With atherosclerosis, systemic damage to the arteries occurs as a result of lipid and protein metabolism disorders in the walls of blood vessels. Metabolic disorders are characterized by a change in the ratio between cholesterol, phospholipids and proteins, as well as excessive formation of β-lipoproteins.
It is believed that in its development atherosclerosis goes through several stages:
I stage – lipid (or fat) stain. For the deposition of fats in the vascular wall, an essential role is played by microdamage to the walls of the arteries and local slowdown of blood flow. Areas of vascular branching are most susceptible to atherosclerosis. The vascular wall loosens and swells. Enzymes of the arterial wall tend to dissolve lipids and protect its integrity. When the protective mechanisms are depleted, complex complexes of compounds are formed in these areas, consisting of lipids (mainly cholesterol), proteins, and they are deposited in the intima (inner shell) of the arteries. The duration of the lipid spot stage is different. Such grease spots are visible only under a microscope, they can be found even in infants.
Stage II – liposclerosis. It is characterized by growth in areas of fatty deposits of young connective tissue. Gradually, atherosclerotic (or atheromatous) plaque is formed, consisting of fats and connective tissue fibers. At this stage, the atherosclerotic plaques are still liquid and may be subjected to dissolution. On the other hand, they are dangerous, because their loose surface can rupture, and fragments of plaques can clog the lumen of the arteries. The vessel wall at the site of attachment of the atheromatous plaque loses its elasticity, cracks and ulcerates, leading to the formation of blood clots, which are also a source of potential danger.
Stage III – atherocalcinosis. Further formation of the plaque is associated with its compaction and the deposition of calcium salts in it. Atherosclerotic plaque can behave stably or gradually grow, deforming and narrowing the lumen of the artery, causing a progressive chronic violation of the blood supply to the organ affected by the artery. In this case, there is a high probability of acute blockage (occlusion) of the lumen of the vessel with a thrombus or fragments of a decaying atherosclerotic plaque with the development of a site of heart attack (necrosis) or gangrene in the blood supply to the limb artery or organ.
This point of view on the mechanism of development of atherosclerosis is not the only one. There are opinions that infectious agents (herpes simplex virus, cytomegalovirus, chlamydial infection, etc.), hereditary diseases accompanied by increased cholesterol, mutations of vascular wall cells, etc. play a role in the development of atherosclerosis.
With atherosclerosis, the thoracic and abdominal aorta, coronary, mesenteric, renal vessels, as well as arteries of the lower extremities and brain are more often affected. In the development of atherosclerosis, there are distinguished preclinical (asymptomatic) and clinical periods. In the asymptomatic period, an increased content of β-lipoproteins or cholesterol is detected in the blood in the absence of symptoms of the disease. Clinically, atherosclerosis begins to manifest itself when there is a narrowing of the arterial lumen by 50% or more. During the clinical period, three stages are distinguished: ischemic, thrombonecrotic and fibrous.
In the stage of ischemia, a lack of blood supply to one organ or another develops (for example, myocardial ischemia due to coronary atherosclerosis manifests itself as angina pectoris). In the thrombonecrotic stage, thrombosis of the altered arteries joins (thus, the course of coronary atherosclerosis can be complicated by myocardial infarction). At the stage of fibrotic changes, there is an overgrowth of connective tissue in poorly supplied organs (for example, atherosclerosis of the coronary arteries leads to the development of atherosclerotic cardiosclerosis).
The clinical symptoms of atherosclerosis depend on the type of affected arteries. The manifestation of coronary atherosclerosis is angina pectoris, myocardial infarction and cardiosclerosis, which successively reflect the stages of heart circulatory failure.
The course of aortic atherosclerosis is asymptomatic for a long and long time, even in severe forms. Clinically, atherosclerosis of the thoracic aorta is manifested by aortalgia – pressing or burning pains behind the sternum, radiating to the arms, back, neck, and upper abdomen. Unlike pain in angina pectoris, aortalgia can last for several hours and days, periodically weakening or intensifying. Reducing the elasticity of the walls of the aorta causes increased heart function, leading to left ventricular myocardial hypertrophy.
