Atherosclerosis: Symptoms and Treatment
Atherosclerosis is a fairly common chronic disease characterized by its own progression. Atherosclerosis, the symptoms of which appear against the background of the lesions of the middle and large arteries due to the accumulation of cholesterol in them (which determines the cause of this disease), causes blood circulation disorders and a number of serious risks, this violation of the provoked.
Atherosclerosis, atherosclerotic plaques form on the walls of the vessels (their basis is formed by fat deposits in combination with a proliferating connective tissue). Because of these plaques, there is a narrowing of the vessels and their subsequent deformation. These changes, in turn, lead to a violation of blood circulation, as well as to damage to internal organs. In general, large arteries are subject to this lesion.
Let’s take a closer look at the picture of this disease. First of all, we note that the occurrence and subsequent formation of atherosclerosis depends on the following factors:
- condition in which the vascular walls are located;
- the relevance of the genetic inheritance factor
- violations in fat (lipid) metabolism.
The initially noted cholesterol refers to fats, it provides a number of different functions in our body. In other words, it can be considered as a building material used in cell walls. In addition, cholesterol is a constituent of vitamins and hormones, due to which an adequate vital activity of the body is provided. Cholesterol is synthesized approximately by 70% of its total amount in the liver, the remaining part of it enters the body through food.
Note that cholesterol in the body is not in a free state, it is included in the specific complex compounds of fats and protein — lipoproteins. Lipoproteins, in turn, provide the possibility of its transfer from the liver to the tissues through the bloodstream. If the cholesterol in the body is in excess, then from the tissues it is sent to the liver, and it is here that the excess amount of it is utilized. The disruption of the functioning of this mechanism leads to the development of the disease we are considering, that is, atherosclerosis.
In the development of atherosclerosis, the main role is assigned to lipoproteins, which have a low density, in the abbreviated form it is LDL. At their expense, cholesterol is transported from the liver to the cells, with a certain amount of it being transported, otherwise exceeding the level determines a serious risk for the possible development of atherosclerosis against this background.
As for the return transport from tissues to the liver of cholesterol, it is provided already by high-density lipoproteins, which in the abbreviated form defines them as HDL, a separate class of anti-atherogenic lipoproteins. They provide purification of the surface layer of cells from excess cholesterol. The risk of developing atherosclerosis occurs with a lowered level of HDL cholesterol and with an elevated LDL level.
Let us dwell on the age-related features of atherosclerosis. Thus, it can be noted that the initial type of changes within the walls of the arteries (their average and large caliber) are already observed at a young age. Subsequently, their evolution takes place, in which they are transformed into fibro-adenomatous plaques, they, in turn, often develop at the age after 40 years. This atherosclerotic vascular lesion is relevant in approximately 17% of cases in patients under the age of 20, in 60% under the age of 40, in 85% at the age of 50 and older.
In the future, the picture of the disease is as follows. The arterial wall undergoes penetration into its basis of fibrin, cholesterol and a number of substances, due to which the atherosclerotic plaque is formed. Being in excess amount, cholesterol, when it comes to appropriate exposure, causes plaque enlargement in size, which causes an obstacle to adequate blood flow through the vessels in the area of the constricted narrowing. Inflow of blood on this background decreases, inflammation develops. Clots are also formed, they can later come off, thereby determining a significant danger to the vessels that are vitally important in our body. This is due to the possibility of their blockage, because of which, in turn, the organs will be deprived of the required blood supply.
Causes of atherosclerosis
The causes of atherosclerosis can be very different, they are also equated with risk factors for atherosclerosis, which indicates that compliance with these factors increases the risk of possible development in patients with atherosclerosis. In general, such risk factors can be divided into two main groups, depending on the nature of the impact on them by the patient. Thus, the causes of the development of atherosclerosis can be changeable and unchangeable (modifiable and not modifiable).
Unchangeable (not modifiable) reasons, as you can define already from their name, can not be changed by some or other measures of influence (including medical ones). As such factors, we can distinguish the following:
- Gender. This factor is considered as an independent risk factor in considering the pattern of atherosclerosis. Atherosclerosis in men develops about 10 years earlier, which is known on the basis of certain statistical data on this score when compared with the female incidence. In addition, before the age of 50, the risk of developing this disease in men is four times higher than, respectively, in women. When the threshold of 50 years is reached, the morbidity rate for both sexes is equalized. This feature is explained by the fact that in the female body, specific hormonal changes begin from this period, and the protective function provided by estrogens disappears (here, as you can understand, we are talking about menopause and the gradual decrease in the intensity of the release of these hormones of estrogens).
