What is carotid atherosclerosis and what are its features

The mechanism of formation of atherosclerotic plaques is very complex. There are 3 stages of development of this pathology. It is based on the deposition of atherogenic lipids on the inner membrane of the carotid arteries. The latter include LDL and VLDL. Favorably affect blood vessels high density lipoproteins. When the ratio of LDL to HDL is changed towards the former, fatty spots form on the walls.

Atherosclerosis develops. At stage 1, atherogenic lipoproteins are deposited. Contributes to this damage to the walls of the arteries and a decrease in blood flow. Lipid spots do not disturb blood flow in the vessels. They are visible under a microscope. If treatment is not carried out, then stage 2 develops. It is called liposclerosis.

In areas of fat deposition, connective tissue grows. Plaques begin to form. They are soft and well dissolve. At this stage, there is a risk of developing fat embolism. The state of the vascular wall also changes. It becomes less elastic. Various defects are formed, which further exacerbates the situation.

At this stage, blood clots often form. Stage 3 disease is called atherocalcinosis. Changes become irreversible. Medicines can no longer dissolve plaques, as the latter become dense.

The reason is the deposition of calcium salts. Plaques increase in size, reducing the clearance of the carotid arteries. This leads to their narrowing. There is a risk of occlusion, which can lead to ischemic stroke and blindness.

The main reason for the development of atherosclerosis is a long-term increase in blood cholesterol due to impaired lipid metabolism. What could be causing this failure? The following risk factors exist:

  • The presence of negative habits in the anamnesis is smoking, abuse of alcohol. In this case, a frequent abrupt change in pressure under the influence of these bad habits can provoke the development of atherosclerosis. The elasticity and tone of the arteries decreases, they lose their margin of safety and therefore it is easier to deposit cholesterol into their endothelium.
  • Hypertension or episodes of high blood pressure.
  • Improper, unbalanced diet with a predominance of fatty foods with fats of animal origin.
  • Sedentary lifestyle, lack of exercise.
  • Frequent stressful conditions
  • Background diseases – diabetes, hypertension, etc.
  • Age. Numerous studies prove that with age, especially after 50 years, the risk of atherosclerosis of arteries of any location increases significantly. This is due to age-related wear of blood vessels, a decrease in their tone and elasticity, as well as hormonal changes.
  • Burdened by heredity. Atherosclerosis is a genetically determined disease. People whose relatives suffered from this vascular pathology are shown a more thorough and frequent preventive examination.

The diagnosis of carotid arteriosclerosis is made on the basis of a number of laboratory and instrumental diagnostic tests. When contacting a competent specialist, he meticulously collects an anamnesis, conducts an objective examination, using ultrasound with contrast visualizes the structure and condition of the arteries. A lipid chart must be given to determine the level of cholesterol and the selection of the appropriate treatment.

If the ultrasound procedure is not enough, then CT / MRI can be prescribed. With their help, you can consider smaller arteries and veins, especially blood flow and look into more distant vascular branches. In rare cases, an invasive technique may be prescribed – angiography. It is rarely used because of the risk of damage to the atheromatous plaque, but nevertheless, this procedure gives the most accurate and most detailed diagnostic results.

After detecting the ailment and the first symptoms of the disease, you should immediately seek qualified medical help. The first step towards getting rid of the disease is diagnosis. It is carried out in several stages.

The first step familiar to each disease is the initial appointment with a specialist. It is very important for further research and treatment. At this stage, all important information about the patient is collected: symptoms and complaints, the presence of diseases of the cardiovascular system and operations, heredity, etc.

At this stage, the patient simply needs to fully and thoroughly tell his doctor about his complaints. This will undoubtedly help with further diagnosis and treatment.

The doctor can perform the following procedures for the initial diagnosis:

  • Blood pressure measurement.
  • Patient weighing.
  • Listening to the heart and carotid arteries.
  • Palpation of the carotid arteries, etc.

If at least one sign of the disease is confirmed, further diagnosis is necessary, which will give more accurate indications of the patient’s condition.

