What is Atherosclerosis?

Atherosclerosis (atherosclerotic heart disease) is a heart condition that develops as plaque – fat, cholesterol and other cellular waste – builds up inside your blood vessels, causing them to grow thick and stiff. This gradual process often restricts the flow of oxygenated blood and nutrients to organs and tissues. 

Atherosclerosis symptoms may go undetected in mild cases. But as plaque continues to weaken arteries, blood clots can form. Blood clots can block arteries in the chest, brain, arms, legs and kidneys. 

There is reason to be concerned if you develop atherosclerosis because it can cause heart disease, strokes, circulation problems in arms and legs including in gangrene in rare cases, aneurysms (enlargements of weakened artery walls) that can cause life-threatening internal bleeding and chronic kidney disease.

Baptist Health is known for advanced, superior care for patients with heart disease and the diagnosis, management and treatment of atherosclerosis. You will appreciate timely appointments and a professional, friendly atmosphere where we take time to listen to your concerns. At Baptist Health, you have access to the region’s most comprehensive, multidisciplinary team of specialists and innovative therapies, including many available only through specialized clinical trials. In every way, we work to demonstrate the utmost in excellent care to those who trust us with their health

Signs and Symptoms

Atherosclerosis symptoms can occur in various organs of your body, but mild cases may go undetected. As the condition worsens, affected arteries may cause you to experience different types of moderate to severe atherosclerosis symptoms including:

Arteries in the heart: 

• Chest pain or pressure (angina)

Arteries leading to the brain: 

• Sudden arm or leg weakness or numbness
• Slurred speech or difficulty speaking
• Brief loss of vision in one eye
• Drooping facial muscles

Arteries in the arms and legs:

• Pain when walking

Arteries leading to kidneys: 

These atherosclerosis signs and symptoms may indicate you had a transient ischemic attack (TIA). If left untreated, you may experience a stroke.

• High blood pressure
• Kidney failure

Diagnosis

Early diagnosis is critical for managing atherosclerosis. To diagnose atherosclerosis, we ask questions about your medical history and do a physical exam. During the physical exam, your physician can use a stethoscope to listen to your arteries for an abnormal whooshing sound called a bruit (broo-E). A bruit may indicate poor blood flow due to plaque buildup.

We then use advanced diagnostic procedures and technology to effectively diagnose, inform treatment and carefully monitor the condition. Common diagnostic and atherosclerosis testing procedures can include:

• Angiogram: A thin tube (catheter) is inserted into a blood vessel and dye is injected to make the blood vessel visible during an X-ray. This can show any blood clots or other blood vessel issues. 
• Blood test: Blood tests check the levels of certain fats, cholesterol, sugar and protein in the blood that could indicate heart conditions.
• CT scan: X-rays and computers are used to create images of the aorta, heart and blood vessels. This provides a more detailed picture than an ultrasound. 
• Electrocardiogram (EKG): This test measures the electrical activity of the heart and can help determine if parts of the heart are enlarged, overworked or damaged. The heart’s electrical currents are detected by 12 to 15 electrodes that are attached to the arms, legs and chest via sticky tape.
• Stress testing: This test is conducted during exercise. If a person can't exercise, medicine is given to increase heart rate. Used along with an EKG, the test can show changes to the heart’s rate, rhythm or electrical activity as well as blood pressure. Exercise makes the heart work hard and beat fast while heart tests are administered.
• Magnetic resonance angiogram (MRA): A large magnet, radio waves and a computer can produce pictures of specific blood vessels (veins and arteries).
• Ultrasound: An ultrasound device can measure blood pressure on various points of your arm or leg, which will help the physician determine if you have any blockages and how quickly blood flows through your arteries.

Causes

A number of factors contribute to atherosclerosis. Atherosclerosis causes include:

• High cholesterol
• High triglycerides, a fat in your blood
• High blood pressure
• Inflammation from infections, lupus, arthritis or an unknown cause
• Insulin resistance or diabetes
• Obesity
• Smoking or use of other tobacco products

Risk Factors

Atherosclerosis risk factors include:

Family history: People with a family history of atherosclerosis can develop the condition, even at a young age, and are at higher risk of developing blood clots that can rupture.