Atherosclerotic lesion of the abdominal aorta is manifested by pain in the abdomen of various localization, flatulence, constipation. With atherosclerosis of the abdominal aortic bifurcation, numbness and cooling of the legs, swelling and hyperemia of the feet, necrosis and ulcers of the toes, alternating claudication are observed.
Manifestations of atherosclerosis of mesenteric arteries are attacks of “abdominal toad” and a violation of digestive function due to insufficient blood supply to the intestines. Patients experience severe pain several hours after eating. The pains are localized in the navel or upper abdomen. The duration of a pain attack is from several minutes to 1-3 hours, sometimes the pain syndrome is stopped by taking nitroglycerin. Bloating, belching, constipation, palpitations, increased blood pressure appear. Fetid diarrhea with fragments of undigested food and undigested fat later join.
Atherosclerosis of the renal arteries leads to the development of vasorenal symptomatic arterial hypertension. In the urine, red blood cells, protein, and cylinders are determined. With unilateral atherosclerotic lesions of the arteries, slow progression of hypertension is observed, accompanied by persistent changes in the urine and persistently high numbers of blood pressure. Bilateral damage to the renal arteries causes malignant arterial hypertension.
With atherosclerosis of the cerebral vessels, there is a decrease in memory, mental and physical performance, attention, intelligence, dizziness, and sleep disturbances. In cases of severe atherosclerosis of the cerebral vessels, the patient’s behavior and psyche change. Atherosclerosis of the arteries of the brain can be complicated by acute disturbance of cerebral circulation, thrombosis, hemorrhage.
The manifestations of atherosclerosis obliterans of the arteries of the lower extremities are weakness and pain in the calf muscles of the lower leg, numbness and chilliness of the legs. The development of the syndrome of “intermittent claudication” is characteristic (pains in the calf muscles occur when walking and subside at rest). Cooling, pallor of limbs, trophic disturbances (peeling and dry skin, development of trophic ulcers and dry gangrene) are noted.
The signs of stenosing atherosclerosis are diverse and depend mainly on the localization of the process. As we have already noted, the leading symptom of damage to the arteries of the heart is pain behind the sternum, and the arteries of the lower extremities are pain when walking, combined with trophic disorders.
When plaque is deposited in the walls of the arteries of the brain, frequent manifestations become:
- Memory impairment;
- Decreased performance.
With stenotic atherosclerosis of the aorta, symptomatic arterial hypertension appears, a complication in the form of aortic aneurysm is also possible.
Onset of peritoneal arteries may be indicated by paroxysmal abdominal pain.
Atherosclerosis of the renal arteries contributes to impaired renal function and, ultimately, leads to renal failure.
Unfortunately, the appearance of any of these symptoms suggests that the disease is already quite neglected, and its treatment at this stage is reduced to slowing the progression of atherosclerosis, the reverse development of plaques is no longer possible.
The most effective treatment for atherosclerosis can be in the latent period, when a vivid clinical picture is still missing, and there are fat spots and strips in the walls of the vessels that have not yet developed into real plaques.
In most cases, at the initial stages, stenotic atherosclerosis occurs without visible clinical signs. Only as the disease progresses do certain symptoms appear. Clinical manifestations and possible consequences depend on the vascular elements of which organs are involved in the pathological process.
Stenosing atherosclerosis does not develop from scratch. There are a number of reasons leading to the emergence of this multi-organ pathology. These include:
- the presence of addictions (abuse of alcohol, smoking tobacco or hookah);
- food enriched with animal fats;
- lack of adequate physical activity;
- functional and organic lesions of the liver;
- violation of carbohydrate metabolism;
- belonging to the stronger sex (women are less susceptible to atherosclerosis);
- age over 45 years.
At the first signs of stenosing atherosclerosis, you must consult a doctor who will prescribe the necessary examination. The gold standard for the diagnosis of stenosing atherosclerosis is Doppler imaging of blood vessels. It is the echographic signs of a blood flow disturbance that indicate the presence of this pathology.
Stenosing atherosclerosis is a pathological process that spreads to the main arteries of the body. The mechanism of its occurrence is quite simple. Under the influence of certain factors, free fats (cholesterol) begin to be deposited in the walls of blood vessels and plaques form. The disease goes through several stages of development, the final stage is the narrowing of the artery to a minimum (stenosis). As a result, tissues and organs that are dependent on the site of impaired blood supply are deficient in oxygen and nutrients.
