Atherosclerosis

Atherosclerosis is a hardening and narrowing of your arteries caused by cholesterol plaques lining the artery over time. It can put blood flow at risk as your arteries become blocked.

Causes

Atherosclerosis begins with damage to the endothelium. Common causes include:

  • High cholesterol

  • High blood pressure

  • Inflammation, like from arthritis or lupus

  • Obesity or diabetes

  • Smoking

Symptoms

  • Arrhythmia, an unusual heartbeat

  • Pain or pressure in your upper body, including your chest, arms, neck, or jaw. This is known as angina.

  • Shortness of breath

  • Numbness or weakness in your arms or legs

  • A hard time speaking or understanding someone who’s talking

  • Drooping facial muscles

  • Paralysis

  • Severe headache

  • Trouble seeing in one or both eyes

  • Leg pain when walking

  • Numbness

Risk factors

  • Abdominal obesity

  • Diabetes

  • High alcohol intake (more than one drink for women, one or two drinks for men, per day)

  • High blood pressure

  • High cholesterol

  • Not eating fruits and vegetables

  • Not exercising regularly

  • Smoking

  • Stress

Diagnosis

  • Angiogram, in which your doctor puts dye into your arteries so they’ll be visible on an X-ray

  • Ankle-brachial index, a test to compare blood pressures in your lower leg and arm

  • Blood tests to look for things that raise your risk of having atherosclerosis, like high cholesterol or blood sugar

  • CT scan or magnetic resonance angiography (MRA) to look for hardened or narrowed arteries

  • EKG, a record of your heart’s electrical activity

  • Stress test, in which you exercise while health care professionals watch your heart rate, blood pressure, and breathing

Treatment

Medication

Drugs for high cholesterol and high blood pressure will slow and may even halt atherosclerosis. They lower your risk of heart attack and stroke.

Your doctor can use more invasive techniques to open blockages from atherosclerosis or go around them:

Angiography and stenting

Your doctor puts a thin tube into an artery in your leg or arm to get to diseased arteries. Blockages are visible on a live X-ray screen. Angioplasty (using a catheter with a balloon tip) and stenting can often open a blocked artery. Stenting helps ease symptoms, but it does not prevent heart attacks.

Bypass surgery

Your doctor takes a healthy blood vessel, often from your leg or chest, and uses it to go around a blocked segment.

Endarterectomy

Your doctor goes into the arteries in your neck to remove plaque and restore blood flow. They also may place a stent higher risk patients.

Fibrinolytic therapy

A drug dissolves a blood clot that’s blocking your artery.

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