With this disease, the following types of instrumental diagnostics are most often used:

Ultrasound examination is a safe and effective method of instrumental diagnostics. He is able to give accurate indications of the degree of narrowing of the carotid arteries and the location of cholesterol plaques. This diagnostic method becomes a priority when the patient’s condition is unstable.

X-ray is a diagnostic method, which consists in introducing a contrast medium into the necessary area and creating a picture. In the picture, you can accurately determine the thickness of the lumen of the vessels, the location of the lesion, the location of the slowdown in blood flow, etc. But the x-ray is not suitable for everyone. It can not be done often, which is not always convenient.

Computed tomography is now rarely used due to a significant lag behind other instrumental diagnostic methods.

Apart is a biochemical blood test. Using it, you can determine the level of substances in the body that lead to the formation of plaques.

In most cases, damage to the carotid arteries occurs after blockage of the vascular systems of other areas. Among the reasons predisposing the formation of growths, internal and external are distinguished. The former are associated with the progression of concomitant pathologies, the latter are related to the patient’s lifestyle characteristics. Stenotic and non-stenotic atherosclerosis of the carotid arteries can develop as a result of the presence of the following factors:

  • diabetes mellitus;
  • ischemic heart disease;
  • genetic predisposition;
  • impaired lipid metabolism, which leads to an increase in cholesterol;
  • endocrine pathologies;
  • hypertension;
  • previous infectious diseases;
  • process of stenosis of other vessels.
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Often the factors become the patient’s wrong lifestyle:

  • smoking;
  • excessive drinking;
  • problems with excess weight caused by poor (harmful) nutrition;
  • constant exposure to stressful situations;
  • lack of mobility, lack of optimal physical activity. Under such circumstances, there is a risk of developing uncovertral arthrosis.

In rare cases, the development of pathology as a result of aneurysm of the carotid arteries is possible. To establish the exact cause, the doctor must carefully examine the patient using different diagnostic methods. The future treatment depends on the factor that triggered the onset of the ailment.

After collecting the patient’s medical history and studying the main complaints, the doctor directs him to additional studies in order to confirm or refute suspicions and make the correct diagnosis.

The complex of procedures includes ultrasound of the cervical spine and head. Using this method, it is possible to visualize the inner wall and detect growths. Blood flow, structural features of the vascular systems in the body are also monitored. Mandatory patients are prescribed magnetic resonance imaging and computed tomography. The growths are studied using micropreparations.

Doctors also measure blood pressure and study eddy currents. It is necessary to donate blood for analysis in order to determine the level of cholesterol. After confirmation of suspicions, appropriate therapy is prescribed. It depends on the stage and form of the disease.

In most cases, the lesion occurs against the background of the development of diseases of other vessels (diffuse atherosclerosis). The deposition of cholesterol plaques occurs under the influence of various external factors and with internal disturbances. The main causes of stenosis of the carotid (as well as other vessels) artery are:

  • high blood cholesterol;
  • the presence of bad habits;
  • high blood pressure;
  • changes in the metabolism of fats in the body;
  • improper diet;
  • hereditary vascular diseases;
  • stress;
  • sedentary lifestyle;
  • diabetes.

Due to the wide diameter of the artery, it is difficult to identify the disease at the initial stage. A person feels the appearance of the first signs after more than half of the clearance is clogged. The patient draws attention to the appearance of frequent tingling and numbness in various parts of the body. Seizures of severe itching of the extremities are periodically observed. A person may experience a symptom of numbness – short-term paralysis of the body. There are problems with vision and speech.

Risk Factors

There are several reasons for the defeat of the carotid arteries. The following factors take part in the development of atherosclerosis:

  • male gender;
  • passive and active smoking of cigarettes and hookahs;
  • advanced age;
  • high blood pressure;
  • obesity;
  • endocrine diseases;
  • improper diet;
  • cytomegalovirus infection;
  • lack of motor activity;
  • dyslipidemia.

