Medical Management of Atherosclerosis Vascular Disease

Treatment of atherosclerosis
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Atherosclerosis disease occurs when the arteries that carry oxygen and nutrients from the heart to the rest of the body become thick and stiff, sometimes blocking flow to tissues and organs.

Normally vessels are flexible, however, over time the walls of the arteries may also harden, an ailment commonly referred to as atherosclerosis disease.

Atherosclerosis disease is a type of hardening of the arteries due to the buildup of fat, cholesterol, and other materials in and on the walls of your arteries.

These build-ups are referred to as plaque.

Plaque can narrow the arteries and block flow.

Plaque may also break off, causing a clot.

Although atherosclerosis disease is usually a cardiac problem, it may affect arteries anywhere in the.

Healthy lifestyle habits can help prevent atherosclerosis disease.

What is Atherosclerosis?

Atherosclerosis disease is a gradual process in which substances containing fatty acids and cholesterol accumulate on the vessel wall, which leads to a narrowing of the artery and may even block it completely.

Atherosclerosis disease is a disorder as a result of the development of layers of fatty deposits on the inner walls of the arteries.

The process is called calcification, because when examining a vessel like this, we find a hardened substance, sometimes close to white, called calc, where the development of these deposits or plaque leads to narrowing and slow blockage of flow in the vessels, and this disorder usually influences large or medium vessels.

How common is atherosclerosis?

Atherosclerosis disease is a common problem, especially with the elderly, and also some things such as diet, exercise, and genetics can contribute to the formation of it.

It usually forms over time, and its rate increases with some conditions such as smoking, high pressure, and diabetes.

What are types of atherosclerosis?

Arterial stenosis may affect many arterial walls, including the arteries of the heart, arms, legs, pelvis, and kidneys, each with a name according to the affected vessels:

  • Coronary Artery Disease: It is the buildup of plaque and hardening of the arteries of the heart.
  • Peripheral arterial disease is the buildup of plaque in the legs, but plaque can also build up in the arms or pelvis.
  • Carotid artery disease is the buildup of plaque in the arteries of the neck, such plaque reduces flow to the brain.
  • Renal artery stenosis is the buildup of plaque in the vessels that supply the kidneys.
  • Vertebral artery disease is a hardening of the arteries that supply blood to the back of the brain.
  • Mesenteric artery ischemia is the accumulation of plaque in the arteries that supply blood to the intestines.

What are risk factors of atherosclerosis?

Risk factors that can be controlled or avoided include:

  • Smoking cigarettes.
  • High cholesterol levels.
  • Hypertension.
  • Diabetic.
  • Weight gain, especially in the abdominal region.
  • Not doing exercise.
  • Eating too much saturated fats, such as butter, and not eating enough fruits and vegetables.

Here are some important risk factors that cannot be avoided:

  • Having close relatives with atherosclerosis disease.
  • Being male.
  • Age.

How atherosclerosis develops?

Atherosclerosis disease in a complex manner, but the main event appears to be recurrent insidious damage to the inner lining of the artery endothelium, through various mechanisms

These mechanisms are:

  • Physical distress due to disturbed flow (4 such as at the sites where branching, especially in people with high blood pressure).
  • Inflammatory severity of the immune system (as occurs in cigarette smokers).
  • Chemical abnormalities in the bloodstream (such as high cholesterol levels or high glucose, as occurs in diabetes).
  • Infection with certain bacteria or viruses (such as Chlamydia pneumonia or cytomegalovirus) may increase inflammation in the inner lining of the vessel and also lead to atherosclerosis disease.

Atherosclerosis disease begins when a diseased vessel wall releases chemical signals that cause certain types of white cells (monocytes and T cells) to stick to the vessel wall.

These cells enter the artery wall, where they turn into foam cells that collect cholesterol and other fatty substances.

It stimulates the growth of smooth muscle cells in the artery wall.

Over time, these foamy, fat-laden cells build up and form macular deposits (atheromas, also called plaque) with a fibrous covering in the lining of the vessel wall.

Over time, calcium builds up in plaque.

Medium and large, but they usually begin where the arteries branch.

Complication of atherosclerosis

What are causes of atherosclerosis disease?

Many reasons lead to atherosclerosis disease, and we will discuss through the following lines about the most common of these causes, as follows:

What are complications of atherosclerosis disease?

  1. Artery blockage in the brain or heart due to blood clots and thrombosis may result in a brain attack (aneurysm) or myocardial infarction (heart attack).
  2. Chronic kidney disease can occur as a consequence of the narrowing of arteries in the kidneys caused by high blood pressure and arterial stiffness.
  3. Disruptions in heart rhythms (arrhythmia) and heart failure may be induced by artery blockage leading to inadequate pressure or reduced blood flow to the heart muscle.
  4. Peripheral artery disease, which affects blood flow to the limbs and manifests in symptoms such as leg pain and weakness, can arise from the narrowing of arteries supplying blood to the limbs.

