Arteriosclerosis

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Arteriosclerosis
Blausen 0227 Cholesterol.png
Blood vessel-plaque and cholesterol
Specialty Pathology
CausesSmoking, High blood pressure [1]
Diagnostic method Blood test, EKG [1]
TreatmentTreatment of underlying condition [2]

Arteriosclerosis is the thickening, hardening, and loss of elasticity of the walls of arteries. [3] This process gradually restricts the blood flow to one's organs and tissues and can lead to severe health risks brought on by atherosclerosis, which is a specific form of arteriosclerosis caused by the buildup of fatty plaques, cholesterol, and some other substances in and on the artery walls. [4] It can be brought on by smoking, a bad diet, or many genetic factors. Atherosclerosis is the primary cause of coronary artery disease (CAD) and stroke, with multiple genetic and environmental contributions. Genetic-epidemiologic studies have identified a surprisingly long list of genetic and non-genetic risk factors for CAD. However, such studies indicate that family history is the most significant independent risk factor.[ citation needed ]

Contents

Signs and symptoms

The signs and symptoms of arteriosclerosis may include sudden weakness, facial or lower limb numbness, confusion, difficulty understanding speech, and problems seeing. [1]

Pathophysiology

Monckeberg's arteriosclerosis Moenckeberg.jpg
Monckeberg's arteriosclerosis

The lesions of arteriosclerosis begin as the intima (innermost layer of blood vessel wall) of the arterial wall start to fill up with the deposition of cellular wastes. As these start to mature, they can take different forms of arteriosclerosis. All are linked through common features such as the stiffening of arterial vessels, thickening of arterial walls and degenerative nature of the disease. [5] [6]

Diagnosis

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EKG

Diagnosis of an individual suspected of having arteriosclerosis can be based on a physical exam, blood test, EKG and the results of these tests (among other exams). [1]

Treatment

Treatment is often in the form of preventive measures of prophylaxis. Medical therapy is often prescribed to help prevent arteriosclerosis for underlying conditions, such as medications for the treatment of high cholesterol, medications to treat high blood pressure (e.g., ACE inhibitors), [2] and antiplatelet medications. Lifestyle changes are also advised, such as increasing exercise, stopping smoking, and moderating alcohol intake. [1]

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ACE inhibitor

There are a variety of types of surgery:

Epidemiology

In 2008, the US had an estimate of 16 million atherosclerotic heart disease and 5.8 million strokes. Cardiovascular diseases that were caused by arteriosclerosis also caused almost 812,000 deaths in 2008, more than any other cause, including cancer. About 1.2 million Americans are predicted to have a heart attack each year. [16]

History

The diagnostics and clinical implications of this disease were not recognized until the 20th century. Many cases have been observed and recorded, and Jean Lobstein coined the term arteriosclerosis while he was analyzing the composition of calcified arterial lesions. [17] The name comes from the Greek words ἀρτηρία (artēría, artery) and σκληρωτικός (sklērōtikós, hardened). [18]

Related Research Articles

Coronary artery disease artery disease characterized by plaque building up along the inner walls of the arteries of the heart resulting in a narrowing of the arteries and a reduced blood supply to the cardiac muscles

Coronary artery disease (CAD), also known as coronary heart disease (CHD) or ischemic heart disease (IHD), involves the reduction of blood flow to the heart muscle due to build-up of plaque in the arteries of the heart. It is the most common of the cardiovascular diseases. Types include stable angina, unstable angina, myocardial infarction, and sudden cardiac death. A common symptom is chest pain or discomfort which may travel into the shoulder, arm, back, neck, or jaw. Occasionally it may feel like heartburn. Usually symptoms occur with exercise or emotional stress, last less than a few minutes, and improve with rest. Shortness of breath may also occur and sometimes no symptoms are present. In many cases, the first sign is a heart attack. Other complications include heart failure or an abnormal heartbeat.

Atherosclerosis form of arteriosclerosis

Atherosclerosis is a disease in which the inside of an artery narrows due to the build up of plaque. Initially, there are generally no symptoms. When severe, it can result in coronary artery disease, stroke, peripheral artery disease, or kidney problems, depending on which arteries are affected. Symptoms, if they occur, generally do not begin until middle age.

Macrovascular disease is a disease of any large (macro) blood vessels in the body. It is a disease of the large blood vessels, including the coronary arteries, the aorta, and the sizable arteries in the brain and in the limbs.

Ischemia restriction in blood supply to tissues, causing a shortage of oxygen and glucose

Ischemia or ischaemia is a restriction in blood supply to tissues, causing a shortage of oxygen that is needed for cellular metabolism. Ischemia is generally caused by problems with blood vessels, with resultant damage to or dysfunction of tissue. It also means local anemia in a given part of a body sometimes resulting from constriction. Ischemia comprises not only insufficiency of oxygen, but also reduced availability of nutrients and inadequate removal of metabolic wastes. Ischemia can be partial or total.