Often this disease develops in malnourished people. Of greatest importance is the abuse of foods rich in animal lipids and simple carbohydrates. Fatty varieties of meat and fish, mayonnaise, chips, butter, sour cream, confectionery, pastries, sandwiches and egg yolk negatively affect the condition of the carotid arteries. Excess in the menu of these products is a risk factor for the development of atherosclerosis.

Nicotine and tar contained in tobacco smoke have a negative effect on blood vessels. At an early age, atherosclerosis can be a consequence of physical inactivity. Young people move very little, preferring to drive a car, sit for a long time at a computer and TV. All this leads to obesity and metabolic disorders.

People who play sports are less likely to suffer atherosclerosis. A risk factor is high blood pressure. It contributes to damage to the walls of arteries and facilitates the absorption of endothelium by fats. With age, the incidence rate increases. The reason is the natural process of aging. The greatest importance in the development of atherosclerosis of the carotid arteries is played by such factors as heredity, dyslipidemia, and damage to the vascular wall.

As mentioned above, the main reason for the development of a disease such as carotid atherosclerosis is an increased content of “bad” cholesterol in the patient’s body. But what is the reason for this phenomenon?

There are several risk factors for the development of lesions of the carotid arteries.

Carotid arteriosclerosis is a disease that occurs in a wide variety of age groups. But for the most part it is characteristic of older people.

With age, arteries lose their elasticity. Life of pensioners is not so active. This leads to damage to the blood vessels.

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Excess weight

Being overweight can lead to serious health problems. As a rule, they are closely related to the cardiovascular system. A huge load on the heart and blood vessels leads to diseases such as arrhythmia, atherosclerosis of the carotid arteries, etc.

A fairly common ailment is a high level of blood pressure. Sometimes it does not cause any discomfort to the patient. But in any case, a number of serious changes occur in the body.

High pressure negatively affects the state of blood vessels. They quickly thin out and wear out, which makes them more vulnerable to various diseases.

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Diabetes

Diabetes mellitus is a disease that is accompanied by metabolic disorders. The body cannot process and remove excess cholesterol in the usual rhythm. This leads to the formation of cholesterol plaques in the vessels.

What is meant by the term “wrong lifestyle”? First of all, this is the presence of addictions, the lack of a regime and regular physical exertion, an unbalanced diet.

Nicotine, alcohol and other harmful substances negatively affect the state of blood vessels. Eating semi-finished foods, fatty and highly salty foods increases the percentage of low density lipoproteins in the body. The absence of a regime impairs immunity, slows down metabolic processes. Under the influence of these factors, the disease easily affects the vessels.

symptomatology

In the initial stages, the pathology proceeds without visible signs. Differential diagnosis often occurs only after the patient has suffered a stroke. At the same time, there are symptoms of atherosclerosis of the carotid artery, which can manifest periodically as the disease develops. Timely contacting a doctor will help stop the pathological process, preventing its progression.

Common clinical manifestations include:

  • Feeling of weakness, constant fatigue.
  • Sensation of numbness, numbness.
  • Itching or tingling in the upper and lower extremities. Until the loss of control over one of them.
  • Confusion of speech.
  • Visual impairment. Often the development of an ailment leads to the fact that one eye completely ceases to see.

In the early stages, the disease can manifest itself in the form of transient ischemic attacks. They occur periodically and have a weak intensity (lasting up to sixty minutes). As the disease develops, their duration is up to twenty-four hours.

Similar symptoms often indicate the presence of other ailments. To establish their cause, you need to contact a specialist for a thorough examination.

How the disease proceeds

Symptoms appear with a significant (more than 50%) decrease in the lumen of the carotid arteries. The defeat is unilateral and bilateral. The following manifestations of the disease are possible:

  • headache;
  • tingling sensation;
  • itching;
  • weakness;
  • speech impairment;
  • decreased vision;
  • weakness;
  • chest pain;
  • violation of sensitivity;
  • dizziness;
  • violation of orientation in space;
  • weakness in the limbs;
  • behavior change;
  • sleep disturbance;
  • noise in ears;
  • anxiety;
  • increased excitability;
  • memory loss;
  • slowness of movements;
  • choking while eating.

