General Illness Information Common Name: ATHEROSCLEROSIS Medical Term: None Specified Description: Atherosclerosis is a condition in which the wall of an artery becomes thick and less elastic due to the accumulation of fatty material under the inner lining of the arterial wall. It is the most important and common cause of hardening of the arteries in which plaque deposits form in the walls of the blood vessels that carry oxygen and other nutrients from the heart to other body parts. Atherosclerosis may lead to kidney damage, decreased circulation to the brain and extremities, and coronary-artery disease. Atherosclerosis is a major cause of strokes and heart attacks. Onset can be in the 30's, but up to age 45. Atherosclerosis is more common in men. After menopause, women have the same incidence. Causes: Atherosclerosis begins when blood cells called macrophages migrate into the arterial wall and are transformed into cells that accumulate fatty material in the presence of high LDL (low-density lipoprotein.). These fat-laden cells are called foam cells. Eventually these foam cells accumulate, leading to a patchy thickening in the inner lining of the artery and this lesion is called an atheroma or an atherosclerotic plaque. An atheroma usually comprises of fatty materials, mainly cholesterol, smooth muscle cells and connective tissue cells. Patches of fatty tissue that damage artery walls may be scattered throughout the medium and large arteries but form more often at artery junctions- probably because the constant turbulence of the blood flow in these areas injures the arterial wall, making it more susceptible to atheroma formation.. As fatty deposits accumulate, they reduce the blood vessel's elasticity and narrow the passageway, interfering with blood flow. Eventually, the atheromas collect calcium deposits and become brittle, and may rupture. Blood may then enter a ruptured atheroma, causing further narrowing of the artery. A ruptured atheroma may spill it's fatty contents and trigger the formation of a blood clot (thrombus).The thrombus may further narrow or occlude the artery or may dislodge and cause an occlusion (embolus). Prevention: You can prevent atherosclerosis by the following: Don't smoke; Follow suggestions under Diet; Children and young adults of parents with this condition may benefit from a low-fat diet;Exercise regularly; Lose weight if overweight; Reduce stress to a manageable level when possible; If you have diabetes or high blood pressure, adhere strictly to your treatment program and maintain good control. Signs & Symptoms Symptoms are often absent until atherosclerosis reaches advanced stages. Symptoms depend on what part of the body has a deceased blood flow, and on the extent of the disease. Angina pectoris or a heart attack if it involves blood vessels to the heart. Stroke or transient ischemic attack if it involves vessels to the neck and brain. Leg cramps (intermittent claudication)- if it involves an artery in the leg. Risk Factors High blood pressure. High cholesterol levels. Adults over 60. Male sex. Stress. Diabetes mellitus. Obesity. Smoking. Sedentary lifestyle. Poor nutrition (too much fat and cholesterol in diet). Family history of atherosclerosis. Inherited disease homocystinuria. Diagnosis & Treatment Diagnosis can be confirmed by sending skin scrapings from the rash to the laboratory for microscopic examination and also for fungal culture. General Measures: Diagnostic tests may include laboratory studies, ECG (electrocardiograph that measures electrical activity of the heart), exercise-tolerance test, blood studies of cholesterol and high-density lipoproteins, blood-sugar tests, and X-rays of the chest and blood vessels. Best treatment for atherosclerosis is prevention. When it is severe enough to cause complications, the treatment is generally directed at its complications- which could be one of the following-angina, heart attack, abnormal heart rhythm, heart failure, kidney failure, stroke or obstructed peripheral arteries. Counseling to learn to cope with stress is sometimes helpful. Stop smoking. Surgical treatment is available in some high-risk patients. Balloon angioplasty can open narrowed vessels; veining graft bypass can help restore blood to the heart; large arterial obstructions can be removed by endarterectomy; entire segments of diseased vessels can be replaced by woven plastic tube grafts. Additional information available from the American Heart Association, local branch listed in telephone directory or call (800) 242-8721 and the local branch of the Canadian Heart and Stroke Foundation. Medications: Intensive research is underway, and to date since the damage has already been done, there is no satisfactory medicine that can treat atherosclerosis. Recent studies show that lowering cholesterol levels in persons with high levels can increase life expectancy. If you have symptoms of a disorder caused by atherosclerosis and diet and exercise fail to reduce cholesterol, anti-hyperlipidemic drugs may be prescribed. Other drugs may be necessary to treat symptoms of an associated problem (high blood pressure, heartbeat irregularities). Some studies have indicated that aspirin and vitamin E may reduce the risk of heart attack. Get medical advice to see if they should be recommended for you. Activity: Usually no restrictions. Activity will depend on general state of health and any other illnesses present. A routine exercise program is encouraged. Diet: Eat a diet that is low in fat and low in salt, and high in fiber. Increase your grains, fresh fruits and vegetables. Possible Complications : Heart attack. Stroke. Angina pectoris. Kidney disease. Congestive heart failure. Heartbeat irregularity problems. Eye disease. Sudden death. Prognosis This condition is currently considered incurable. However, numerous reports now indicate that vigorous treatment of risk factors can reverse some blockage. Complications are eventually fatal without treatment. Scientific research into causes and treatment continues, so there is hope for increasingly effective treatment and cure.