The problem of proliferation of cholesterol plaques and connective tissue between them affects various major arteries. Taking into account the place of development of the pathological process, several varieties of the disease are distinguished. The most vulnerable are the peripheral arteries of the lower extremities, the brain and the coronary aorta of the heart.
Causes of the disease
The reasons for the development of atherosclerosis are still not fully understood. Scientists have developed a number of theories, but a single view of the problem has not been found.
The best known is the cholesterol theory of atherosclerosis, according to which the disease is a consequence of a violation of fat metabolism, leading to the deposition of lipids in the walls of arteries and the appearance of irreversible changes in them.
An important role in this process is played by poor heredity, excessive intake of cholesterol from food, diseases of the liver, kidneys, thyroid and pancreas, and diabetes mellitus.
Autoimmune processes, excessive blood clotting, and even viral infections, such as flu or herpes, can also contribute to the formation of atherosclerotic plaques.
Usually, several pathogenic factors act on a person at once, which together lead to the development of atherosclerosis.
The following negative factors can provoke this ailment:
- unhealthy diet (abuse of fatty foods);
- emotional stress, nervous overload;
- alcohol, smoking.
Due to the fact that the disease often affects the vessels of the lower extremities, working conditions and human life play an important role. After all, the disease can occur as a result of injuries, prolonged hypothermia. Particular attention should be paid to smoking and alcohol. In the case of smoking, everything is very simple: nicotine causes intoxication of blood vessels, as a result they spasm.
Regarding atherosclerosis of the carotid arteries, they are already affected after other arteries in the body have been affected. The disease develops in the carotid arteries due to the appearance of atherosclerotic plaque in the vessels.
The development of atherosclerotic lesions of the main arteries is due to the action of three factors:
- Violation of fat metabolism. When the system of cholesterol synthesis and transportation fails in the body, excesses of this substance begin to be deposited on the walls of blood vessels. The trigger mechanism can be somatic diseases, unbalanced nutrition, obesity.
- Hereditary predisposition. If stenosing atherosclerosis has been diagnosed in close relatives, the likelihood of this disease increases several times.
- Decreased elasticity of the vascular walls. Cholesterol plaques cannot form on a smooth and healthy surface. The following disorders contribute to damage to the vascular wall: diabetes mellitus, a sedentary lifestyle, and smoking.
If you have one or more of the factors listed above, you need to pay special attention to your own health, more often undergo preventive examinations.
In order to delay the formation of atherosclerotic plaques and avoid the development of complicated forms, such as stenotic atherosclerosis, it is necessary to remember the existing risk factors for its development and try to reduce their effect.
However, this is not always possible. There are non-modifiable factors: gender, age and heredity:
- Stenosing atherosclerosis in men appears more often than in women, and usually the disease manifests itself in them at a younger age. Moreover, the general trend is this: the older the person, the higher the likelihood that he has atherosclerosis. With age, the severity and volume of vascular lesions increase.
- Of great importance for the development of atherosclerosis is heredity, and it can play both a positive and a negative role. If the disease is present in many close relatives of a person, then, with a high probability, he will also someday encounter atherosclerosis. At the same time, there are people who are lucky: they inherited from their parents a type of metabolism that reduces the likelihood of developing atherosclerosis to a minimum.
However, there are much more modifiable risk factors that we can eliminate, and their influence is stronger:
- The main one is an unbalanced diet with excess calorie content and excessive consumption of animal fats. It provides the accumulation of “bad” cholesterol in the body, which sooner or later will be deposited in the form of plaques on the walls of blood vessels. This is especially dangerous for the development of atherosclerosis in the presence of another concomitant factor – physical inactivity. Low physical activity contributes to the violation of the destruction of these very excess fats, which means it only exacerbates the process.
- No less formidable risk factor was smoking. Many people with stenotic atherosclerosis are experienced smokers. When tobacco smoke is inhaled, vasospasm occurs, blood flow slows down and cholesterol plaque deposits on the walls of the arteries.