Coronary arteries artery of the coronary circulation which transports blood into and out of the cardiac muscle

The coronary arteries are the blood vessels (arteries) of coronary circulation, which transports oxygenated blood to the substance of the heart. The heart requires a continuous supply of oxygen to function and survive, much like any other tissue or organ of the body.

Atheroma accumulation of degenerative material in the inner layer of artery walls

An atheroma, or atheromatous plaque ("plaque"), is an abnormal accumulation of material in the inner layer of the wall of an artery. The material consists of mostly macrophage cells, or debris, containing lipids, calcium and a variable amount of fibrous connective tissue. The accumulated material forms a swelling in the artery wall, which may intrude into the channel of the artery, narrowing it and restricting blood flow. Atheroma is the pathological basis for the disease entity atherosclerosis, a subtype of arteriosclerosis.

Intravascular ultrasound (IVUS) is a medical imaging methodology using a specially designed catheter with a miniaturized ultrasound probe attached to the distal end of the catheter. The proximal end of the catheter is attached to computerized ultrasound equipment. It allows the application of ultrasound technology, such as piezoelectric transducer or CMUT, to see from inside blood vessels out through the surrounding blood column, visualizing the endothelium of blood vessels in living individuals.

A vulnerable plaque is a kind of atheromatous plaque – a collection of white blood cells and lipids in the wall of an artery – that is particularly unstable and prone to produce sudden major problems such as a heart attack or stroke.

Arteriolosclerosis Human disease

Arteriolosclerosis is a form of cardiovascular disease involving hardening and loss of elasticity of arterioles or small arteries and is most often associated with hypertension and diabetes mellitus. Types include hyaline arteriolosclerosis and hyperplastic arteriolosclerosis, both involved with vessel wall thickening and luminal narrowing that may cause downstream ischemic injury. The following two terms whilst similar, are distinct in both spelling and meaning and may easily be confused with arteriolosclerosis.

A vascular bypass is a surgical procedure performed to redirect blood flow from one area to another by reconnecting blood vessels. Often, this is done to bypass around a diseased artery, from an area of normal blood flow to another relatively normal area. It is commonly performed due to inadequate blood flow (ischemia) caused by atherosclerosis, as a part of organ transplantation, or for vascular access in hemodialysis. In general, someone's own vein (autograft) is the preferred graft material for a vascular bypass, but other types of grafts such as polytetrafluoroethylene (Teflon), polyethylene terephthalate (Dacron), or a different person's vein (allograft) are also commonly used. Arteries can also serve as vascular grafts. A surgeon sews the graft to the source and target vessels by hand using surgical suture, creating a surgical anastomosis.

Vascular disease cardiovascular system disease that primarily affects the blood vessels

Vascular disease is a class of diseases of the blood vessels – the arteries and veins of the circulatory system of the body. It is a subgroup of cardiovascular disease. Disorders in this vast network of blood vessels, can cause a range of health problems which can be severe or prove fatal.

Tangier disease or hypoalphalipoproteinemia is an extremely rare inherited disorder characterized by a severe reduction in the amount of high density lipoprotein (HDL), often referred to as "good cholesterol", in the bloodstream. Worldwide, approximately 100 cases have even been identified.

Monckebergs arteriosclerosis Humans arterial pathology

Mönckeberg's arteriosclerosis, or Mönckeberg's sclerosis, is a form of arteriosclerosis or vessel hardening, where calcium deposits are found in the muscular middle layer of the walls of arteries. It is an example of dystrophic calcification. This condition occurs as an age-related degenerative process. However, it can occur in pseudoxanthoma elasticum and idiopathic arterial calcification of infancy as a pathological condition, as well. Its clinical significance and cause are not well understood and its relationship to atherosclerosis and other forms of vascular calcification are the subject of disagreement. Mönckeberg's arteriosclerosis is named after Johann Georg Mönckeberg, who first described it in 1903.

The following outline is provided as an overview of and topical guide to cardiology, the branch of medicine dealing with disorders of the human heart. The field includes medical diagnosis and treatment of congenital heart defects, coronary artery disease, heart failure, valvular heart disease and electrophysiology. Physicians who specialize in cardiology are called cardiologists.

Lipohyalinosis is a cerebral small vessel disease affecting the small arteries, arterioles or capillaries in the brain. Originally defined by C. Miller Fisher as 'segmental arteriolar wall disorganisation', it is characterized by vessel wall thickening and a resultant reduction in luminal diameter. Fisher considered this small vessel disease to be the result of hypertension, induced in the acute stage by fibrinoid necrosis that would lead to occlusion and hence lacunar stroke. However, recent evidence suggests that endothelial dysfunction as a result of inflammation is a more likely cause for it. This may occur subsequent to blood–brain barrier failure, and lead to extravasation of serum components into the brain that are potentially toxic. Lacunar infarction could thus occur in this way, and the narrowing – the hallmark feature of lipohyalinosis – may merely be a feature of the swelling occurring around it that squeezes on the structure.