What are symptoms of atherosclerosis disease?

Atherosclerosis disease often does not cause any symptoms until the artery becomes very narrow or completely blocked. Many people do not know they have atherosclerosis until after a medical emergency such as a heart attack or stroke.

It can take many years for plaque to build up and cause narrowing and blockage in the artery by this plaque.

Symptoms of moderate to severe atherosclerosis disease depend on which arteries are affected, and include:

A. Symptoms of atherosclerosis disease of the carotid arteries (brain arteries):

The carotid vessels provide blood flow to the brain.

Blockage of these vessels may lead to a stroke, which requires immediate medical attention. Symptoms of the disease include:

  • Weakness in the arms or legs.
  • Difficult breathing.
  • Difficulty speaking.
  • Recurrent fainting (diagnosed by a tilt table test).
  • Headache.
  • Numbness (tingling) or pain in the face.
  • Difficulty or temporary loss of vision in one eye.
  • Facial muscles droop.
  • Paralysis.

If the patient is elderly, he may also suffer from sudden personality and behavioral changes, such as:

  • Carelessness.
  • Crying.
  • Transient disorder.

B. Symptoms of coronary atherosclerosis disease:

Coronary arteries supply blood to the heart, and when blood flow to the heart is reduced, it may cause angina and heart attacks, which may be accompanied by symptoms such as:

Pain in chest.


Extreme anxiety.


C. Symptoms of renal atherosclerosis:

Renal arteries are the vessels that supply blood to the kidneys.

If blood flow to the kidneys is reduced, this may lead to many chronic kidney diseases and kidney failure, symptoms of which include:

  • Anorexia.
  • Swelling of hands and feet.
  • Difficulty concentrating.

D.Symptoms of blocked peripheral vessels:

These arteries supply blood to the arms, legs, and pelvis.

If blood does not reach these areas adequately, a person may experience symptoms such as:

  • Numbness and pain in the extremities.
  • Difficulty doing any physical activity.
  • Numbness or weakness in the leg.
  • Slow growth of toenails.
  • Change in color of legs.
  • Erectile dysfunction in men.
  • Coldness in the lower leg or foot, especially when compared to the other leg.
  • Non-healing ulcers on the toes or on the feet themselves or legs.
  • Loss or slow growth of hair on the feet or legs.
  • No or weak pulse in the legs or feet (shown on a Doppler scan).
  • Painful cramps in one of the hips, thighs, or leg muscles after certain physical activities such as walking or climbing stairs.
  • Feeling pain when using the arms in activities such as knitting, writing, or other manual tasks.

In severe cases, tissue death and gangrene may occur.

Peripheral arteriosclerosis also increases the risk of strokes and heart attacks.

How to diagnose atherosclerosis?

The doctor performs a physical exam and listens to the sounds of the heart and lungs through a stethoscope.

Some distinct sounds (a bruising sound over narrowed arteries) may help the doctor diagnose atherosclerosis.

Conducting blood cholesterol level tests starting at the age of 35 for men, and 45 for women.

Some tests help detect problems with blood flow in the vessels, such as:

  • Doppler tests, surface waves, and ultrasound.
  • Magnetic resonance of the arteries.
  • CT scan and X-ray of arteries.

What is the treatment of atherosclerosis?

Treatment of atherosclerotic disease can be conservative or surgical.

Conservative treatment is unable to eliminate the manifestations of atherosclerosis and the formation of plaque.

Its objectives:

  • Slowing the progression of the disease.
  • Prevention of blood clots.
  • Preventing acute cardiovascular conditions.
  • Maintaining the function of target organs.
  • Reducing the symptoms of the disease to improve the patient’s quality of life

With significant obstruction of the vessel lumen, which is accompanied by a severe violation of the patient’s quality of life, the risk of cardiovascular events (heart attack, stroke, aneurysmal aortic rupture) increases and requires surgical treatment.

It can be done in different ways depending on:

  • Localization of the damaged vessel.
  • Length of atherosclerotic changes in the arteries.
  • The patient’s condition and financial capabilities.
  • Equipment and staff present in the hospital.
  • In coronary atherosclerosis disease, the most common operations are stent placement (dilating the vessel by inserting a screw into the lumen) and coronary artery bypass graft surgery (creating a bypass blood flow to normalize the blood supply to the heart muscle).

But other techniques are also used. For example:

  • Atherotomy – removal of a blood clot from an artery.
  • Laser myocardial revascularization.

There are also innovative trends in non-surgical treatment of atherosclerosis disease of different localizations, for example:

  • Shock wave therapy.
  • Quantitative therapy.
  • Strengthening the external pulse.
  • Using stem cells to restore damaged organs.


Atherosclerosis disease is a disorder that may be serious and life-threatening if not treated quickly and efficiently by the right surgeon so knowing the symptoms of this disease is a very important thing to seek medical advice when feeling any of them.