What is Atherosclerosis?

The build-up of fats, cholesterol, and other substances in and on the artery walls.
A build-up of cholesterol plaque in the walls of arteries causes obstruction of blood flow. Plaques may rupture causing acute occlusion of the artery by a clot.


What Is Atherosclerosis?

Atherosclerosis is a hardening and narrowing of your arteries. It can put blood flow at risk as your arteries become blocked. You might hear it called arteriosclerosis or atherosclerotic cardiovascular disease. It’s the usual cause of heart attacks, strokes, and peripheral vascular disease, together are called cardiovascular disease.

A condition that afflicts the large and medium-sized arteries of almost every human, at least in societies in which cholesterol-rich foodstuffs are abundant and cheap, is atherosclerosis. This condition begins in childhood and, in the absence of accelerating factors, develops slowly until it is widespread in old age.
However, it is accelerated by a wide variety of genetic and environmental factors. It is characterized by localized fibrous thickenings of the arterial wall associated with lipid-infiltrated plaques that may eventually calcify. Old plaques are also prone to ulceration and rupture, triggering the formation of thrombi that obstruct flow. Therefore, atherosclerosis leads to vascular insufficiency in the limbs, abnormalities of the renal circulation, and dilations (aneurysms) and even rupture of the aorta and other large arteries. 


It also leads to common severe and life-threatening diseases of the heart and brain because of the formation of intravascular clots at the site of the plaques. In the United States and most other developed countries, it has been calculated that atherosclerosis is the underlying cause of about 50% of all deaths.
Almost all patients with myocardial infarction and most of those with stroke resulting from cerebral thrombosis have atherosclerosis. 

Atherosclerosis is an thickening and hardening of large and medium-sized muscular arteries, primarily due to involvement of tunica intima and is characterised by fibrofatty plaques or atheromas. The term atherosclerosis is derived from athero-(meaning porridge) referring to the soft lipid-rich material in the centre of atheroma, and sclerosis (scarring) referring to connective tissue in the plaques. Atherosclerosis is the commonest and the most important of the arterial diseases. Though any large and medium-sized artery may be involved in atherosclerosis, the most commonly affected are the aorta, the coronaries and the cerebral arterial systems. Therefore, the major clinical syndromes resulting from ischaemia due to atherosclerosis are as under:
  1. Heart (angina and myocardial infarcts or heart attacks)
  2. Brain (transient cerebral ischaemia and cerebral infarcts or strokes)
  3. Other sequelae are: peripheral vascular disease, aneurysmal dilatation due to weakened arterial wall, chronic ischaemic heart disease, ischaemic encephalopathy and mesenteric arterial occlusion.

Risk factors in Atherosclerosis

A. Major Risk Factors

Modifiable
  1. Dyslipidaemia
  2. Hypertension
  3. Diabetes mellitus
  4. Smoking

Constitutional
  1. Age
  2. Sex
  3. Genetic factors
  4. Familial and racial factors

B. Emerging Risk Factors
Environmental influences
  1. Obesity
  2. Hormones: oestrogen defi- ciency, oral contraceptives
  3. Physical inactivity
  4. Stressful life
  5. Homocystinuria
  6. Role of alcohol
  7. Prothrombotic factors
  8. Infections (C. pneumoniae, Herpesvirus, CMV)
  9. High CRP

What causes Atherosclerosis?

It's not clear exactly how atherosclerosis starts or what causes it. However, a gradual buildup of plaque or thickening due to inflammation occurs on the inside of the walls of the artery. This reduces blood flow and oxygen supply to the vital body organs and extremities.

It is unknown how atherosclerosis develops or what causes it. Atherosclerosis is a slow and progressive vascular disease that can begin in childhood. The disease, on the other hand, has the potential to spread quickly. It is distinguished by the accumulation of fatty deposits in the arteries' innermost layer. Plaque formation may occur as the disease process progresses. This thickening narrows the arteries, reducing or completely blocking blood flow to organs and other body tissues and structures.

Certain risk factors, according to some scientists, may be linked to atherosclerosis, including:
  1. High levels of cholesterol and triglycerides
  2. Blood pressure is high.
  3. Smoking
  4. Type 2 diabetes (type 1 diabetes)
  5. Obesity
  6. Inactivity physically

What are the symptoms of Atherosclerosis?

Signs and symptoms of atherosclerosis may develop gradually and maybe few, as the plaque gradually builds up in the artery. Symptoms may also vary depending on the affected artery. However, when a major artery is blocked, signs and symptoms may be severe, such as those occurring with heart attack, stroke, or blood clot.

Symptoms of atherosclerosis, a heart condition in which a substance known as plaque accumulates in the arteries, may appear gradually. The symptoms appear as the plaque accumulates. Depending on which artery is affected, your symptoms may vary. If a major artery becomes blocked, you may experience severe symptoms resembling a heart attack or stroke.


Symptoms of coronary artery atherosclerosis
These arteries carry blood to and from your heart. If these arteries become clogged, you may experience the following symptoms:
  • Angina (chest pain) (chest pain)
  • Breathing difficulty
  • Arrhythmias (abnormal heartbeat) (abnormal heartbeat)

Symptoms of carotid artery atherosclerosis
These arteries carry blood to the brain. Symptoms of an artery blockage are similar to those of a stroke:
  • Weakness
  • Numbness or paralysis in the face, arms, or legs
  • Confusion
  • Breathing difficulties
  • Dizziness
  • A severe and sudden headache

Symptoms of Peripheral Artery Atherosclerosis
These arteries carry blood to the legs, arms, and pelvic region. Numbness and pain in those areas are symptoms of a blockage.

Symptoms of renal artery atherosclerosis
Renal arteries carry blood to the kidneys. Plaque accumulation can result in chronic kidney disease. As kidney disease progresses, the following symptoms appear:
  • Fatigue
  • Changes in urination frequency
  • Appetite loss
  • Nausea
  • Numbness or itchiness

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