Vascular atherosclerosis: first manifestations, symptoms and treatment. Severe atherosclerosis what is it

The development of vascular atherosclerosis occurs in adulthood, and the manifestation of the disease occurs in large arteries and vessels. The chemical composition of the blood is disturbed, and the presence of an increased concentration of lipids slows down the flow of the biological fluid, reduces the permeability of the vascular walls. Progressive arterial atherosclerosis is a chronic diagnosis, so the patient's task is to prolong the period of remission.

What is vascular atherosclerosis

This chronic disease belongs to the category of cardiovascular pathologies, prone to periodic relapses in a weakened body. Since protein-lipid metabolism is disturbed in the walls of blood vessels, doctors talk about such unpleasant concepts as "bad cholesterol" and "atherosclerotic plaques." This disease often develops in the body of women, but men, under the influence of provoking factors, also fall into the risk group. More often it is atherosclerosis of the aortic arch, which leads to the development of incurable cardiac ischemia.

Symptoms

Clinical signs of a characteristic disease do not appear immediately; at first, atherosclerosis is an asymptomatic diagnosis. Further symptoms depend on the department of the cardiovascular system, which receives an insufficient amount of oxygen-enriched blood with valuable nutrients. It is important to determine the blood-supplying organ - the focus of pathology. As a result - impaired activity of the myocardium, brain, other complications that are not always associated with human viability.

Atherosclerosis of the heart vessels

If a characteristic ailment occurs, the general well-being of the patient gradually worsens, and signs of atherosclerosis are bedridden, they are forced to issue a sick leave once again. It is recommended to pay attention to the following symptoms of the disease, which can be temporarily eliminated mainly by medication, alternative methods:

acute chest pain, localized in the myocardium;
increased pressure on the sternum;
signs of angina;
pain when taking a deep breath;
kidney failure;
the risk of developing a heart attack;
decrease and jumps in blood pressure;
pathological increase in heart rate.

Vessels of the lower extremities

The upper and lower extremities are equally involved in the pathological process against the background of abnormal narrowing of the lumen of the vascular walls of large and medium-sized arteries. Such internal sections are removed from the myocardium, however, the severity of symptoms adversely affects the general condition of the patient, limits his mobility. Signs of obliterating atherosclerosis of the lower extremities are as follows:

pain in the legs during long walks;
numbness of the lower extremities;
the temperature difference between the body and legs, palpable;
prolonged healing of open wounds;
increased swelling of the lower extremities;
violation of the pulse of the arteries of the legs;
limited mobility.

Vessels of the brain

Large arteries are involved in the pathological process, in the structure of which the presence of atherosclerotic plaques is observed. As a result of disturbed blood flow, the usual origin of nerve impulses in the cerebral cortex is lost, oxygen starvation progresses, the number of painful migraine attacks, dizziness and confusion increases. In modern cardiology, the symptoms of such a dangerous disease are as follows:

frequent dizziness and nausea;
circles before the eyes;
discomfort in a stuffy room;
decreased memory, physical and mental abilities;
sleep phase disorder;
emotional instability;
disturbed metabolic processes;
signs of a mental disorder.

The reasons

Before treating atherosclerosis, it is necessary to study the etiology of the pathological process. It all starts with the formation of blood clots that narrow the lumen of the vessels, resulting in the formation of atherosclerotic plaques that block the vessels. The cause of the pathology is the accumulation of fats, a change in the chemical composition of the blood. The main causes of such pathogenic mechanisms and risk factors are presented below:

the presence of bad habits;
one of the stages of obesity;
diabetes;
dyslipidemia;
malnutrition;
hypodynamia;
genetic factor;
energy overvoltage;
arterial hypertension;
age-related changes in the body;
sedentary lifestyle;
transferred infectious diseases with complications;
intoxication and infection;
pathology of the endocrine system;
prolonged exposure to stress.

stages

Having determined what can cause atherosclerosis, an individual consultation with a cardiologist is necessary. Before conducting clinical examinations and laboratory studies, it is shown to study the existing stages of a characteristic ailment, the high probability and severity of an acute attack. In modern cardiology, the following stages of atherosclerosis are distinguished:

First stage. Decrease in the rate of systemic blood flow, the growth of a fatty spot, the absence of painful symptoms.
Second stage. Liposclerosis is accompanied by the growth and spread of adipose tissue, a high probability of a blood clot and impaired systemic circulation.
Third stage. Atherocalcinosis is accompanied by thickening of atherosclerotic plaques, calcium deposition, vascular deformity and narrowing of the lumen with the risk of blockage.