- Age. As the reader could already notice, the risk of developing the disease under consideration increases with age. Accordingly, the older the person, the greater the risk. And, of course, it is also impossible to influence this factor, because it is considered in this group of them. It should be noted that in general, atherosclerosis as a disease is often compared with the aging of the organism, that is, as one of the manifestations of this process. This is explained by the fact that atherosclerotic changes after a transition beyond a particular age period are determined absolutely in all patients. And, as already noted, from the age of 45-50 the risk of such changes in particular increases.
- Genetic predisposition. This risk factor is also unchanged when considering atherosclerosis. Thus, in particular, those patients whose closest relatives are diagnosed with one or another of its forms are particularly prone to this disease. It is considered that the genetic predisposition (it is heredity) also acts as such factor, due to which the relative acceleration of the development of atherosclerosis (before reaching the age of 50) is determined. Meanwhile, in people whose age exceeds the 50-year mark, the heredity factor in practice determines an insignificant effect on the development of atherosclerosis, so a clear statement regarding the early development of this disease can not be given if it is present in relatives.
Modifiable causes, , in turn, are characterized by the fact that the patient can affect them. This may include adjusting lifestyle, treatment, etc. Separate the relevant for the disease in question:
- Arterial hypertension. This cause (factor) is independent in considering the development of atherosclerosis. The peculiarity of the effect of hypertension lies in the fact that intensification of the intensity of impregnation with the fats of artery walls occurs in its background, which, in turn, is considered as the initial stage in the development of the main manifestation of atherosclerosis, atherosclerotic plaque. At the same time, atherosclerosis, due to which the elasticity of the arteries is subject to change, is a factor that increases the risk of developing hypertension in the patient.
- Smoking. This factor is a great help for the development of many diseases, and atherosclerosis is no exception. With prolonged smoking, the risk of developing the hypertension discussed above, as a predisposing factor in the development of atherosclerosis, increases, which already makes it possible to trace the chain of actual changes in this case. In addition, smoking also contributes to the development of coronary heart disease (ischemic heart disease) and hyperlipidemia, which also speeds up the development process in smokers of atherosclerosis. The basis of influence is based on the negative impact that the components of tobacco smoke have on the vessels directly
- Obesity. Another factor that is equally important in influencing the development of atherosclerosis. Again, obesity predisposes not only to the development of atherosclerosis proper, but also one of the factors already listed by us, arterial hypertension, which in any case, as one can understand, relates this factor to the disease we are considering. In addition, we note that obesity is also one of the main factors in the development of diabetes mellitus, which also plays an important role in considering the modifying factors of interest to us.
- Diabetes mellitus. The relevance of this factor for patients significantly increases the risk of atherosclerosis and development (approximately 5-7 times). Such a high risk is explained by the urgency of metabolic disorders (in particular, it concerns fats), which provokes the development of atherosclerotic changes in the vessels.
- Hyperlipidemia (dyslipidemia). This factor implies a violation in the metabolism of fats, which determines its equally important role in considering the provoking atherosclerosis factors. It should be noted that all of the above factors are directly related to dyslipidemia, that is, in each of them the problem of metabolic disturbance is actual. The main role in the development of atherosclerosis (as well as other types of diseases associated with the cardiovascular system) is assigned to the following forms of fat metabolism disorders: increased cholesterol level, elevated level of triglycerides and elevated levels of lipoproteins in the blood.
- Peculiarities of nutrition. The development of atherosclerosis in particular is affected by the presence of a significant amount of animal fats in the diet.
- Hypodinamy (lack of mobility of a way of life). This factor also plays an important role in the development of atherosclerosis, including the development of previously listed conditions (diabetes, arterial hypertension, obesity). Because of reduced motor activity, as it is not difficult to guess, the metabolism of carbohydrates and fats is disturbed, due to which, accordingly, the risk of development of the listed disorders and atherosclerosis in particular increases.