- Interestingly, frequent stresses, conflict situations, and depression also increase the likelihood of developing atherosclerosis, especially in the coronary arteries. In addition, at risk are people with obesity, arterial hypertension, diabetes. Timely and adequate treatment of these diseases can slow the progression of atherosclerosis.
Factors affecting the development of atherosclerosis are divided into three groups: fatal, removable and potentially removable.
Fatal factors include those that cannot be ruled out through volitional or medical exposure. These include:
- Age. With age, the risk of developing atherosclerosis increases. Atherosclerotic changes in blood vessels to one degree or another are observed in all people after 40-50 years.
- Floor. In men, the development of atherosclerosis occurs ten years earlier and exceeds the incidence rate of atherosclerosis among women by 4 times. After 50-55 years, the incidence of atherosclerosis among women and men is evened out. This is due to a decrease in estrogen production and their protective function in women during menopause.
- Burdened family heredity. Atherosclerosis often develops in patients whose relatives suffer from this disease. It is proved that hereditary atherosclerosis contributes to the early (up to 50 years) development of the disease, while after 50 years, genetic factors do not have a leading role in its development.
The eliminated factors of atherosclerosis are those that can be excluded by the person himself by changing the usual way of life. These include:
- Smoking. Its effect on the development of atherosclerosis is explained by the negative effects of nicotine and tar on blood vessels. Long-term smoking several times increases the risk of hyperlipidemia, arterial hypertension, ischemic heart disease.
- Unbalanced diet. Eating large amounts of animal fats accelerates the development of atherosclerotic vascular changes.
- Lack of exercise. Maintaining a sedentary lifestyle contributes to the violation of fat metabolism and the development of obesity, diabetes mellitus, vascular atherosclerosis.
Potentially and partially removable risk factors include those chronic disorders and diseases that can be corrected through the prescribed treatment. They include:
- Arterial hypertension. Against the background of increased blood pressure, conditions are created for increased impregnation of the vascular wall with fats, which contributes to the formation of atherosclerotic plaques. On the other hand, a decrease in the elasticity of arteries in atherosclerosis helps to maintain high blood pressure.
- Dyslipidemia. Violation of fat metabolism in the body, manifested by an increased content of cholesterol, triglycerides and lipoproteins, plays a leading role in the development of atherosclerosis.
- Obesity and diabetes. They increase the likelihood of atherosclerosis 5-7 times. This is due to a violation of fat metabolism, which underlies these diseases and is the trigger mechanism for atherosclerotic vascular lesions.
- Infections and intoxication. Infectious and toxic agents have a damaging effect on the vascular walls, contributing to their atherosclerotic changes.
Knowledge of the factors contributing to the development of atherosclerosis is especially important for its prevention, since the influence of disposable and potentially removable circumstances can be weakened or completely eliminated. Elimination of adverse factors can significantly slow down and facilitate the development of atherosclerosis.
What is stenotic atherosclerosis
Stenosing atherosclerosis can affect any large arteries. Depending on the predominant localization of plaques, its following types exist:
- Atherosclerosis of the coronary arteries of the heart;
- Atherosclerosis of the aorta;
- Atherosclerosis of the peritoneal arteries;
- Atherosclerosis of the renal arteries;
- Cerebral arteriosclerosis;
- Atherosclerosis of the pulmonary arteries;
- Atherosclerosis of the peripheral arteries (upper and lower extremities).
Atherosclerosis rarely affects only one group of vessels. As a rule, such lesions are multiple.
Stenosing atherosclerosis of the arteries of the heart is a very common form of atherosclerosis.
It is atherosclerotic plaques that are the main cause of the development of coronary heart disease. They create an obstacle to blood flow, and heart nutrition is disturbed: angina pectoris, arrhythmia, myocardial infarction, or even sudden cardiac death can develop.
The first manifestations of coronary atherosclerosis are often pressing pains behind the sternum that occur during physical exertion. The appearance of this symptom is a wake-up call requiring medical attention.
Timely diagnosis and treatment of coronary atherosclerosis can help avoid the development of serious complications.
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Stenosis of the arteries of the legs
Stenosing atherosclerosis of the arteries of the legs is also a very unpleasant problem. It begins gradually, with the appearance of a feeling of coldness in the legs and minor pain after a long walk, but over time, in the absence of proper treatment, can lead to the development of gangrene and amputation of the leg.