Diagnostics

In modern cardiology, it is impossible to determine coronary atherosclerosis by collecting anamnesis data; in addition to examining the patient and studying his medical history, it is necessary to take tests, visit a number of highly specialized specialists, and undergo a comprehensive examination. The specifics and features of diagnostics include the following areas:

blood chemistry;
duplex scanning of brachiocephalic arteries and extremities;
radiopaque angiography;
ECG, stress ECG, echocardiography;
Ultrasound, CT and MRI;
ultrasound dopplerography of cerebral vessels;
radiography.

Treatment

With the manifestation of a characteristic ailment, it is required to start treatment of atherosclerosis in a timely manner. Intensive care can be provided through conservative methods and physiotherapy. The main goal is to determine the pathogenic factor and eliminate it from the life of a clinical patient, normalize systemic blood flow, lower the level of bad cholesterol with the help of prescribed medications. It is allowed to carry out alternative treatment, however, all the nuances need to be further discussed with the attending physician. If there is no effect, surgery is recommended.

Medical

The first step is to control your daily diet, exclude fatty and fried foods, limit the intake of salt, spices, animal fats, and fast food. Nutrition should be balanced, contain a sufficient amount of vegetable fiber. This will help control weight, treat obesity and remove the stomach, avoid another attack. As for taking medications, they are determined by a knowledgeable cardiologist strictly for medical reasons. These are the pharmacological groups:

Nicotinic acid and preparations containing it to provide anti-atherogenic properties, eliminate harmful cholesterol and triglycerides;
Bile acid sequestrants to reduce the concentration of lipids in cells. These drugs are Colestyramine, Colestipol, Colesevelam.
Beta-blockers to eliminate unpleasant symptoms, reduce the severity of a pain attack. These are Carvedilol, Metoprolol, Betaloc.
Diuretics with a diuretic effect for high-quality cleaning of blood from cholesterol. These are Hypothiazid, Diakarb, Indapamide.
Calcium channel blockers, represented by such medicines as Anipamil, Finoptin, Gallopamil.
Fibrates for the synthesis of own fats. These are Clofibrate, Bezafibrate, Fenofibrate, Bezafibrate, Gemfibrozil.
Statins to accelerate the breakdown and elimination of fats. These are Simvastatin, Atorvastatin, Rosuvastatin.

Surgical

If conservative methods proved to be ineffective in practice, the patient is prescribed an operation to eliminate all manifestations of atherosclerosis, ensure high-quality cleaning of the vessels and a long period of remission. Since such a disease poses a threat to the patient's life, the doctor suggests one of the following surgical interventions in a hospital:

thrombolytic therapy. The pathogenic clot dissolves, while the systemic blood flow normalizes, the vessels are cleaned.
Angioplasty. The vascular lumen is expanded by injecting oxygen with a special medical balloon.
Shunting. Creation of a new blood flow with the help of vessels bypassing the potential lesion site.
Endarterectomy. High-quality cleaning of the vascular walls with special tools, there is a steady positive trend.

After the operation, the patient's sensations are not the most pleasant, so a long period of rehabilitation is required. In order to bring the general condition back to normal, the patient needs to undergo a medication course, exclude the impact of pathogenic factors, give up bad habits and normalize the daily diet. This will be facilitated by vegetable fiber, vitamins, proteins, exclusion from the daily diet of sugar and harmful lipids. With atherosclerosis, alternative medicine methods can be used, and then pathogenic factors are easily eliminated.

Folk remedies

From atherosclerosis, doctors recommend using a rosehip decoction, which has a stable diuretic effect. The medicine productively cleans clogged vessels, removes harmful cholesterol, lipids, and toxic substances. To prepare a healing decoction 1 tbsp. l. dry grass steam 1 tbsp. boiling water, insist and strain, take orally after meals twice a day - in the morning and in the evening. Other folk recipes for atherosclerosis are presented below, useful for problem vessels:

Grind the roots of elecampane, pour the finished mixture in a volume of up to 1. h. Pour 300 ml of water, add oregano, shepherd's purse, blackberries. Boil, boil for 5-7 minutes. Take the finished composition throughout the day in equal portions.
50 g of Japanese Sophora pour 500 g of vodka, insist in a dark place for 30 days. Take orally 1 tsp. three times a day, preferably before meals, drink plenty of fluids.
Place 50 g of cloves in a glass container, pour 500 ml of vodka, infuse the composition for 2-3 weeks. Take 1 tsp. infusion three times a day, while making sure that there are no chronic stomach diseases.