- Infections. The infectious nature of the development of atherosclerosis began to be considered relatively recently. Based on the studies conducted, it was found that cytomegalovirus and chlamydial infections can be considered as two variants representing this point in its connection with atherosclerosis
As we have already identified, the pathological process, relevant for atherosclerosis, focuses on the walls of the arteries. This, in turn, leads to the gradual destruction of the affected wall. In accordance with the degree of damage and its characteristics, sequential stages of atherosclerosis are determined in their manifestation, we will discuss them below and consider them.
- I stage. Within its manifestation lipid spots are formed. This implies the imbibition of fat wall arteries by the molecules of the arteries, the localization of impregnation is noted here only within the limited sections of the walls. These areas are manifested in the form of yellowish strips, concentrated along the entire length of the affected artery. The features of this stage are characterized by the fact that the symptoms of atherosclerosis as such do not manifest themselves, and as a whole there are no specific disorders, due to which it would be possible to determine the urgency of the circulation disturbance along blood arteries. Acceleration of formation of lipid spots can occur due to the effect of the modifiable factors considered above in the form of obesity, arterial hypertension and diabetes.
- Stage II. This stage is also defined as the stage of liposclerosis, characterized by the development of atherosclerosis to a stage in which inflammation of lipid spots occurs, which leads to the accumulation of cells of the immune system in their cavities. In particular, attempts are made to purify the arterial wall from the fats that have accumulated on it (in some cases it may be microbes). Against the backdrop of a prolonged inflammatory process, fats deposited on the arterial wall begin to decompose, and at the same time, connective tissues germinate in it. This leads to the formation of fibrous plaque, which determines this stage. The surface of such a plaque is in a somewhat elevated position with respect to the inner surface of the affected vessel, as a result of which, its lumen is narrowed, and blood circulation is disturbed.
- Stage III. This stage is the final development of atherosclerosis, it is characterized by the development of a number of complications , directly related to the development of fibrous plaque. In addition, it is from this stage of the disease that his symptoms begin to manifest. This stage is defined as the stage of atherocalcinosis. The progression of plaque deformation at this stage is determined by the compaction that is relevant to it, as well as the deposition of calcium salts in it. The nature of atherosclerotic plaque manifestation can determine both its stability and gradual growth, due to which it will also continue to deform the lumen of the artery and narrow it. Against the backdrop of this last option, in turn, the development of a progressive form of chronic disturbance in the blood supply of that organ, which is fed by an artery that has undergone such a defeat, will be provoked. This also causes a significant risk of formation of occlusion (acute form of blockage), in which the lumen of the vessel is blocked by either a blood clot or an element of plaque decay, as a result of which the blood supply organ or limb undergoes a different type of injury on this background — in the form of a necrosis (infarction) Or gangrene.
The aorta (abdominal and thoracic areas), mesenteric, coronary and renal arteries, as well as the arteries of the brain and lower limbs, are mainly affected by atherosclerosis.
Within the development of the disease, its asymptomatic (or preclinical) period and clinical period are distinguished. The asymptomatic period is accompanied by an increased content of beta-lipoproteins in the blood or an increased content of cholesterol in it, while symptoms, as can be understood from the definition of this period, are absent.
As for the period of clinical manifestations, they are relevant for narrowing by 50% or more of the arterial lumen. This, in turn, determines the relevance of the three main stages of the period: the ischemic stage, the thrombonecrotic stage and the fibrous stage.
Ischemic stage is characterized by the fact that the blood supply to a particular organ is impaired. As an example, we can single out a picture of the flow of this stage, in which myocardial ischemia against coronary artery atherosclerosis is manifested in the form of angina. The thrombo-necrotic stage is characterized by the adherence of thrombosis to the arteries undergoing changes. Atherosclerosis of the coronary arteries in this case can in its current flow reach complications in the form of myocardial infarction. And, finally, the fibrous stage, for which the proliferation of connective tissue that occurs in ineffectively blood-supplying organs is characteristic. Again, when considering atherosclerosis of the coronary arteries at this stage, we can distinguish the transition to the development of such a pathology as atherosclerotic cardiosclerosis.
As for specific manifestations of atherosclerosis, its symptoms are determined on the basis of what type of arteries was affected. Below we will consider the main variants of the course of this disease.
Atherosclerosis of the aorta: symptoms
Atherosclerosis of the aorta acts as the most common variant of manifestation of atherosclerosis, respectively, in most patients it is he who is revealed. Atherosclerosis can affect its various areas, on the basis of which, in turn, the symptoms of the disease and the prognosis for it are determined.