The disease progresses gradually:
- First, the intensity of pain increases, the distance that a person can go without stopping decreases.
- The hair on the legs falls out and the skin turns pale.
- Then trophic ulcers appear.
- To preserve the limb, treatment of atherosclerosis should be started as early as possible, without waiting for the appearance of ulcers.
This type of lesion is most characteristic of smokers. This is why giving up cigarettes is a critical condition for recovery.
Stenosing atherosclerosis is a serious disease that requires an integrated approach to treatment.
Atherosclerosis therapy is always based on diet. It implies a decrease in the intake of saturated animal fats and cholesterol with food, as well as a decrease in calories and weight loss in the event of obesity.
Clinical nutrition implies limiting the use of fatty meats and fish, salt, sausage, butter, egg yolk, caviar, lard, etc. On the contrary, products such as cottage cheese, cod, mackerel, tuna, oatmeal, cereal bread, vegetable oils, vegetables and fruits must be present in the diet without fail.
Too many patients in the initial stages of the disease manage to normalize their cholesterol levels solely through diet. But here self-discipline is very important, errors in nutrition are unacceptable.
Another way to lower cholesterol is to take medications. The most common of these are statins. However, self-medication with these means is unacceptable, only a doctor can prescribe the optimal drug therapy, otherwise there can be more harm than good.
Also, the treatment of atherosclerosis implies an increase in motor activity. This can be ordinary moderate physical activity, or physiotherapy exercises conducted under the supervision of a specialist. It helps improve blood flow, remove excess fats, and reduce hypoxia.
In some cases, stenotic atherosclerosis requires surgical intervention, the decision on the need for which is made by the attending physician together with the vascular surgeon.
In addition, the treatment of atherosclerosis also involves the treatment of concomitant diseases, such as hypertension, diabetes mellitus, etc.
The brachiocephalic arteries are large vessels extending from the aortic arch toward the brain. Their multiple interweaving form the Willis circle. It provides full blood supply to the brain.
When an obstacle in the form of an atherosclerotic plaque is formed in one of the sections of the Willis circle, one speaks of the development of stenosis. This disease affects the functioning of the entire blood supply system of the brain. Lack of timely treatment can lead to hypoxia or stroke. Signs of a pathological process depend on the number of atherosclerotic plaques in the arterial bed.
At the very beginning, the disease is asymptomatic. If the lumen of the vessel is blocked by a plaque by 50% or more, the patient may notice the appearance of uncharacteristic disorders. Among them are:
- periodic dizziness with a decrease in blood pressure;
- emotional lability with a predominance of depressive mood;
- auditory-visual problems (tinnitus, hearing loss, the appearance of flies in front of the eyes);
- chronic fatigue syndrome;
- numbness of the fingers;
- violation of thermoregulation.
The listed symptoms at first practically do not affect the quality of life. Many patients simply ignore them. Progressive stenosing atherosclerosis of the brachiocephalic arteries makes you seek help from a doctor.
Oxygen and nutrients enter the heart through the coronary arteries. The defeat of these vessels by atherosclerosis poses a serious threat to the main muscle of the body, affecting its rhythm and completeness of contractions. With this disease, patients usually complain of pain in the sternum. First they appear after physical exertion or stress. Over time, discomfort does not leave a person, even at rest. The duration of the pain attack is about 30 minutes.
An acute manifestation of the pathological process is myocardial infarction. The disease is accompanied by severe pain in the heart, which cannot be stopped with the Nitroglycerin tablet. Blood pressure drops, resulting in severe dizziness, weakness. Atherosclerosis stenosing, affecting the coronary arteries, can lead to serious complications.
Through the femoral artery, blood flows to the most extreme points of the body, located on the feet. Stenosing atherosclerosis of the lower extremities takes third place in frequency of occurrence. The clinical manifestations of this form of the disease are diverse. Therefore, it is advisable to consider the development of the pathological process in stages:
- At the initial stage, the patient is disturbed by a feeling of chilliness, burning or tingling in the feet. The skin on the legs noticeably turns pale.
- The second stage is characterized by the appearance of intermittent claudication. One limb, when walking or playing sports, begins to tire earlier than the other. Gradually, unpleasant sensations develop in the calf muscle area, persistent cyanosis appears.
