from settling on the mesh.
  • By streaks. If it is not possible to open the artery, it is sometimes necessary to perform the so-called bridging. A piece of he althy vein, e.g., from the patient's leg, is taken and sewn with one end above and the other below the obstruction (i.e. plaque build-up) blocking blood flow. After the bypass, the blood will flow rapidly.
Important

Test your cholesterol

There is no single standard for cholesterol levels common to all people. Its concentration depends, among others, on on how old you are, whether you are generally he althy, whether you suffer, for example, from diabetes, high blood pressure, smoke cigarettes, or lead an active lifestyle. In European countries it has been assumed that in an adult human the concentration of total cholesterol in the blood should not be higher than 200 mg / dl (e.g. in the USA - 220 mg / dl). If it is higher - cholesterol fraction (LDL and HDL) and triglyceride concentration tests should be performed.

  • Total cholesterol - normal concentration below 200 mg / dl
  • LDL fraction (bad cholesterol) - normal concentration below 130 mg / dL
  • HDL fraction (good cholesterol) - normal concentration above 45 mg / dL
  • Triglycerides - normal concentration below 200 mg / dl
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Author: Time S.A

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Cardiology