Prevention

While the risk factor of heredity cannot be controlled, there are ways you can help to possibly reverse or prevent atherosclerosis:

Practice good heart health: Watch what you eat, exercise and avoid smoking

Take your medications as prescribed: If you have high blood pressure, high cholesterol or diabetes, be certain to take your prescribed medications as directed.

Prognosis

Atherosclerosis prognosis is good when a blocked artery is treated early with healthy life-style changes, medicines or medical procedures.

Treatment and Recovery

Atherosclerosis treatment can reduce the size of blood clots and keep others from forming. A healthy diet, exercise and medication may control or reverse your condition. Once a blocked artery has been diagnosed, our goal is to develop an individualized plan to treat it so it will not develop to a dangerous level and rupture. Depending on your conditions, atherosclerosis treatment can include:

Medication

Medications for treating atherosclerosis are prescribed based on the location of your blocked artery and other underlying conditions you may have: 

• Cholesterol medications can protect your heart arteries. 
• Aspirin can prevent platelets from forming blood clots. 
• Beta blocker medications can reduce your blood pressure and heart rate and diminish chest pains, the risk of heart attack and irregular heart rhythm. 
• Angiotensin-converting enzyme (ACE) inhibitors can lower blood pressure and lower the possibility of having another heart attack.
• Calcium channel blockers and diuretics (water pills) can reduce blood pressure. 
• A clot-busting drug may dissolve blood clots. Your physician may also prescribe other medications, based on your needs. It is imperative your blood pressure be monitored and medications be taken daily as prescribed to lower the possibility of complications. 

Procedures

Sometimes minimally invasive procedures can be done to help correct atherosclerosis. Those atherosclerosis procedures can include:

• Percutaneous coronary intervention (PCI): This procedure, commonly known as coronary angioplasty, can open a blocked artery, improve blood flow and reduce the risk of rhythm problems. During this procedure, the doctor places a small catheter in your arm or groin, and threads a thin tube through the blood vessel to your heart. This tube may first be used to inject dye to get a clearer picture of any plaque buildup or blockages. Once a buildup or blockage is identified, a wire with a tiny balloon attached is sent through the tube and into the blockage, where the balloon is inflated. This stretches the artery and pushes the plaque to the side, helping restore blood flow. In many cases, a mesh tube or stent is then placed in the previously blocked area to ensure the artery stays open.

Surgery

Atherosclerosis surgery is sometimes the best option. Severe symptoms or a blocked artery may call for surgery including:

• Carotid endarterectomy: This surgery removes plaque from a blocked neck artery, which helps blood flow more freely to the brain and reduces the chance of stroke. 
• Coronary artery bypass grafting (CABG): This surgery improves blood flow to your heart by creating a bypass around your narrowed coronary arteries using arteries or veins taken from other parts of your body. 

Recovery After Surgery

Depending on how your body heals, you will be in the hospital for one to three days after a carotid endarterectomy and should feel fully recovered in two to three weeks. After CABG surgery, you will be in the hospital for four to seven days and full recovery may take six to 12 weeks.

Complications of Atherosclerosis

If atherosclerosis is not diagnosed and treated, it could cause serious health problems and complications, including: 

• Coronary artery disease: Narrowed arteries near the heart may lead to chest pain, heart attack or heart failure.
• Peripheral artery disease: Narrowed arteries in your arms or legs may cause circulation problems that make you less sensitive to heat and cold, and can cause gangrene, when tissue dies.
• Carotid artery disease: Narrowed arteries near the brain may cause transient ischemic attack (TIA) or stroke.
• Aneurysms: A bulge in the wall of an artery, if it bursts, can cause a slow leak or life-threatening internal bleeding.
• Chronic kidney disease: Narrow arteries near the kidneys prevents effective kidney function because your lack of blood flow keeps waste from exiting the body.