Management of Atherosclerosis

Symptoms and Treatment

Atherosclerosis is an arterial disease, characterized by narrowing and hardening of the arteries that carry oxygen-rich blood to the heart and other parts of the body. This impedes blood flow leading to ischemia, chest pain, heart attack, and wounds that appear to refuse to heal. Tissues begin to die when they are denied the blood flow carrying oxygen and nutrients that nourishes them.

What Causes it?

Atherosclerosis is caused by plaque that deposits in the arteries over a period of time, in the presence of high cholesterol and triglyceride levels in the blood. As fatty deposits form and increase, the artery is narrowed interrupting blood flow to the heart. Cracks begin to appear on the plaque, to which blood cells and other debris stick to it causing a blood clot to form. The blood clot grows in size and eventually totally occludes the artery preventing blood flow from reaching it's intended destination. This leads to chest pain and heart attack, or myocardial infarction (MI). The blood clot can also break away resulting in a thrombus that can lodge in a major organ such as the brain. This can result in a stroke because the blood clot halted the flow of blood to an area of the brain.

Symptoms of Atherosclerosis:

Symptoms occur depending on the area of the body that is affected. In the coronary arteries, atherosclerosis affects the arteries that feed the heart. You may feel chest pain or pressure (angina) or a heart attack.

Intracranial atherosclerosis affects arteries feeding the brain. This can lead to a transient ischemic attack (a temporaryblockage that does not cause damage) or a thrombotic stroke (a stroke caused by a clot, also called a thrombus).

Peripheral Artery Disease (PAD) involves the arteries in the legs, resulting in leg pain on ambulation, and wounds that are slow to heal.

Atherosclerosis of bowel arteries can cause cramping sensations after eating. Severe abdominal pain results from acomplete blockage causing death of the bowel tissue.

Diagnosis:

If you experience any of the above symptoms, consult your physician. Your doctor will perform a physical examination and get a medical history. Be truthful about the use of tobacco, alcohol, current medications, diet, exercise, and anysymptoms you may be experiencing.

Blood tests can determine blood lipid levels (cholesterol and triglycerides). Other tests depend on the location of symptoms. An electrocardiogram or an echocardiogram, usually with a stress test, can reveal poor circulation to the heart.

A Doppler ultrasound measures blood flow through the legs. Comparing blood pressure between the arm and leg can also reveal blood flow problems. Other tests can present an image of plaques and calcium deposits.

Treatment:

Atherosclerosis can not be cured, but is manageable and preventable with proper monitoring and treatment. The best you can do for yourself is prevention. It will be necessary to make healthy lifestyle changes for improved quality of life.

• Regular exercise - Walking is great!


• Control your blood pressure


• Control serum cholesterol and triglyceride levels


• Do NOT smoke


• Eat a heart healthy diet of fresh fruits and veggies, low fat foods, and lean meats

In the mild stages of this disease, lifestyle changes can slow its progression and help to avoid or delay more advancedtreatment. Once symptoms worsen, other treatments may be necessary:

Balloon Angioplasty involves inserting a thin tube into the femoral artery in the groin, or the arm can be used, with aballoon on the end, into the artery. The balloon is inflated which pushes the plaque against the wall of the artery. Oftena stent (a mesh tube) is inserted at the same time to keep the artery open preventing re-occlusion.

Your doctor can surgically remove plaque by performing an endarterectomy.

Thrombolytic medications can break up blood clots and restore blood flow to the affected area. Anti-platelet and anti-coagulant medications help keep the blood flowing and prevent clot formation by thinning the blood.

Atherosclerosis is a chronic health condition, meaning you will have it for the rest of your life. Take the time to educate yourself and work in concordance with your doctor to devise a treatment plan that fits your individual needs. In addition to this, your doctor, the National Heart Association, and the National Stroke Association are great points of reference for up to date information on vascular health.

by Barb Hicks, RN/LMT