Onion juice with honey from atherosclerosis

This is an effective remedy against atherosclerosis, which can be prepared at home. It takes 300 g of grated garlic (onions) to combine with the juice of three lemons. Stir, place in a glass container, leave in the refrigerator overnight. 1 tsp. composition diluted in a glass of warm water, taken orally.

Complications

If atherosclerosis occurs in a complicated form, complications are not excluded even after long-term treatment. The consequences of the operation are especially dangerous, therefore, it is necessary to carefully prepare for the surgical intervention, undergo diagnostics and pass all the necessary tests. Among the potential complications of atherosclerosis, the following dangerous pathologies should be distinguished:

heart failure;
acute blockage of blood vessels;
infarction of internal organs;
sudden death;
arterial aneurysm rupture.

Prevention

To avoid atherosclerosis, productive cleaning of blood vessels requires the use of alternative medicine methods for reliable prevention. In addition, it is shown to change the habitual lifestyle, adhere to the basic rules of proper nutrition, play sports and take walks in the fresh air. With a tendency to atherosclerosis, a multivitamin complex will not be superfluous to strengthen the vascular walls, it is supposed to drink enough water to normalize the body's water metabolism.

One of the important ways to prevent diseases of the heart and blood vessels is to provide the body with Omega polyunsaturated fatty acids. For example, taking the unique Doppelgerz Active Omega 3-6-9 complex. It contains PUFAs from salmon fish fat - alpha-linolenic, eicosapentaenoic and docosahexaenoic, which contribute to the regulation of blood cholesterol, lower blood pressure, and are involved in fat metabolism. In addition, the complex includes flaxseed oil - a source of Omega-6 PUFAs, in particular, linoleic acid, which is involved in carbohydrate and fat metabolism, and olive oil, rich in omega-9 PUFAs, especially oleic acid. A pleasant bonus of taking such a complex will be a significant improvement in the condition of the skin, hair and nails.

Video: atherosclerotic cardiosclerosis

Atherosclerotic lesion of blood vessels is an unpleasant diagnosis faced mainly by older people. In official medicine, atherosclerosis of the arteries is called the main cause of the development of life-threatening conditions: ischemic stroke, myocardial infarction, insufficiency of internal organs.

To date, no such methods have been found for the treatment of atherosclerosis of the vessels, which could permanently get rid of the disease. Patients have to take a number of special drugs for the rest of their lives. But even this does not guarantee the absence of the risk of deadly complications. In order for the treatment of atherosclerosis to be effective, you have to change your lifestyle, follow a diet, and systematically undergo complex diagnostics.

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What is atherosclerosis and can it be cured

Official medicine classifies vascular atherosclerosis as a complex lesion of large and medium arteries with deposits consisting of cholesterol. Lipids form so-called plaques that interfere with normal blood flow and, under certain conditions, exfoliate, blocking the lumen of smaller vascular branches. With the progression of the disease, cholesterol deposits thicken, become more rigid due to the presence of connective tissue cells and calcifications in them. It becomes impossible to remove them by conservative methods.

In recent decades, pathology has become rampant:

the disease is diagnosed in every third man over 50 years old, and in every fifth woman at the same age;
half of the patients, even despite the timely treatment of atherosclerosis, develop serious life-threatening complications;
deaths from atherosclerosis have exceeded those of cancer, injury, and infection.

Such statistics are due to people's ignorance of what atherosclerosis is, how it manifests itself and how you can protect yourself from this dangerous disease. Moreover, at least 15% of patients experiencing symptoms of the disease deny the need for diagnosis and treatment of atherosclerosis, do not follow the doctor's recommendations and refuse to take medications.

Contrary to the opinion of many patients who are sure that atherosclerosis affects single vessels of individual organs (only the heart or only the brain), experts consider this disease to be systemic. The causes of atherosclerotic changes are multifaceted, so they cannot affect single vessels: the pathogenesis of atherosclerosis is based on a complex change in metabolism, metabolism and the functioning of internal organs, which is why pathological changes are observed in all large and medium arteries.

Significant efforts are required for the effective treatment of vascular atherosclerosis. Doctors and the patient will have to work on nutrition, lifestyle, while simultaneously reducing the level of harmful lipids in the blood with medications. At the same time, there is no question of whether it is possible to recover from atherosclerosis once and for all. To date, this disease is considered incurable, requiring lifelong therapy and constant monitoring of the state of the circulatory system and the functioning of the affected organs.

Which doctor treats atherosclerosis?