In the early stages of atherosclerosis of the internal carotid arteries, complaints are negligible. Symptoms occur periodically. After rest, the condition improves. In the stage of progression, the symptoms intensify. Perhaps the appearance of trembling in the limbs. Speech is disturbed. All these symptoms are due to oxygen deficiency of the brain.

In the stage of decompensation, mnestic abilities (memory, thinking, memory ability) are violated. Such people need care from loved ones. Atherosclerosis can cause paresis and paralysis. The risk of developing ischemic stroke increases. Transient ischemic attacks often develop. Symptoms disappear during the day. In their clinical picture, transient attacks resemble a stroke.

Supply system

A special role in the treatment process is played by diet. Initially, alcoholic drinks, soda, fried, salty and fatty foods are excluded from the diet. You should also avoid the use of confectionery, flour.

For prevention, a first-degree diet is usually used. It implies a restriction of fatty meats, egg yolks, butter. The diet should be low-fat dairy products, and during cooking, vegetable oil (olive, sunflower) should be used. Lenten meats (poultry, beef), as well as seafood are allowed.

The second degree diet provides for a more rigid nutrition system. Only low-fat fish, cheeses and cottage cheese are allowed. It is desirable that most of the diet consisted of vegetables and fruits, as well as cereals and legumes.

The consequences of arteriosclerosis of arteries

In the initial stages, atherosclerosis of the carotid arteries very often occurs without obvious clinical signs. The vascular walls and endothelium have high elasticity, so the symptoms will be smoothed and mild. However, there are a number of signs that indicate atherosclerosis localized in the region of carotid arteries. These include:

  • Transient ischemic attacks. The main manifestation of the disease. Ischemic attacks can provoke tingling, numbness, burning, itching of the skin of the limbs on the affected side. In addition, there will be a violation of tactile sensitivity on the skin of the face, shoulders, chest and neck. These signs are not only important diagnostic criteria, but also reflect the current risk of developing a stroke.
  • Intense cephalalgia (headaches), weakness, dizziness. These symptoms are associated with the complex nature of the atherosclerotic lesion – usually, if the process is active in the region of the carotid arteries, it can be diagnosed in all the cerebral regions of these vessels.
  • All types of ischemia.
  • Violation of sensory (visual) function.
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Atherosclerosis of the arteries that provide blood supply to the brain, by its definition, has a lot of negative consequences and complications. With a prolonged course, mental abilities can be affected – cognitive and memory functions of the brain are reduced. In addition to the general negative effect on well-being, there is a risk of ischemic attacks and the development of a stroke.

With atherosclerotic lesions of the carotid arteries, occlusion is possible. This is a dangerous condition, which is characterized by full or partial blockage of the lumen of the vessels that feed the brain. More than 50% of cases of cerebral ischemia are due to damage to the carotid arteries. Against the background of a decrease in the lumen of blood vessels, a lack of oxygen and nutrients occurs.

Often, such people develop dyscirculatory encephalopathy. Its main features are:

  • depression;
  • headache;
  • noise in the head;
  • back pain
  • arthralgia;
  • distraction;
  • difficulty concentrating;
  • fatigue during physical work;
  • impaired thinking;
  • memory impairment.

In the later stages, intelligence decreases. Dementia often develops. Self-service skills are lost. Sick people become apathetic and indifferent to everything. Interest in hobbies is lost. Walking slows down. Symptoms of oral automatism, epileptic seizures, paresis, paralysis, pelvic dysfunction, dysarthria, pseudobulbar syndrome and tremor appear at the 3 stages of encephalopathy against the background of atherosclerosis.

With the development of transient ischemic attacks, transient disorders occur. The following symptoms are possible:

  • monoparesis;
  • hemiparesis;
  • monocular visual impairment;
  • paresthesia;
  • numbness of the face or hands;
  • the appearance of spots in front of the eyes;
  • decreased visual acuity.

