Heart & Stroke Conditions Explained

Definition

Atherosclerosis

Atherosclerosis is a descriptive term to denote the appearance of plaques on the inner lining of our arteries.

Namely “Athero” (meaning porridge or gruel) and “sclerosis” (meaning hardness). Atherosclerosis can affect large and medium sized arteries.

Some arteries such as the arteries in the forearm or those on the inner lining of our chest wall (called the internal mammary arteries), are less likely to develop atherosclerosis.

When the plaques grow to a large size, they push into the inner channel in our arteries and thus limit the amount of blood the artery can transport.

In addition to the build up of plaques, the plaques may also tear and cause a blood clot to develop at the site of the tear that can block the blood flowing down the artery.

Sometimes bleeding can occur within a plaque that causes it to swell causing the plaque to push into the inner channel of the artery. This a major problem if it occurs in the coronary arteries which supply blood to the heart muscle as a heart attack can occur.

If the blood supply to the brain is cut off, a stroke can occur and if the supply to the limbs is blocked, it can result in gangrene.

 

Related topics: coronary heart disease, angina, heart attack, stroke.

Symptoms

Atherosclerosis

Atherosclerosis develops gradually over years.

You usually don’t have symptoms until the artery becomes tightly narrowed or blocked, then the symptoms depend on where the blockage is e.g. angina, acute coronary syndrome, heart attack if the heart is affected; stroke or TIA if the brain is affected; leg pain and intermittent pain when walking if the peripheral arteries are affected.

 

Causes

Atherosclerosis

It is not exactly known what starts the atherosclerotic process but many researchers agree that it starts with damage to the inner lining of arteries.

In addition, there is increasing evidence that certain spots on the inner lining of arteries become stickier such that the circulating cholesterol particles can become trapped at specific sites.

Plaques occur on the inner lining of an artery and are due to deposits of fatty substances like cholesterol, as well as calcium and blood clots. The higher the cholesterol levels the more fat that is available to stick to the wall. These plaques develop in infancy and build-up over years.

The rate at which plaques build up depends in part on one’s genes, cholesterol levels, smoking habits, blood pressure and presence or absence of diabetes.

Usually, most people do not present with the problems related to plaque build up until they are in their fifties but more people are presenting at a younger age.

Prevention

Atherosclerosis

Most people with atherosclerosis don’t know they have it until they get symptoms like angina or have a heart attack or stroke.

Having a healthy lifestyle and managing your risk factors if you have them is vital to reducing your chances of developing atherosclerosis.

 

Risk factors include:

Diagnosis

Atherosclerosis

No single test can diagnose atherosclerosis and unfortunately sometimes it’s not known until a person presents with a heart attack or stroke.

This is why controlling your risk factors and adopting a heart healthy lifestyle is so important.

If your doctor suspects you are at risk based on a physical examination, your risk factors, your family history and your symptoms, then further tests may be required such as:

 

  • Exercise stress test
  • Cardiac CT or coronary angiogram to look at your coronary arteries
  • A scan of your neck to look at your carotid arteries supplying blood to your brain
  • Scanning of your legs looking for disease in your peripheral arteries

Treatment

Atherosclerosis

There is no cure for atherosclerosis but we can slow down its progress and help prevent heart attack and stroke.

Having a healthy lifestyle and managing your risk factors is often the most important treatment.

Most people will be prescribed medication to protect them from the conditions caused by atherosclerosis such as angina, heart attack, stroke, peripheral artery disease.

 

These may include:

  • Cholesterol lowering drugs
  • Medications to control high blood pressure
  • Medications such as aspirin, to reduce the stickiness of your blood and prevent it clumping in the blood vessels
  • Medications to reduce the demands on the heart if the coronary arteries are affected
  • Other medications may be required in certain specific conditions.

 

Other treatment procedures which may be required include angioplasty and stenting, or surgery to remove or bypass the blockage.

The good news is that by making small changes to your lifestyle and by taking medicines, as directed, you can greatly reduce your risk of heart attack and stroke from atherosclerosis.

Resources

Atherosclerosis

Read our resources for further information:

Symptoms