As you probably know, the aorta is the largest vessel in our body. It begins with the heart (left ventricle), then branched, thus forming a lot of small vessels that spread to the tissues and organs of our body. The aorta consists of two main divisions, which are located in anatomically different areas. The abdominal and thoracic aorta serve as such departments.
The thoracic aorta in the aorta is the initial site, at its expense provides the blood supply to the upper part of our body, respectively, this is the organs of the thorax, neck, head and upper limbs. As for the abdominal aorta, it is the final site, blood supply at its expense is provided for the abdominal organs. In its turn, its terminal section is divided into two main branches, which serve as the left and right iliac artery, through them the blood flows to the lower extremities and to the organs of the small pelvis.
In atherosclerosis of the aorta, a lesion that is relevant for this disease, covers either the entire aorta along its length, or its individual areas. Symptomatics in this case is also determined depending on where the pathological process is localized and how much the changes that have arisen in the walls of the aorta upon its impact become apparent.
The aortic aneurysm acts as the most dangerous complication, provoked by atherosclerosis of the aorta. With an aortic aneurysm, an extension of a certain area of the artery occurs, which is accompanied by a thinning of the vessel wall and an increased risk of rupture of the artery, against which, in turn, bleeding dangerous to life may develop.
Atherosclerosis of the thoracic aorta: symptoms
There is no symptomatology for a long time. Often atherosclerosis of this department develops along with such forms of the disease as atherosclerosis of coronary arteries of the heart (ie coronary arteries), as well as atherosclerosis of cerebral vessels.
The manifestation of symptoms is mainly observed at the age of 60-70 years, which is explained by the significance of the damage to the walls of the aorta by this time. Patients complain of burning pain in the chest area, systolic blood pressure increases, swallowing becomes difficult, dizziness is important.
As less specific manifestations of symptoms can be noted early aging, which is combined with the early appearance of gray hair. At the same time, hair growth in the area of the auricles is noted, along with the outer edge of the iris, a characteristic light strip appears, and greens appear on the skin of the face.
Atherosclerosis of the abdominal aorta: symptoms
This form of the disease is diagnosed in almost half the cases of all possible variants of its manifestation. Like the previous form, for a long time it can not manifest itself at all.
Atherosclerosis of the examined area serves as a cause of development in patients of such pathology as abdominal ischemic disease. It, like CHD (ischemic disease), is characterized by the fact that it leads to a violation of blood supply against the background of vascular lesions by atherosclerosis, which is particularly important for those organs that feed these vessels.
The symptomatology associated with a lesion of the abdominal aorta can be manifested as follows:
- Pain in the abdomen. Such pains arise after eating, the nature of the manifestation is paroxysmal, aching. As a rule, they are not too intensive, they do not have a clear localization. Disappear such pain in a few hours on their own.
- Digestive disorders. In particular, complaints of bloating, the appearance of constipation and diarrhea (alternation of conditions) and a decrease in appetite are relevant.
- Weight loss. This symptom is progressive, is caused by a persistent form of digestive disturbance.
- Arterial hypertension (high blood pressure), kidney failure. The increased blood pressure is caused by the kidney blood supply being impaired. As for kidney failure, it develops due to the fact that gradually their normal tissues begin to be replaced by connective tissues. This, in turn, determines their gradual necrosis against a background of insufficient blood supply
- Thrombosis of the visceral arteries. This complication is deadly in atherosclerosis of the part of the aorta in question, moreover, it requires immediate specialized medical care. With the necrosis of the vessels, due to which the blood supply of the intestine is ensured, necrosis of its loops occurs, which leads to a massive inflammation of the organs concentrated in the abdominal cavity and in the peritoneum (which determines peritonitis). Symptoms of this condition include pronounced pain sensations, which do not disappear when taking antispasmodics and pain medications. In addition, a sudden deterioration in overall well-being is soon associated with pain.
Atherosclerosis of cerebral vessels: symptoms
This form of atherosclerosis is no less common, in this case the intracranial and extracranial vessels feeding the brain are subject to injury. Severity of symptoms is determined based on the degree of damage to these vessels. Due to the atherosclerosis of the cerebral vessels, the activity of the nervous system is gradually suppressed, mental disorders or stroke may develop.
