Atherosclerosis - a widespread progressive disease of chronic nature, characterized by lesions of the inner shells of medium and large arteries in the form of deposits of multiple or single foci of lipid (cholesterol often) plaques. With further progression of the disease grows connective tissue, leading to a gradual deformation and narrowing of the lumen, thereby causing slow growing undernourished through the affected artery body.
In today's economically developed countries in recent years is atherosclerosis is the most common cause of overall mortality and morbidity.According to the statistics the disease is much more common in people living in big cities, than those who live in rural areas.Women suffer from atherosclerosis to four times less than men.Most often, the disease occurs in people over fifty years
Arteriosclerosis - the cause of
To date, there are five main factors that contribute to the development and further progression of atherosclerosis, is:
- Sedentary lifestyle
- The metabolic and endocrine disorders (are harbingers of disease)
- nutritional factors (food the body receives a large amount of fat, protein foods and cholesterol)
- Nervous disorders (alter lipid-protein balance)
main reason for the development of atherosclerosis is a surpluscholesterol in human blood, which is deposited as plaques in arterial walls, thereby reducing their lumen and interfering with normal blood flow.Incoming body reduced to a certain amount of blood leads to its oxygen starvation, disruption of the proper functioning and, ultimately, heart attack, stroke, or heart attack.
Some risk factors for atherosclerosis are unfortunately unavoidable, it: gender, heredity and age, others are quite realistic to eliminate it: obesity, hypertension, smoking.In addition, there is a group of risk factors that can be eliminated only in part: diabetes , various types of hyperlipidemia etc.
Atherosclerosis - Symptoms
As a result, the compensatory response artery in the deposition of cholesterol, its walls vybuhayut out, soa sufficiently long period of time there is no obvious symptoms of atherosclerosis.As the disease progresses, under the influence of different systemic factors (irregular heartbeat, hypertension, emotional stress, physical activity) comes from the transformation of the atherosclerotic plaque unstable to a stable state, which often ends with the appearance of cracks or rupture of the plaque.Unstable plaque surface exposed clots (atherothrombosis) that leads to progressive luminal narrowing of blood vessels.The tissues and organs is a violation of circulation, there are noticeable to the patient's clinical symptoms.
Depending on the localization in the vascular system of a person, atherosclerosis may be a harbinger of the following diseases:
- Cerebrovascular disease (ischemic stroke, transient ischemic attack)
- Coronary heart disease (heart failure, sudden cardiac death,arrhythmia, myocardial infarction, angina)
- Atherosclerosis mesenteric arteries
- Atherosclerosis of renal artery
- Atherosclerosis of the arteries of the lower extremities (gangrene of the legs and feet, intermittent claudication)
- Atherosclerosis of the aorta
atherosclerotic process involves severalvascular beds.People who have had a stroke, three times more likely to develop myocardial infarction.In the case of peripheral artery disease risk of myocardial infarction is increased four times.
Atherosclerosis of the coronary arteries and is characterized by a variety of symptoms, depending on the severity of acute manifest coronary insufficiency or stenocardia, marked by the development of heart failure or myocardial infarction.Against the background of atherosclerosis occur all forms of CHD (coronary heart disease).
Atherosclerosis of the aorta in the majority of cases seen after sixty years.In the case of atherosclerotic lesions of the thoracic aorta of the patient concerned about the intense burning pain behind the breastbone, which is given in the upper part of the abdomen, back and neck.Against the background of stress and physical exertion pain intensifies.Painful symptoms may not subside for a few days (as opposed to angina), occasionally fainting, and seeking.In some cases the following symptoms may occur: swallowing disorders, fainting, dizziness, hoarseness.Atherosclerosis of the abdominal aorta is often observed constipation, bloating, abdominal pain.When atherosclerosis affects the aortic bifurcation, develops Leriche syndrome, which is characterized by symptoms such as ulcers toes, impotence, coldness of the lower extremities, intermittent claudication.And aneurysm rupture (separation) of the aorta are the most serious complications of aortic atherosclerosis.
renal artery atherosclerosis manifested by changes in urine and persistent high blood pressure.
Atherosclerosis mesenteric vessels is shown cutting sharp burning pain sensations in the abdomen, which appear during the meal, and then continue for two to three hours, defecation disorders and bloating.
peripheral arterial disease often manifests fatigue and weakness of the leg muscles, feeling them chilliness that is intermittent claudication (during walking pain in the limbs is forcing the patient to stay)
diagnosis of atherosclerosis
primary diagnosis of this disease is carried out a family physician orphysician during an annual checkup.Determined by body mass index, blood pressure measured, identified risk factors ( obesity , diabetes, hypertension).
In case of suspicion of atherosclerotic changes is consulted by specialists: vascular surgeon (in atherosclerosis of the aorta and / or blood vessels of the lower limbs), nephrology (in atherosclerosis of the renal arteries), neurologist (with cerebral arteriosclerosis), eye (with atherosclerosis fundus)and cardiology (coronary heart disease).
In order to clarify the extent of damage is shown to carry out additional instrumental examination: intravascular ultrasound, coronary angiography, angiography, ultrasound of the aorta and the heart, electrocardiography with exercise test, triplex and duplex scanning, MRI
Atherosclerosis - treatment
Treatment of atherosclerosis iscomplex, laborious and lengthy enough.For the patient, the most difficult test is mandatory refusal established for many years, habits and inclinations.The patient must abandon the usual food intake, change the common mode and power mode, constantly carried out by designated physician treatment to enhance motor activity and normalize living conditions and working conditions, to take timely measures to slow the progression of the disease.
is mandatory to get rid of a bad habit like smoking, because smokers vessels wear out much faster.It is also necessary to completely abandon the use of alcohol and strictly adhere antiatherosclerotic diet.
Drug treatment of atherosclerosis is the use of four groups lowering lipids (lipid lowering) medications: statins, niacin, fibrates, bile acid sequestrants.These drugs have on the atherosclerotic plaque stabilizing effect, improve the function of the inner lining (endothelium) of blood vessels and inhibit the development of atherosclerosis.
Surgical treatment of atherosclerosis is shown in the case of a threat of complications and is aimed at restoring patency of the arteries.When coronary artery disease to prevent the possible development of myocardial infarction or bypass surgery performed coronary stenting.To prevent the possible development of gangrene of the lower extremities prosthetics carried out of the main arteries.For the prevention of stroke (with cerebral atherosclerosis) performed carotid stenting.