Atherosclerosis

Introduction

• Atherosclerosis is a condition characterized by the buildup of plaques made of fat, cholesterol, and other substances in the arteries, leading to narrowed and hardened arteries.

Picture representation of Atherosclerosis

Types

1. Coronary Artery Disease (CAD): Affects the arteries supplying blood to the heart.

2. Carotid Artery Disease: Affects the arteries supplying blood to the brain.

3. Peripheral Artery Disease (PAD): Affects the arteries supplying blood to the limbs.

4. Renal Artery Stenosis: Affects the arteries supplying blood to the kidneys.

Etiology

1. High Cholesterol: Elevated levels of LDL cholesterol contribute to plaque formation.

2. Hypertension: High blood pressure damages the inner lining of arteries.

3. Smoking: Damages the endothelium (inner lining) of arteries.

4. Diabetes: High blood sugar levels increase the risk of plaque buildup.

5. Inflammation: Chronic inflammation can accelerate plaque development.

Pathogenesis of Atherosclerosis

Mechanism of Atherosclerosis

1. Endothelial Injury: Damage to the inner lining of arteries initiates the process.

2. Lipid Accumulation: Low-density lipoprotein (LDL) cholesterol infiltrates the arterial wall.

3. Inflammation: Immune response to lipid deposits leads to chronic inflammation.

4. Plaque Formation: Smooth muscle cells and extracellular matrix proliferate, forming fibrous plaques.

Signs and Symptoms

1. Asymptomatic: Often no symptoms until arteries are significantly narrowed or blocked.

2. Coronary Artery Disease: Chest pain (angina) or heart attack.

3. Carotid Artery Disease: Stroke or transient ischemic attack (TIA).

4. Peripheral Artery Disease: Leg pain (claudication) during walking.

5. Renal Artery Stenosis: Hypertension and kidney dysfunction.

Management and Treatment

1. Lifestyle Changes:

• Healthy diet

• Regular exercise

• Smoking cessation

• Blood pressure and diabetes management

2. Medications:

• Statins: Lower cholesterol levels.

• Antiplatelet Agents: Prevent blood clots.

• Antihypertensives: Control blood pressure.

• Diabetes Medications: Manage blood sugar levels.

3. Medical Procedures:

• Angioplasty and Stenting: Open narrowed arteries.

• Endarterectomy: Surgical removal of plaque.

• Bypass Surgery: Create new pathways for blood flow.