- At the next stage, the intensity of intermittent claudication noticeably increases. It becomes difficult for the patient to go the usual way without stopping. Often patients complain of pain in the toes, which does not disappear at rest. The skin on the foot acquires a marbled hue, can crack and thin.
- At the fourth stage, lameness becomes so pronounced that a person is forced to make stops every 50 steps of the path. The appearance of trophic ulcers, swelling. Severe leg pain interferes with night rest.
You can not wait for the irreversible consequences of the disease to appear in the form of gangrene. If symptoms of circulatory disorders in the legs (weakness, intermittent claudication) occur, you should immediately consult a doctor. If a specialist confirms stenotic atherosclerosis of the arteries of the lower extremities, treatment will be prescribed immediately.
Therapy of these conditions is carried out medically and promptly. When the patient has occlusive atherosclerosis, it will be enough to include in the treatment regimen drugs that thin the blood and affect the level of low and very low density lipoproteins, triglycerides and cholesterol. Thus, it will be possible to avoid the formation of a thrombus at the site of the cholesterol plaque and the subsequent complications in the form of acute cerebrovascular accident or coronary syndrome.
But if the patient has a wall-occlusal type of the disease, it is more likely that he will have to resort to surgery to remove a critical narrowing of the artery section and to place an artificial stent on this site. Therefore, stenotic atherosclerosis of the arteries of the lower extremities is most often treated surgically.
Often, patients, having heard about the diagnosis of stenosing atherosclerosis, ask themselves: “What is this?” Stenosing atherosclerosis is an atherosclerotic lesion of the inner lining of the vascular bed of most vital organs. The development of the disease is associated with a persistent increase in blood cholesterol.
Signs of pathology
Laboratory tests, such as determination of total cholesterol and its fractions in blood serum, are very important for the diagnosis of atherosclerosis.
Of course, high cholesterol alone cannot 100% say that a person has atherosclerosis at the moment, but he, at least, indicates a high predisposition to the formation of cholesterol plaques.
In this case, their education is only a matter of time. Detection of cholesterol metabolism according to a biochemical blood test allows you to start the treatment of atherosclerosis in a timely manner, even before the first symptoms appear.
For those people who have certain symptoms of stenosing atherosclerosis, suspected by a doctor based on the clinical picture, an instrumental examination is also performed.
ECG, ECHO-Kg, helping to >
The most accurate method to establish the localization and extent of atherosclerotic lesions is arteriography, including coronary angiography. A special contrast agent is injected into the patient’s artery, and then an X-ray examination is performed.
However, this method is invasive, and therefore it is shown only in doubtful cases or in preparation for surgical operations on the vessels.
In order to timely identify the disease and start its therapy, all people after 40 years of age are recommended by doctors to undergo a routine examination once a year. It is enough to take a blood test for the following indicators:
- cholesterol, lipoproteins, triglycerides;
These parameters may indirectly indicate a violation of protein-lipid metabolism, which provokes the development of pathology.
Stenosing atherosclerosis of the arteries of the brain, heart or lower extremities is easy to diagnose. For this, the patient is prescribed a comprehensive examination, which includes the following procedures:
- intravenous / arterial angiography of blood vessels using contrast;
- Doppler study;
- triplex scanning.
Based on the results of the examination, the doctor can confirm the preliminary diagnosis. After this, the patient is prescribed treatment.
It is possible to recognize the presence of an atherosclerotic process in the body by the following clinical symptoms:
- Pain in different parts of the body. They appear in the first stage and indicate tissue ischemia. Patients begin to hurt their legs, head and neck.
- Paresthesia. This is a feeling of crawling on the skin. A similar phenomenon occurs when the small vessels blocking the sensitive cells of the skin are blocked.
- Flashes of flies before the eyes. It appears when the atherosclerotic process has reached the vascular plexuses of the retina.
- Tinnitus and dizziness. Such symptomatology debuts when cholesterol plaques appear in the arteries and veins of the head, reaching the vestibular apparatus.
- Ulceration of the skin of the lower extremities. Similar symptoms occur when the disease reaches the second, thrombonecrotic stage. Thromboses appear in the vascular beds of the legs with necrosis of tissue sites in which oxygenation is absent.