The first manifestations of the symptomatology of this form of atherosclerosis are diagnosed by the age of 60-65 years of patients, while their interpretation is reduced in most cases only to signs of aging. Meanwhile, this belief is correct only partially. Aging itself is an irreversible physiological process, while atherosclerosis acts as a specific type of disease, the course of which, before reaching certain limits, determines the possibility of cure, as well as the implementation of certain preventive measures against it.
Now let’s move on to the symptomatology. As initial manifestations of atherosclerosis of this form are episodic attacks of «ischemic attack», within which relatively stable neurological symptoms manifest themselves. This includes, in particular, disorders of sensitivity, which can manifest themselves either in its decrease from one side of the body, or in total loss. Also, violations of movements in the form of paresis (partial loss of muscle strength) and paralysis are noted. In addition, hearing, vision and speech disorders may occur. The listed symptomatology, meanwhile, manifests itself within a short time interval after which it disappears.
With a pronounced manifestation of atherosclerosis of the cerebral vessels, a stroke often occurs, in which the necrosis of a certain area of the brain tissue occurs. This condition is characterized by a persistent manifestation of the symptoms that we have already considered (loss of sensitivity, paralysis, loss of speech), and it can be treated to an insignificant degree.
As other manifestations of atherosclerosis symptoms of this form, one can note a disorder of higher nervous activity in one form or another (in particular, it concerns intellectual abilities and memory), changes in character (faultiness, capriciousness, etc.), sleep disorders, development of depressive States.
Lack of adequate treatment can lead to dementia (senile dementia). It, in turn, is a heavy and, unfortunately, irreversible manifestation of a decrease in the higher functions inherent in the brain.
Stroke is the greatest danger of this disease. This condition is inherently a condition similar to a myocardial infarction condition in which tissue necrosis occurs. The condition is accompanied by increased lethality, as well as frequent disability of patients.
It should be noted that in some cases, the symptoms that indicate arterial atherosclerosis of the cerebral arteries can be quite difficult to differentiate, for example, from the symptomatology manifested in hypertensive encephalopathy or from actual cerebral blood flow disorders due to the development of degenerative scale spine diseases (for example, Osteochondrosis). In fact, it often happens that many of the diseases with which it is possible to confuse atherosclerosis are relevant in patients of the senile age group, so the diagnosis of this disease determines the need for an integrated approach to this process.
Atherosclerosis of the vessels of the lower extremities: symptoms
Similarly to the forms considered earlier, atherosclerosis of the lower extremities (obliterating atherosclerosis) for a long time does not manifest itself by anything, and it lasts until the blood circulation through the vessels is seriously disturbed against the background of the disease we are considering.
As a classic symptom, one might say, in this case, the pain that occurs when walking in the muscles of the lower extremities is considered. This symptom has a definition corresponding to its manifestation — «intermittent claudication» (which is explained by periodic stops during walking due to the pain that arises to reduce their intensity). The pains arise in this case due to the fact that there is a lack of oxygen in the functioning muscles, which, in turn, is due to the specifics of atherosclerosis itself.
What is noteworthy, arterial insufficiency arising in this form of atherosclerosis, affects not only the functions peculiar to the legs, but it also acts as a cause of the development of trophic disorders, in which the lower limbs are particularly affected. Manifestations of trophic disorders can occur in hair loss and in skin changes (thinning, pallor). Nails are prone to deformation, become brittle. In severe cases, atherosclerosis of the legs is accompanied not only by muscle atrophy, but also by the formation of trophic ulcers in combination with gangrene.
Arterial insufficiency of the legs is manifested in accordance with the violations that determine the main four stages of it.
- I stage . In this case, the pains in the legs are manifested only in combination with significant physical exertion (for example, it can be walking for long distances (from one kilometer or more).
- Stage II . In this case, the limiting distance for the occurrence of pain is reduced, being no more than 200 meters, after overcoming, respectively, the pain appears.
- Stage III . Here, pain occurs when walking within a distance of no more than 25 meters, or even completely at rest.
- Stage IV . At this stage, patients develop trophic ulcers, develop gangrene of the lower extremities.
As another sign that corresponds to manifestations of atherosclerosis, the disappearance of the pulse noted in the arteries of the lower extremities (this may be the area from the back of the inner ankle, the region of the popliteal fossa or the thigh region) is considered.
