Atherosclerosis: The Silent Killer

What Does the Word Atherosclerosis Mean?

The word 'athero' means paste and 'stenosis' means to harden. So, atherosclerosis is the hardening of deposits formed inside the blood vessels, gradually building up to obstruct the blood flow in the vessel, and eventually, restricting the blood flow completely.

When the arteries get older, calcium, fats, and cholesterol accumulate in them and form plaque. This plaque buildup makes it difficult for the blood to move freely in the arteries. Atherosclerosis can occur in any artery of the body, such as the legs, heart, and kidneys. This narrowing of the blood vessels results in a lack of blood and oxygen to various parts of the body. If left untreated, plaque can break off, resulting in a blood clot, which can lead to a heart attack, stroke, etc. This condition can be prevented and can be treated effectively in most cases.

Are Atherosclerosis and Arteriosclerosis the Same?

Arteriosclerosis is when blood vessels carrying oxygen and nutrients from the heart to the body become thick and hardened, while the healthy ones are elastic and flexible. This restricts blood flow to the organs and tissues. Atherosclerosis, a type of arteriosclerosis, is when the arteries of the heart become narrow due to plaque buildup. This plaque can get dislodged at any time and can trigger a blood clot.

What Are the Causes of Atherosclerosis?

In a healthy person, the innermost lining of the arteries is smooth and elastic. But, in persons with risk, the layer is damaged. This attracts the bad cholesterol to build up in the artery wall, forming plaques. The white blood cells (WBC) in the blood react to this by invading the area to ingest the LDL (low-density lipoprotein) cholesterol. During this process, some of the WBC adhered to the plaque, making it bigger and more dangerous. Thus, the lumen (space in the artery) is narrowed, until it affects blood flow to the concerned organ.

Also, a chunk of the plaque can dislodge from the site and get carried by the bloodstream to get deposited elsewhere, causing blocks there. This site can be anywhere in the body, however far from the place of its origin.

What Are the Risk Factors of Atherosclerosis?

The risk factors of atherosclerosis include:

• High cholesterol.

• Aging.

• Consuming a diet rich in fat.

• Smoking.

• Lack of physical activity.

• Family history of CVD (cardiovascular diseases).

• Hypertension.

• Diabetes.

• Being overweight or obese.

What Are the Signs and Symptoms of Atherosclerosis?

Unfortunately, there are no symptoms felt until there is a full-fledged block. This is why this disease is also called a silent killer. Depending on the location of the artery, symptoms can vary as follows.

• Chest pain.

• Chest discomfort.

• Weakness.

• Difficulty in breathing.

• Confusion.

• Leg pain.

• Numbness.

• Excessive sweating.

• Lightheadedness.

• Loss of balance.

• A sudden headache.

• Difficulty in speech.

• Trouble understanding speech.

These are also the signs and symptoms of a heart attack and stroke, so get immediate medical care if you experience such symptoms.

How Is Atherosclerosis Diagnosed?

The doctor will first perform a physical examination, where they will listen to the arteries, and breathing sounds, and check if your pulse is normal, weak, or absent. Then, the doctor might order some of the following tests:

• Blood Tests - To check the levels of cholesterol and blood sugar.

• Chest X-ray - To detect signs of heart failure.

• CT Scan or Magnetic Resonance Angiography (MRA)- This looks for narrowed arteries.

• EKG (Electrocardiogram) - It records the electrical activity of the heart.

• Stress Test - Here, the patient’s heart rate, blood pressure, and breathing are monitored while exercising.

• Angiogram - The doctor checks the patent of arteries by injecting a dye into the arteries. Then the arteries are viewed on an X-ray.

• Ankle-Brachial Index - This test compares the blood pressures in the arm and lower leg.

What Are the Treatment Options for Atherosclerosis?

Depending on the severity, treatment options can be one of the following as suggested by your doctor.

1. Lifestyle Modification -

• Limit intake of unhealthy fats.

• Restrict salt in the diet.

• Exercise regularly.

• Eat healthy, high-fiber foods.

• Manage weight.

• Stop alcohol consumption.

2. Medications - Medicines that prevent plaque buildup are prescribed by the doctor, to be taken long-term. Depending on the case, drugs such as:

1. Statins to lower cholesterol.

2. Antiplatelet and anticoagulant drugs to prevent blood from clotting and blocking the arteries.

3. ACE (angiotensin-converting enzyme) inhibitors to prevent arteries from getting narrow.

4. Beta-blockers and calcium channel blockers to lower blood pressure.

5. Diuretics to lower blood pressure.

3. Surgery - More severe cases require surgical intervention in the form of:

• Angioplasty - A catheter is used to widen your arteries with the help of a balloon.

• Stenting - In some cases, after angioplasty is done, a stent is placed to keep the artery patent.

• Endarterectomy - The doctor surgically removes fat deposits from the artery.

• Bypass Surgery - A vessel is taken from somewhere else in the body, which is used to divert blood from around the artery that is blocked.

• Thrombolytic Therapy - A drug injected into the artery to dissolve the blood clot.

• Atherectomy - A catheter with a blade is used to remove plaque buildup.

What Are the Possible Complications of Atherosclerosis?

If left untreated, atherosclerosis can possibly lead to cardiovascular disease (CVD). The different types of CVD are:

1. Angina - It is short episodes of dull or heavy chest pains that result from coronary heart disease.

2. Heart Attack - The blood supply to the heart gets blocked, resulting in sudden chest pain, which radiates to the jaws, and arms, shortness of breath, and dizziness.

3. Coronary Heart Disease - The coronary arteries, which are the main arteries that supply the heart, get clogged.

4. Transient Ischaemic Attack (TIA) - It results in temporary symptoms similar to a stroke.

5. Peripheral Arterial Disease - The blood supply to the legs is blocked.

6. Strokes - The blood supply to the brain gets interrupted, resulting in slurred speech, one-sided face droop, and weakness.

How Can Atherosclerosis Be Prevented?

Prevention or delay of atherosclerosis is possible by reducing risk factors. This involves adopting a healthy lifestyle, which includes a balanced diet, weight loss, physical activity, and avoiding smoking.

A healthy diet comprises whole grains, fruits, vegetables, lean meats, skinless chicken, seafood, and fat-free or low-fat dairy products while limiting sodium, processed sugars, refined grains, and solid fats. If someone is at risk due to a family history or high cholesterol, it is essential to follow the healthcare provider's medication regimen.

Conclusion:

Atherosclerosis is more common than is commonly thought. It stays silent in most individuals. But, once symptoms appear, it is already too late. It is a dangerous condition that can be prevented with healthy habits. Begin now, and do what can be done to keep the heart healthy. If symptoms linked to atherosclerosis worsen or if new symptoms arise, inform the healthcare provider