- Cyanosis of the nasolabial triangle and distal parts of the body. Such a symptom arises as a result of sequential fibrosis and sclerosis of vessels affecting various organs. Blood is simply not able to reach distant sites, which consequently become cyanotic.
To determine the presence of the disease, auscultation is used, which helps to hear the flow of blood.
- Auscultation. It helps to listen to the characteristic noise of a turbulent blood flow using a stethophonendoscope.
- Visual inspection. In patients with the described lesions, vascular contouring and pulsation is often observed in those parts of the body where the latter lie directly under the skin.
- Dopplerography. Most accurately determines stenotic atherosclerosis. This significant method allows you to identify such echoes, such as occlusion with a thrombus, plaque or embolus, swirling of blood in stenotic areas, and a decrease in the speed of its flow through the main arteries.
- Angiography of blood vessels using a contrast medium. This is an X-ray method that allows you to determine the location and degree of narrowing.
Initial data for atherosclerosis are established by clarifying patient complaints and risk factors. Cardiologist consultation recommended. A general examination reveals signs of atherosclerotic lesions of the vessels of the internal organs: edema, trophic disorders, weight loss, multiple wen on the body, etc. Auscultation of the vessels of the heart, aorta reveals systolic murmurs. For atherosclerosis, there is evidence of a change in arterial pulsation, increased blood pressure, etc.
Laboratory data indicate elevated levels of blood cholesterol, low density lipoproteins, triglycerides. X-ray on aortography reveals signs of aortic atherosclerosis: its elongation, compaction, calcification, expansion in the abdominal or thoracic regions, the presence of aneurysms. The condition of the coronary arteries is determined by coronary angiography.
CT angiography of the aortic arch. Atherosclerosis of the vessels of the aortic arch. Atherosclerotic plaque
Blood flow disorders in other arteries are determined by angiography – contrast radiography of blood vessels. In atherosclerosis of the arteries of the lower extremities according to angiography, their obliteration is recorded. With the help of ultrasound of the vessels of the kidneys, atherosclerosis of the renal arteries and the corresponding impaired renal function are detected.
Methods of ultrasound diagnostics of the arteries of the heart, lower extremities, aorta, carotid arteries register a decrease in the main blood flow through them, the presence of atheromatous plaques and blood clots in the lumen of the vessels. Reduced blood flow can be diagnosed with rheovasography of the lower extremities.
Principles of therapy
Treatment of stenosing atherosclerosis largely depends on at what stage of the development of the disease the patient went to the doctor. At the initial stage, in addition to drug therapy, it is necessary to try to change the lifestyle. It is important to abandon bad habits, try to relax more. Otherwise, taking medication will only slow down the progression of the disease, but will not stop it completely.
Without fail, the doctor prescribes a sick diet (table number 10), rich in plant foods. It is usually recommended for patients with hypertension or heart failure. If you adhere to such a diet, you can not only reduce the amount of cholesterol consumed, but also remove its excess from the body.
Patients with a diagnosis of “stenotic atherosclerosis of the lower extremities” treatment should be supplemented with sports. Preference should be given to Nordic walking or swimming. At the first signs of fatigue in the legs, you must immediately rest, without overloading the body.
Consequences of the disease
Atherosclerosis is a dangerous disease. Over time, it can lead to disability or even death.
The most common negative consequences of atherosclerosis are:
- Coronary heart disease;
- Gangrene, including intestinal gangrene, aortic aneurysm, renal failure.
To avoid them, you should begin treatment of atherosclerosis as early as possible, even before the onset of the first symptoms, adhering to all the doctor’s recommendations and following a diet.
The consequences of this disease can be very serious and life-threatening. For example, stenotic atherosclerosis of the arteries of the brain often provokes the development of a stroke. Of course, this complication does not appear at all. It all depends on the characteristics of the body, a predisposition to the occurrence of an ailment. Studies show that approximately 70% of the population over 60 complains of various manifestations of atherosclerosis. This pathology is the main cause of brain failure syndrome.
Stenosing atherosclerosis of the vessels of the lower extremities also does not always have a favorable prognosis. If the artery is completely blocked, the likelihood of developing ischemic gangrene increases. Especially often, pathology occurs in people with diabetes, since this disease accelerates the process of stenosis.