Atherectomy endovascular procedure in which atheromatous plaque is excised by a cutting or rotating catheter

Atherectomy is a minimally invasive endovascular surgery technique for removing atherosclerosis from blood vessels within the body. It is an alternative to angioplasty for the treatment of peripheral artery disease, but the studies that exist are not adequate to determine if it is superior to angioplasty. It has also been used to treat coronary artery disease, albeit ineffectively.

Arterial embolism Interruption of blood flow to an organ

Arterial embolism is a sudden interruption of blood flow to an organ or body part due to an embolus adhering to the wall of an artery blocking the flow of blood, the major type of embolus being a blood clot (thromboembolism). Sometimes, pulmonary embolism is classified as arterial embolism as well, in the sense that the clot follows the pulmonary artery carrying deoxygenated blood away from the heart. However, pulmonary embolism is generally classified as a form of venous embolism, because the embolus forms in veins. Arterial embolism is the major cause of infarction.

Tracheobronchomalacia congenital disorder of respiratory system

Tracheobronchomalacia or TBM is a condition characterized by flaccidity of the tracheal support cartilage which leads to tracheal collapse. This condition can also affect the bronchi. There are two forms of this rare condition: primary TBM and secondary TBM. Primary TBM is congenital and starts as early as birth. It is mainly linked to genetic causes. Secondary TBM is acquired and starts in adulthood. It is mainly developed after an accident or chronic inflammation.

The BaleDoneen Method is a risk assessment and treatment protocol aimed at preventing heart attack and stroke. The method also seeks to prevent or reduce the effects of type 2 diabetes, technically known as diabetes mellitus type 2. The method was developed by Bradley Field Bale and Amy Doneen.

Blood vessel disorder generally refers to the narrowing, hardening or enlargement of arteries and veins. It is often due to the build-up of fatty deposits in the lumen of blood vessels or infection of the vessel wall. This can occur in various locations such as coronary blood vessels, peripheral arteries and veins. The narrowed arteries would block the blood supply to different organs and tissues. In severe conditions, it may develop into more critical health problems like myocardial infarction, stroke or heart failure, which are some of the major reasons of death.

References

  1. 1 2 3 4 5 "How Is Atherosclerosis Diagnosed? - NHLBI, NIH". www.nhlbi.nih.gov. Retrieved 2015-06-19.
  2. 1 2 "ACE inhibitors: MedlinePlus Medical Encyclopedia". www.nlm.nih.gov. Retrieved 2015-06-19.
  3. " arteriosclerosis " at Dorland's Medical Dictionary
  4. "Atherosclerosis". PubMed Health Glossary.
  5. Rubin, Raphael; Strayer, David S.; Rubin, Emanuel (2011-02-01). Rubin's Pathology: Clinicopathologic Foundations of Medicine. Lippincott Williams & Wilkins. ISBN   9781605479682.
  6. Insull, William (2009). "The Pathology of Atherosclerosis: Plaque Development and Plaque Responses to Medical Treatment". The American Journal of Medicine. 122 (1 Suppl): S3–S14. doi:10.1016/j.amjmed.2008.10.013. PMID   19110086.
  7. Diehm, C.; Allenberg, J.-R.; Nimura-Eckert, K.; Veith, F. J. (2013-11-11). Color Atlas of Vascular Diseases. Springer Science & Business Media. ISBN   9783662062876.
  8. "Atherosclerosis: MedlinePlus". www.nlm.nih.gov. Retrieved 2015-06-19.
  9. Mohan, Harsh (2012-11-30). Pathology Practical Book. JP Medical Ltd. ISBN   9789350902660.
  10. "hyperplastic arteriosclerosis" . Retrieved 2015-06-19.
  11. "hyaline arteriolosclerosis" . Retrieved 2015-06-19.
  12. "Angioplasty: MedlinePlus". www.nlm.nih.gov. Retrieved 2015-06-19.
  13. "Coronary artery bypass surgery". MedlinePlus.
  14. "Atherosclerosis -Treatment". UK NHS. Retrieved 21 November 2013.
  15. "Thrombolytic therapy: MedlinePlus Medical Encyclopedia". www.nlm.nih.gov. Retrieved 2015-06-19.
  16. "Atherosclerosis". Merck Manuals. Retrieved 13 February 2015.
  17. Mayerl, Christina; Lukasser, Melanie; Sedivy, Roland; Niederegger, Harald; Seiler, Ruediger; Wick, Georg (2006). "Atherosclerosis research from past to present—on the track of two pathologists with opposing views, Carl von Rokitansky and Rudolf Virchow". Virchows Archiv. 449 (1): 96–103. doi:10.1007/s00428-006-0176-7. PMID   16612625.
  18. Copstead-Kirkhorn, Lee-Ellen C.; Banasik, Jacquelyn L. (2014-06-25). Pathophysiology. Elsevier Health Sciences. p. 322. ISBN   9780323293174 . Retrieved 25 July 2016.

Further reading

Classification
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