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Atherosclerosis

Plaque buildup in your arteries is called atherosclerosis. These deposits are made up of cholesterol, fatty substances, cellular waste products, calcium, and fibrin (a clotting material in the blood).

When plaque builds up in the arteries, the wall of the blood vessel thickens and narrows. This reduces blood flow. Less blood means less oxygen and other nutrients reach your body.

What happens once you have atherosclerosis?

You usually won't have symptoms from atherosclerosis until an artery can't supply enough blood to your organs and tissues.

Plaque that narrows an artery may lead to a blood clot that sticks to the blood vessel’s inner wall. Plaque can also break off and be carried by the bloodstream until it gets stuck and causes blockage or a blood clot.

If a blocked artery supplies the heart or brain, a heart attack or stroke may occur. If an artery supplying oxygen to the arms and legs is blocked, gangrene or tissue death can result.

Symptoms of moderate to severe atherosclerosis depend on which arteries are affected. For example, if you have atherosclerosis:

  • In your coronary arteries, you may have symptoms like chest pain or pressure (angina).

  • In the arteries leading to your brain, you may have sudden numbness or weakness in your arms or legs, difficulty speaking or slurred speech, temporary loss of vision in one eye, or drooping muscles in your face. These are signs of a transient ischemic attack (TIA), which may progress to a stroke if left untreated.

  • In your arms and legs in the arteries, you may have leg pain when walking (claudication).

  • In the arteries leading to your kidneys, you may develop high blood pressure or kidney failure.

What causes atherosclerosis?

The cause of atherosclerosis isn’t completely known. It is a slow, lifelong progression of changes in the blood vessels that may start in childhood and get worse faster as you age.

Many scientists believe plaque begins when an artery’s inner lining (called the endothelium) becomes damaged. Possible causes of such damage are:

  • High cholesterol.
  • High blood pressure.
  • Cigarette smoking.
  • Insulin resistance, obesity or diabetes.
  • Elevated levels of cholesterol and triglycerides in the blood.
  • Inflammation from diseases, such as arthritis, lupus or infections, or inflammation of an unknown cause.

It's worth repeating, smoking plays a big role in the progression of atherosclerosis because it makes fatty deposits more likely to form, and accelerates the growth of plaque.

What types of tests are used to diagnose atherosclerosis?

During a physical exam, your doctor may suspect narrowed, enlarged, or hardened arteries if you have a weak pulse, decreased blood pressure in an affected limb, or a whooshing sounds over your arteries, heard using a stethoscope.

Depending on the results of the physical exam, your doctor may suggest one or more of the following tests:

  • Blood tests: Lab tests can detect increased levels of cholesterol and blood sugar that may increase the risk of atherosclerosis.

  • Doppler ultrasound: Your doctor may use this ultrasound to measure your blood pressure at various points along your arm or leg.

  • Ankle-brachial index: This test can tell if you have atherosclerosis in the arteries in your legs and feet.

  • Electrocardiogram (EKG): An electrocardiogram records electrical signals as they travel through your heart.

  • Stress test: A stress test, also called an exercise stress test, is used to gather information about how well your heart works during physical activity.

  • Cardiac catheterization and angiogram: This test can show if your coronary arteries are narrowed or blocked.

  • Other imaging tests: Your doctor may use ultrasound, a computerized tomography (CT) scan or magnetic resonance angiography (MRA) to study your arteries.

What types of treatments and procedures are used to treat atherosclerosis?

Lifestyle changes, such as eating a healthy diet and exercising, are often the most appropriate treatment for atherosclerosis. Sometimes, medication or surgical procedures may be recommended as well.

Some medications can slow—or even reverse—the effects of atherosclerosis. Here are some common choices:

  • Beta-blockers.
  • Cholesterol medications.
  • Anti-platelet medications.
  • Calcium channel blockers.
  • Water pills (diuretics).
  • Angiotensin-converting enzyme (ACE) inhibitors.

If you have severe symptoms or a blockage that may cause tissue death, you may need one of these surgical procedures:

  • Angioplasty and stent placement.
  • Endarterectomy, fatty deposits are surgically removed from the walls of a narrowed artery.
  • Fibrinolytic therapy uses a clot-dissolving drug to break blockage apart.
  • Bypass surgery creates a graft bypass that allows blood to flow around the blocked or narrowed artery.

What can I do to support my health when I have atherosclerosis?

The same healthy lifestyle changes recommended to treat atherosclerosis also help prevent it. These include:

  • Reduce salt in your diet.
  • Maintain a healthy body weight.
  • Never smoke, or stop smoking.
  • Drink only moderate amounts of alcohol, if any. This means an average of one to two drinks per day for men and one drink per day for women.
  • Eat a healthy, well-balanced diet, rich in fresh fruit and vegetables but low in saturated fats, processed sugar, and salt.
  • If you have diabetes, work closely with your doctor to make sure it is controlled.
  • Get at least 150 minutes of moderate to intense physical exercise every week.

Why choose Presbyterian for atherosclerosis treatment?

Presbyterian Heart and Vascular Care has a skilled vascular care team who can provide a wide range of services from diagnosis to treatment. Their surgeons are trained in many different techniques and procedures, many of which can provide you with a shorter recovery period and less hospital time.