Arteriosclerosis
All information about the causes, symptoms, complications, and treatments of artery hardening.
Symptoms and causes
Arteriosclerosis is the hardening of the arteries, which thicken and lose flexibility over time or due to damage to their inner walls. It is a serious condition that, if not treated properly, can put the patient’s life at risk.
There are different types of arteriosclerosis depending on the affected artery and the reasons for the damage:
- Atherosclerosis: being the most common, it is often referred to by the generic term arteriosclerosis. Medium and large arteries narrow due to the accumulation of atheromatous plaques (fat, cholesterol, lipids, connective tissue, and inflammatory cells), restricting blood flow.
- Arteriolosclerosis: the walls of small-caliber arteries thicken due to deposits of hyaline material (mainly proteins) or proliferation of muscle cells.
- Mönckeberg arteriosclerosis: calcium deposits form in the media layer of medium-caliber arteries, causing a loss of elasticity but not narrowing the lumen.
Arteriosclerosis can eventually block blood flow and compromise the function of vital organs. However, prognosis is usually good if detected early, lifestyle changes are made, and treatment is followed.
Symptoms
Symptoms of arteriosclerosis develop slowly, so the disease is often advanced when noticed. Some signs are actually complications resulting from progressive arterial deterioration. Symptoms vary depending on the type of arteriosclerosis:
- Atherosclerosis: decreased blood flow and resulting tissue hypoxia cause symptoms depending on the body area affected:
- Coronary atherosclerosis:
- Angina pectoris: chest pain radiating to the shoulders, arms, or jaw; shortness of breath; palpitations; fatigue; nausea due to partial artery blockage.
- Myocardial infarction: occurs when the artery is fully blocked. Symptoms are similar to angina.
- Heart failure: the heart cannot pump enough blood to meet the body’s needs.
- Cerebral arteriosclerosis:
- Transient cerebral ischemia: temporary interruption of blood flow to part of the brain, causing numbness, walking difficulties, and visual or speech problems.
- Stroke: persistent interruption as described above.
- Renal atherosclerosis:
- Renal failure: kidneys perform less than 15% of their normal function, causing fatigue, nausea, loss of appetite, and swelling of hands and feet.
- High blood pressure.
- Peripheral arteriosclerosis: mainly affects the legs.
- Muscle pain and cramps.
- Bluish skin color.
- Reduced nail and hair growth.
- Slow wound healing.
- Aortic atherosclerosis: can lead to aneurysms, abnormal artery bulging.
- Arteriolosclerosis: usually asymptomatic; manifests when affected organs begin to show dysfunction.
- Mönckeberg arteriosclerosis: asymptomatic, as calcifications do not narrow the artery.
Causes
Arteriosclerosis occurs when certain substances in the blood penetrate the arterial wall due to endothelial damage, which compromises its protective barrier function.
Risk Factors
Factors that increase the risk of endothelial damage and subsequent arteriosclerosis include:
- High blood pressure
- High cholesterol
- Obesity
- Smoking
- Advanced age
- Diabetes
- Sedentary lifestyle
- Genetic predisposition
Complications
The main complications of arteriosclerosis are diseases caused by arterial damage in various organs. As described in the symptoms section, the most frequent are:
- Heart attack
- Heart failure
- Stroke
- Renal failure
- Embolism: when an atheromatous plaque ruptures, it can form a clot that travels to other organs. If it reaches the lungs, it can be life-threatening.
Prevention
Preventing arteriosclerosis requires adopting healthy lifestyle habits, including:
- Eating a healthy diet rich in fruits, vegetables, and omega-3 fatty acids, avoiding saturated fats and refined sugars.
- Regular moderate exercise.
- Not smoking.
- Limiting alcohol intake.
- Controlling diabetes, high cholesterol, and hypertension.
- Managing stress.
Which doctor treats arteriosclerosis?
Arteriosclerosis is managed in the specialty of angiology and vascular surgery.
Diagnosis
Diagnosing arteriosclerosis can be challenging, as it may be asymptomatic or show symptoms only when advanced. Periodic check-ups, especially from age 40, are essential to monitor overall health. These exams usually include:
- Medical history: evaluating patient’s medical and family history, habits, and lifestyle.
- Vital signs monitoring: heart rate, respiratory rate, temperature, and blood pressure.
- Blood Tests: measures cholesterol, glucose, and triglycerides. If risk factors exist, C-reactive protein is assessed as a marker of arterial inflammation.
For patients suspected of having arteriosclerosis, more specific tests assess heart function and arterial health:
- Electrocardiogram: records electrical activity to check heart rhythm and rate.
- Ergometry: evaluates heart function during physical exertion.
- Echocardiography: examines blood flow through the heart and internal structures.
- Cardiac Catheterization: detects possible arterial obstructions.
- Ankle-brachial index: identifies peripheral artery disease by comparing blood pressure in the ankle and arm.
Treatment
Definitive treatment of arteriosclerosis involves clearing arterial obstructions and restoring adequate blood flow. Depending on the case, different techniques may be used:
- Coronary angioplasty: a catheter with a balloon at the tip is inserted and inflated in the blocked area, breaking the plaque against the vessel wall.
- Stent placement: similar to angioplasty, but the balloon includes a metal mesh that keeps the artery open permanently. These devices can be absorbable or permanent, and sometimes release medication gradually to limit arterial tissue growth.
Arteriosclerosis may recur if these treatments are not accompanied by lifestyle changes.