Thrombosis of the iliac arteries and the terminal part of the abdominal aorta provokes the development of Lerish’s syndrome.
Lerish syndrome is accompanied by a violation of blood circulation, which is relevant for the arteries of the lower limbs, as well as for organs concentrated in the pelvic area. Quite often this syndrome develops against a background of atherosclerosis of the aorta. The manifestations of this pathology are analogous to the manifestations that arise in the atherosclerosis of the vessels of the legs.
In addition, impotence may develop, which, as is understandable, is relevant for men. Obliterating atherosclerosis of the vessels of the lower limbs can act as a serious kind of trophic disturbance, directly affecting the limbs (legs), which can also lead to the development of gangrene, and, ultimately, to the loss of one of them. Accordingly, any alarming sign can serve as an occasion to contact a specialist.
Atherosclerosis of the coronary arteries of the heart: symptoms
This form of the disease acts as the main cause of development in patients with ischemic heart disease, which, in turn, develops against a background of impaired blood supply to the heart muscle. Myocardial infarction and angina pectoris are pathologies that directly depend on the degree of development of atherosclerosis, affecting the arteries of the heart. Thus, with partial blockage develops ischemic disease (of varying degrees of severity of its manifestation), and with full development of myocardial infarction.
Pausing on the features of the pathology of interest to us, which is the atherosclerosis of the coronary arteries of the heart, we shall distinguish the features of the blood supply to the heart. It is provided in particular by two coronary arteries, which follow from the aorta. With any violation that occurs during the circulation of blood through the coronary (coronary) arteries, the work of the heart muscle, respectively, is disrupted. This, in turn, can provoke a heart attack.
Most often, blood circulation is disrupted in the background of coronary artery atherosclerosis. In this case, this pathology is accompanied by the process of formation of dense plaques, due to which the deformation and destruction of the artery wall occurs at a simultaneous narrowing of its lumen (a typical picture of the course of atherosclerosis). Symptoms of coronary artery atherosclerosis correspond to those symptoms that are manifested in IHD, but the main cause in any case is precisely atherosclerosis.
The main manifestations of symptoms, respectively, in this case are the development of angina and coronary artery disease, as complications of atherosclerosis of the heart vessels is cardiosclerosis and myocardial infarction. The attack of angina pectoris manifested in the considered form of atherosclerosis is characterized by the following symptoms:
- the appearance of burning, pressing pain in the chest area; Spreading such pain to the left shoulder and to the back; Occurrence — at occurrence of stressful situations or at an exercise stress
- shortness of breath (there is a feeling of lack of air, it is usually accompanied by the aforementioned pain attack, in some cases there is a need for taking a sitting position, because in a lying patient it starts to choke)
- As an option to complement the picture of the attack, the appearance of symptoms such as headache, nausea, vomiting and dizziness is considered.
Treatment of an attack of angina is ensured by taking nitroglycerin to the patients; moreover, this drug is the main one in considering emergency relief of an attack.
In the case of complications in the form of myocardial infarction patients experience intense pain, reminiscent of those that occur with angina pectoris. The difference is that the use of nitroglycerin does not determine the corresponding effect. As complementary manifestations of symptoms, severe dyspnea is observed, the patient may lose consciousness. The manifestation of heart failure is characterized by its own severity.
If there is such a complication as cardiosclerosis , heart failure with it manifests itself in a gradual manner, which is accompanied by a decrease in physical activity in combination with dyspnoea and the onset of swelling.
Determination of specific signs corresponding to atherosclerosis of the coronary arteries can be performed only using special diagnostic techniques.
Mesenteric arteriosclerosis: symptoms
This form of atherosclerosis manifests itself predominantly from the upper abdomen. The time of symptomatology, which, first of all, consists in the appearance of painful sensations, mainly occurs in late hours, in particular after supper. The duration of the manifestation of pain can be as several minutes, and reach an hour. As a concomitant manifestation of the symptomatology, bloating and belching can also occur, and constipation may occur. Pain in atherosclerosis, if compared with pain syndrome, concomitant peptic ulcer, is not so prolonged in manifestation.
The main symptoms associated with atherosclerosis in this form include the following manifestations:
- a moderate manifestation of pain, determined by probing the abdomen;
- slight muscle tension in the anterior abdominal wall
- loss of peristalsis or complete absence of peristalsis.
