By Thomas Ciarlo

• Atherosclerosis derives from the Greek words athero (gruel or paste) and sclerosis (hardness).

• Atherosclerosis refers to the process in which deposits of fatty substances, cellular waste, calcium, cholesterol and other substances build up and harden in the endothelium (inner lining) of an artery.

• Healthy arteries are strong, flexible and are able to carry blood with oxygen and nutrients from the heart to the rest of the body. • Atherosclerotic arteries can grow large plaques, which reduce blood flow through the vessel and have the potential to rupture and send blood clots throughout the body.

• Atherosclerosis is a slow, complex disease that starts early in childhood and progresses throughout life. Doctors believe that atherosclerosis begins with damage to the endothelium of an artery.

• However, the exact cause of atherosclerosis is unknown.

• Advanced age • Male sex • Having diabetes • Dyslipidemia (elevated serum cholesterol or triglyceride levels) • Tobacco smoking • Having high blood pressure • Being obese • A sedentary life-style • Having close relatives who have had some complication of atherosclerosis • Elevated serum levels of homocysteine • Stress or symptoms of clinical depression • Chronic sub-clinical scurvy (vitamin C deficiency)

• Atherosclerosis begins in childhood and is often found in most major arteries, but it is usually asymptomatic (shows no symptoms) until blood flow through the vessel has become seriously compromised.

• Atherosclerosis can affect arteries anywhere in the body, but the most often arteries affected are in the heart, kidneys, brain, abdominal aorta and legs.

•There are specific signs and symptoms which depend on the specific artery being obstructed. •For instance atherosclerosis becomes prominently symptomatic when it interferes with coronary circulation of arteries supplying the heart. Such symptoms are of a heart attack, which includes angina (chest pain), discomfort, and weakness.

Atherosclerosis in the carotid artery •If the obstruction is of the carotid arteries of the neck, then the symptoms may be that of a stroke which includes sudden numbness, weakness, and dizziness.

• Tests that indicate atherosclerosis include; Doppler studies of the affected area, ultrasonic duplex scanning, CT scan of the affected area, magnetic resonance arteriography, arteriography of the affected area, intravascular ultrasound of the affected vessels, and cardiac stress testing. •Atherosclerosis may also be detected by a bruit (whooshing or blowing) sound heard when a stethoscope is placed over the affected artery. The area affected may also have a decreased pulse.

• Atherosclerosis is best treated by prevention through simple “lifestyle changes”. However, there are medications and surgeries that can also slow down or reverse the effects of atherosclerosis.

• First there are cholesterol-lowering drugs that lower the amount of low-density lipoprotein (LDL), such as statins and fibrates, which can slow, stop, or even reverse the build up of plaques. • Second are anti-platelet medications, such as aspirin, which reduce the probability of platelets clotting in an artery causing further blockage.

• Anticoagulants such as heparin may be prescribed to thin the blood, which may help prevent blood clots. • Lastly blood vessel dilators, such as prostaglandins, may be prescribed to prevent the muscles within an artery from tightening and narrowing the lumen .

• If a patient presents with severe symptoms of a blockage that may threaten the survival of the muscle or tissue, then surgery might be and option. •First is an angioplasty, which is when a doctor inserts a catheter into the blocked or narrowed artery and a wire with a deflated balloon on it is passed though the catheter to the part of the vessel that is narrowed or blocked. Then the balloon is inflated and the plaque gets squished against the vessel’s walls. The doctor may then choose to leave a stent (mesh tube) in the artery to keep it open.

• Endarterectomy is another surgery in which the doctor will make an incision into the diseased artery and remove plaques off the walls, then close the artery. • Vascular surgery is when the doctor creates a bypass around the blockage using a synthetic vessel or a vessel from another part of the body. •Lastly thrombolytic therapy may be used. This is when the doctor inserts a catheter delivers clot dissolving thrombolytic agents directly to the site of the clot.

• The primary way to treat atherosclerosis is by reducing the risk factors though simple lifestyle changes. Doctors often recommend proper daily exercise to use oxygen efficiently, and improve circulation. Smoking contributes to damaged arteries, so quitting smoking will reduce the progression of plaque build up. Keeping cholesterol, blood pressure, diabetes, and stress under control by eating a healthy will greatly reduce the likeliness of atherosclerosis.

• Atherosclerosis is a disease that affects millions of people every year. It is the number one cause of heart attacks and results in the death of thousands of people everyday. Atherosclerosis is not completely preventable, but there are many risk factors that can be easily eliminated.

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