Atherosclerosis
"We have vascular imaging techniques (IVUS, OCT) that can detect atheroma plaques and even identify those that might be getting complicated".
DR. AGNES DÍAZ DORRONSORO
SPECIALIST. CARDIOLOGY DEPARTMENT
Atherosclerosis or atherosclerosis causes narrowing (stenosis) of the arteries that can progress to vessel occlusion preventing adequate blood flow through the affected artery. It usually starts after the age of 20 and grows gradually throughout life.
It is a disease characterized by the development of multiple focal lesions, called atheroma plaques, on the wall of the aorta and the medium and large caliber arteries.
These plaques have a soft, yellowish central core, formed by lipids (cholesterol) and covered by a fibrous plaque. They normally occupy only a part of the circumference of the arterial wall, in the form of patches.
Over time, these plaques can become calcified and calcium can be seen on a chest CT. The plaques may rupture or ulcerate. In these cases the contents of the plaques come into contact with the blood and a thrombus (blood clot) can form, which if it occupies the entire interior of the artery, totally blocks the blood supply to the area of the heart that depends on that artery.
The Clinic has the only cardiovascular check-up that incorporates the latest diagnostic imaging technology to accurately quantify your cardiovascular risk
Thanks to the exclusive dedication of our professionals, they allow us to perform the ICAP Checkup in less than 48 hours with a high precision diagnosis.
What are the symptoms of arteriosclerosis?
The clinical pictures that people with complicated atherosclerosis may present depend on the organ that is irrigated by those arteries.
- When the blockage affects the cerebral arteries, it can appear from transitory cerebral ischemic attacks to an acute stroke or ictus, with more or less permanent sequelae.
- When the obstruction affects the renal arteries, it can facilitate the development of renal failure or the appearance of hypertension, which in this case would be secondary to renal failure.
- The obstruction of the arteries in the lower extremities can lead to intermittent claudication, which is characterized by the presence of muscular pain in the calves, triggered by walking and forcing the patient to stand for a moment, until the pain stops, which is why it is called "the window dressing disease.
- The presence of complicated atherosclerotic lesions in the aorta favors the development of aneurysms, which may show no symptoms or produce sudden death due to aneurysm rupture.
- The presence of lesions due to atherosclerosis in the coronary arteries (those that carry irrigation to the heart) leads to angina pectoris (partial occlusion), acute myocardial infarction (sudden total occlusion) or heart failure.
How does atherosclerosis plaque form? (available in spanish)
What diseases can it cause?
- Stroke or ictus.
- Aortic aneurysms.
- Acute myocardial infarction.
Atherosclerosis takes a long time to give clinical manifestations. For this reason, it must be detected early, before atheroma plaques become complicated and produce irreversible damage to some organs.
Do you have any of these symptoms?
You may have arteriosclerosis
What are the causes of arteriosclerosis?
For the formation of an atheroma plaque to begin, substances and cells in the blood must penetrate the arterial wall.
Under normal conditions, this does not happen, because the blood is separated from the arterial wall by a barrier, the endothelium.
It is now known that various factors can damage the endothelium in such a way that it no longer acts as a barrier. These factors are known as risk factors for atherosclerosis
The main modifiable risk factors are four:
- High blood pressure (presence of blood pressure figures above 139/89 mm/Hg.).
- Hypercholesterolemia (existence of blood cholesterol concentrations greater than 200 mg/dl) and hypertriglyceridemia (existence of blood triglyceride concentrations greater than 150 mg/dl).
- Smoking.
- Diabetes mellitus.
There are other modifiable factors such as advanced age, sex and heredity. Although both men and women suffer from atherosclerosis, men suffer from it 10 years earlier than women.
How is arteriosclerosis prevented?
First of all you have to lead a healthy life, which means:
- Following a healthy cardiovascular diet (avoiding saturated fats and excess calories, and encouraging the consumption of olive oil, vegetables and fruits). The most recommended is the Mediterranean diet.
- Exercise regularly (every day you should walk for no less than an hour or run smoothly, swim and ride a bicycle for at least half an hour).
Eliminate tobacco consumption completely and definitively.- Try to eliminate stressful situations in daily life or, when this is not possible, live them with a positive and minimally self-injurious perspective.
- People with high blood pressure and/or hypercholesterolemia must follow treatment with antihypertensive and/or hypolipemic drugs on a continuous basis, to maintain blood pressure figures below 139/89 millimetres of mercury (mm./Hg.) and total cholesterol figures below 200 and milligrams per decilitre (mg./dl.). The ideal is to have an LDL cholesterol figure below 115 mg/dl. You should also keep a good control of your diabetes.
In cases where clinical manifestations have already emerged, the physician indicates the treatment for each individual case, while recommending secondary prevention measures (e.g., low-dose aspirin) aimed at preventing the emergence of new complications.
How is atherosclerosis diagnosed?
Periodic health examinations (vascular checks) should be done from the age of 40-50, especially in those people with a family history of diseases caused by atherosclerosis.
In these check-ups special importance is given to the study of cardiovascular risk factors. In addition, through the analyses, certain markers of vascular damage are also evaluated.
With all the information gathered in a cardiovascular checkup, the risk of each person can be calculated in an approximate way. For example, it is possible to predict with great reliability the percentage of possibilities of presenting an acute myocardial infarction over the following 10 years. The vascular age of each patient can also be calculated. For example, a 40-year-old smoker may have a vascular age of 60, because he has an atherosclerosis characteristic of people of this age.
How is arteriosclerosis treated?
The best way to combat arteriosclerosis is to prevent it
Since medications cannot clear blocked arteries, a very narrowed coronary artery may need other treatment to improve the patient's quality of life.
Percutaneous coronary angioplasty is one of the most effective treatments for improving patients with ischemia or ischemic heart disease.
The procedure consists of dilating one or more coronary arteries by means of a catheter, at the distal end of which is carried a balloon that is inflated when it reaches the obstructed site, allowing the light (the interior) of the vessel at that point to increase its diameter and restore normal blood flow again.
The catheter is introduced by puncture through the femoral artery or through the radial one (in the wrist), from where it is conducted to the coronary artery.
Stents are metal devices of different designs. They are inserted into the coronary arteries percutaneously (by means of a puncture in the femoral or radial artery) to correct a narrowing of the interior lumen of the artery due to a thrombus or atherosclerosis plaque called atheroma. They are used in approximately 96% of angioplasties.
There are different types of stents:
- Pharmaceutical stents: This is the most advanced material for treating ischemic heart disease. It provides excellent results and its success lies in the reduction of the rate of restenosis (the reproduction of the narrowing of the artery). It releases the exact dose of drug that limits excess tissue growth within the artery.
- Metal stents: no drugs are incorporated to prevent tissue growth. There are times when their use is indicated because the patient does not tolerate the medication that must be taken after implantation of a pharmacological stent over the course of a year.
Where do we treat it?
IN NAVARRE AND MADRID
The Department of Cardiology
of the Clínica Universidad de Navarra
The Department of Cardiology of the Clinica Universidad de Navarra is a center of reference in different diagnostic techniques and coronary treatments.
We have been the first center in Europe to place a pacemaker by means of a catheterization without the need to open the chest, for cases of severe heart failure.
The Cardiology Department of the Clinic collaborates with the Radiology and Cardiac Surgery Departments to achieve a quick and precise diagnosis of the patient.
Why at the Clinica?
- Specialized Arrhythmia Unit of national reference.
- Unit of Hemodynamics and Interventionist Cardiology equipped with the best technology.
- Cardiac Imaging Unit to achieve the highest diagnostic accuracy.
Our team of professionals