The listed manifestations are defined as a condition such as «angina pectoris». It develops because of the discrepancy between the blood volume required for blood supply to the digestive system and the actual volume, which, as can be understood, is not sufficient for this.
As one of the complications of this form of atherosclerosis, thrombosis developing in mesenteric vessels can be noted. As a rule, it appears suddenly, accompanied by the following concomitant symptoms:
- persistent pain sensations of a wandering or diffuse nature that arise in the abdomen
- pain in the umbilicus location
- nausea, multiple vomiting (with a bile of bile, and blood may be present, which is also noted in the stool)
- constipation, flatulence (gases).
Often the thrombosis of mesenteric vessels is completed by the development of gangrene of the intestine, which, in turn, is accompanied by a marked symptomatology of peritonitis.
Atherosclerosis of the renal arteries: symptoms
This form of atherosclerosis causes the development of persistent forms of ischemia, which in turn acts as a factor provoking the development of a stably high form of arterial hypertension.
Some cases of atherosclerosis of the renal arteries are accompanied by the absence of symptoms. Meanwhile, more often the disease pattern is manifested in the form of atherosclerotic plaques development with a simultaneous narrowing of the lumen of the renal artery region, against which the secondary form of arterial hypertension develops.
If only one of the renal arteries is affected, one can speak of a slow progression of this disease, the advanced manifestation of symptomatology becomes in this case increased arterial pressure. If the spread of the process affects both arteries at the same time, this, in turn, causes the development of the disease in a type in which hypertension is malignant, characterized by rapid progression and a serious deterioration in the overall condition of the patient.
Concomitant manifestations of symptoms may include abdominal pain and pain in the lumbar region. The duration of pain sensations manifests itself in different ways, in some cases being about several hours, in others — about a few days. There may also be nausea and vomiting.
The primary diagnostics of atherosclerosis is performed by the therapist within the framework of a standard annual examination of the patient in this direction. For this, pressure is measured, risk factors that contribute to the development of atherosclerosis are identified, and the body mass index is measured.
As a refinement measure, the following research methods can be used:
- ECG (echocardiography) in combination with ultrasound of the aorta and heart, as well as with special exercise tests
- Invasive methods of investigation (coronarography, angiography, ultrasound intravascular study)
- Duplex scanning, triplex scanning (the study is subject to blood flow through ultrasound imaging of vessels)
- MRI (magnetic resonance imaging), through which visualization of atherosclerotic plaques and artery walls is made.
Treatment of atherosclerosis is based on a number of the following principles:
- exposure to infectious agents
- implementation of substitution therapy measures (relevant for women in menopause)
- enhancing the induction of cholesterol from the body, as well as its metabolites
- limiting the intake of cholesterol in the body, reducing the synthesis of cholesterol by cells.
Adjustments against this background are subject to a lifestyle, in addition, a diet is prescribed in which, as you can understand, the maximum exclusion is due to products containing cholesterol.
With regard to drug treatment, it is based on the admission of the following types of drugs:
- nicotinic acid in combination with its derivatives (ensuring the possibility, at their expense, of reducing cholesterol and triglycerides in the blood, as well as increasing the content of lipoproteins with increased density)
- Fibrates (preparations of this group ensure a decrease in the synthesis of their own fats by the body)
- Statins (provide the possibility of reducing cholesterol in the most effective way by influencing the processes of their production by the body)
- sequestrants (ensure the binding and excretion of bile acids from the intestine with reduced cholesterol and fats in cells).
Atherosclerosis may require, in some cases, surgical treatment, which is important in case of a serious threat or with the development of an acute form of blockage by a thrombus or an artery plaque. For this, endarterectomy (open surgery on the arteries) or endovascular surgery (dilatation of the artery, installation in the stenosedropic region, which provides an obstacle for subsequent blockage) can be performed. The pronounced form of atherosclerosis with damage to the heart vessels, against which myocardial infarction may develop, requires aortocoronary shunting.
As the determining factor of the further condition, on the basis of which the prognosis is considered in atherosclerosis, the lifestyle of the patient appears. If the organs begin to develop on the background of the disease necrosis areas in combination with acute circulatory disorders, the prognosis worsens.
If you have symptoms suggestive of atherosclerosis, you will need to visit a therapist, a vascular surgeon, a cardiologist, a neurologist and a nephrologist.