The treatment of atherosclerosis cannot be imagined without the use of medications. Typically, patients with such a diagnosis are prescribed the following groups of drugs:
- Disaggregants. Prevent the formation of blood clots in the bloodstream.
- Antispasmodics. Improve blood circulation throughout the body.
- Medicines to normalize the rheological properties of blood. First, drip administration of the drug is prescribed, then it is replaced by the tablet form.
All medicines are selected for each patient individually. Be sure the doctor must take into account the stage of the disease and its form.
Prevention of atherosclerosis is the elimination of modifiable risk factors. Among the main recommendations are proper nutrition, optimal physical activity, smoking cessation and excessive alcohol consumption, the fight against obesity, diabetes mellitus, and hypertension.
It is also recommended that the level of cholesterol in the blood be regularly monitored for preventive purposes. Such an analysis can be passed free of charge as part of the medical examination.
It is necessary to begin to engage in the prevention of stenosing atherosclerosis from early childhood. All unhealthy people are at risk for the disease.
- hygiene regimen;
- moderate exercise;
- compliance with the regime of work and rest.
Do not forget about proper nutrition. The diet should mainly consist of lean meat and seafood, as well as plant foods.
A healthy lifestyle means giving up addiction. However, it is better not to start smoking and drinking alcohol at all.
The listed recommendations should be observed both during therapy and before it. Such tips can avoid complications of the disease. When the first symptoms appear, indicating stenosing atherosclerosis, you should consult a doctor and check the blood vessels. If necessary, the doctor will prescribe appropriate treatment.
In many ways, the prognosis of atherosclerosis is determined by the behavior and lifestyle of the patient himself. The elimination of possible risk factors and active drug therapy can delay the development of atherosclerosis and achieve improvement in the patient’s condition. With the development of acute circulatory disorders with the formation of foci of necrosis in the organs, the prognosis worsens.
In order to prevent atherosclerosis, smoking cessation, the exclusion of a stress factor, the transition to low-fat and low-cholesterol foods, systematic physical activity commensurate with capabilities and age, weight normalization are necessary. It is advisable to include in the diet foods containing fiber, vegetable fats (linseed and olive oils) that dissolve cholesterol deposits. The progression of atherosclerosis can be slowed by taking cholesterol-lowering drugs.
First of all, preventive measures of atherosclerosis should be aimed at a healthy lifestyle. Even better if this habit will be developed from childhood. It is very important to observe a hygienic regimen, moderate exercise, alternate work with rest, eat right, do not abuse alcohol and smoking, and it is better to exclude them altogether. If a person lives, observing such simple and very important recommendations, he will be able to avoid the development of any form of this ailment.
After diagnosis, stenotic atherosclerosis is necessary to begin treatment as soon as possible. Today, there are medical and surgical methods of treatment. In order to maximize the therapeutic effect, correction of the lifestyle of patients is necessary. Patients must adhere to a rational diet, systematically perform cardiac loads, completely abandon addictions, and if necessary, carry out body weight correction.
Drug treatment is prescribed exclusively by a doctor. For this purpose, drugs of the following groups are used: statins, sequestrants of bile acids, disaggregants, fibrates. Surgical treatment is indicated when the effect of conservative therapy is not achieved. Surgical interventions are closed (stenting) and open (shunting, endarterectomy) type. The doctor discusses the choice of surgical treatment method individually with each patient.
With complications of stenosing atherosclerosis of the arteries of the lower extremities, the treatment is radical. In this case, amputation of the affected limb with further drug therapy is necessary.
Stenosing atherosclerosis is an insidious disease that carries a great danger to the body. In order not to become his victim, it is enough to adhere to simple preventive recommendations: eat rationally, be physically active, avoid frequent stressful situations, maintain a normal body weight, monitor lipid metabolism every year after reaching adulthood, and get rid of addictions.
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Atherosclerosis stenosing in an advanced stage requires surgery. Surgical intervention allows you to restore normal patency of blood vessels, remove cholesterol plaques. For this purpose, shunting, stenting or angioplasty is performed. The listed manipulations are carried out both endoscopically and openly using general anesthesia.