Complete obstruction against the background of atherosclerotic lesions of the carotid artery develops in 1% of cases. With atherosclerosis, the following consequences are possible:

  • loss of movement in the limbs;
  • paresis of the facial nerve;
  • aphasia;
  • ischemic stroke;
  • thrombosis;
  • paralysis;
  • blindness;
  • atrophy of the optic nerve;
  • sclerotic changes in the brain;
  • embolism;
  • hemorrhage;
  • dementia.

The prognosis worsens if a sick person is not cured in a timely manner.

Preventive measures

They consist in observing the rules of a healthy lifestyle. This is a quality and healthy food, the absence of bad habits, the elimination of stressful situations. It is also necessary to regularly visit a doctor and follow all his instructions.

The doctor may prescribe medications that help cleanse blood vessels or recommend alternative drugs. In the latter case, soda is widespread. A teaspoon must be dissolved in hot water and taken in the same amount up to four times a day (on an empty stomach or two hours before meals).

Atherosclerosis (code 170 for mcb 10) in any form is a serious disease that requires immediate treatment. Treatment of atherosclerosis of the carotid arteries should be comprehensive. It implies not only qualified medical care, but also the maximum effort on the part of the patients themselves.

Examination and treatment tactics

With atherosclerosis, the following studies are required:

  • Dopplerography of the vessels of the brain and neck;
  • lipid profile;
  • general and biochemical blood tests;
  • coagulogram;
  • angiography;
  • magnetic resonance or computed tomography.

Additionally, the state of the heart and coronary vessels is evaluated. Patients need to be treated after a survey and examination. Your doctor should measure your blood pressure. For visual disturbances, an ophthalmological examination is required. How to treat atherosclerosis is known to every therapist and neurologist.

  1. Quitting smoking and alcohol.
  2. Increased motor activity.
  3. Strict diet.
  4. Taking statins and other drugs.

With the development of thrombosis, antiplatelet agents and anticoagulants are prescribed. In atherosclerosis, it is important to normalize the lipid spectrum if the blood levels of LDL, VLDL, or triglycerides are elevated. For this, statins are prescribed. These include Aterostat, Liprimar, Torvakard, Atorvastatin-Teva, Atoris, Simvastatin Zentiva, Vasilip, Simvor, Pravastatin, Livazo, Rosucard, Tevastor, Roxer, Krestor, Holetar, Cardiostatin, Rovakor, Vero-Lovolastatin and.

Fibrates are less commonly prescribed. If atherosclerotic changes are detected, then you can not do without a diet. It is necessary to abandon offal, sausages, sour cream, butter, fatty meat, mayonnaise, chips, canned food, egg yolk, sweets and lard. It is necessary to reduce the consumption of salt and bakery products. Antihypertensive drugs are often included in the treatment regimen for carotid arteriosclerosis.

Patients are advised to walk in the fresh air every day for at least 1-2 hours. Useful oxygen cocktails. Perhaps the treatment of folk remedies, but it does not replace drug therapy. In severe cases, endarterectomy or endoscopic surgery is required.

Often stenting and prosthetics are performed. With complete occlusion, an anastomosis is created. Thus, damage to the carotid arteries is a serious pathology that can lead to acute cerebral ischemia.

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Svetlana Borszavich

General practitioner, cardiologist, with active work in therapy, gastroenterology, cardiology, rheumatology, immunology with allergology.
Fluent in general clinical methods for the diagnosis and treatment of heart disease, as well as electrocardiography, echocardiography, monitoring of cholera on an ECG and daily monitoring of blood pressure.
The treatment complex developed by the author significantly helps with cerebrovascular injuries and metabolic disorders in the brain and vascular diseases: hypertension and complications caused by diabetes.
The author is a member of the European Society of Therapists, a regular participant in scientific conferences and congresses in the field of cardiology and general medicine. She has repeatedly participated in a research program at a private university in Japan in the field of reconstructive medicine.

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