If you suspect problems with blood vessels, you should not choose which specialist is better to contact. For starters, it is recommended to consult a therapist. He will prescribe a comprehensive examination and, if atherosclerotic changes are detected, he will refer to a narrow specialist. Which organs are affected by the disease will depend on which doctor treats atherosclerosis in an individual patient. Usually several specialists are involved in this: a cardiologist, a neurologist, a surgeon and other doctors of narrow specializations.

What is dangerous atherosclerosis - the mechanism of development

The development of atherosclerotic changes is very slow. On average, at least 20-30 years pass from the onset of pathological changes in the vessels to the appearance of the negative consequences of atherosclerosis. The slow course causes the symptoms to increase imperceptibly. And this is the first thing that atherosclerotic changes in blood vessels are dangerous for. The exacerbation of the disease or its manifestation is always sudden, because of which the patient may not receive timely assistance - in order to provide it, doctors will first have to diagnose high cholesterol and atherosclerosis.

For a long time, the patient does not notice the changes taking place with him and the initial signs of atherosclerosis, until the first vascular catastrophe occurs:

ischemia of organs (brain, heart, kidneys and others);
hemorrhagic or ischemic stroke;
aneurysm formation and rupture.

To prevent this from happening, it is important to know about the first signs of atherosclerosis and understand what exactly leads to the deposition of cholesterol in the arteries. This will allow you to assess the risks and suspect vascular problems before the changes become irreversible or life-threatening.

The main factors in the development of atherosclerosis are conventionally divided into two groups:

Not dependent on a person, his environment, lifestyle. According to statistics, age is considered the main predisposing factor for the occurrence of cholesterol deposits. The older the person, the higher the risk of getting sick. In medicine, cases are not known when atherosclerosis was detected in children, although theoretically and in practice there are cases of detection in large arteries in adolescents and children at the initial stage of pathology. It is they who have the second irremovable factor - hereditary predisposition. In such patients, the causes of atherosclerosis most often consist of a violation of metabolic processes in which cholesterol is produced in the body in excessive amounts.
Depending on the person, his environment and lifestyle. First of all, this is an unhealthy diet, which contains a lot of fats of animal origin. The situation with cholesterol deposits is complicated by smoking and alcohol, limited physical activity. In the presence of these factors, atherosclerosis first affects the walls of blood vessels, and the body tries to restore them by forming a fatty film consisting of cholesterol.

Often, signs of atherosclerosis appear against the background of other diseases that are partially or completely controllable, but not curable: with diabetes mellitus, dyslipidemia (impaired lipid balance and metabolism in the body), hypertension, with general intoxication of the body. Such conditions lead to damage to the arterial walls, prevent the breakdown and removal of harmful fats from the body.

Important! Atherosclerosis does not develop in the presence of one predisposing factor. For the progression of the disease to dangerous diagnosable stages, a combination of removable and unremovable, controllable and uncontrollable factors in various variations is necessary.

If the disease is not detected in a timely manner, or the patient for some reason does not receive treatment, he is threatened with such dangerous conditions as vascular insufficiency of internal organs, acute heart attack or stroke, aneurysm rupture.

Stages of atherosclerosis

Regarding the stages of development of atherosclerosis, the classification distinguishes 3 stages of disease progression. Each of them is characterized by a different degree of damage to the arteries. The development of atherosclerosis by stages is described in more detail in the table below:

Stage of the disease	Localization of pathological foci	What happens to the vascular wall
Stage I - fatty spot	Large arteries where they branch.	In the initial stage of atherosclerosis, there is a protective reaction of the body to microdamage to the vascular walls. At the site of such damage, local edema and loosening occur. Enzymes dissolve lipids for some time, protecting the integrity of the intima (the inner surface of the vessel), and as the protective functions are depleted, increased deposition of lipids and proteins occurs. At an early stage of development, atherosclerosis does not manifest itself in any way. It can only be detected by examining the damaged section of the artery under a microscope. Such changes can occur even in children. Further development of atherosclerosis will only occur in the presence of predisposing and traumatic factors.
II stage - liposclerosis	Branching of large and smaller arteries.	Progressive atherosclerosis is accompanied by the formation of connective fibers in the fatty spot - an atherosclerotic plaque is formed. It is quite soft and does not interfere with blood flow, but under certain conditions it can come off and clog smaller vessels. The wall of the artery under the plaque, on the contrary, becomes less elastic, and when blood pressure drops, it can collapse, which leads to the formation of blood clots. At this stage of atherosclerosis, the first alarming symptoms are observed.
III stage - atherocalcinosis	Any sections of large and medium arteries.	With atherosclerosis of the 3rd degree, a thickening of the cholesterol plaque occurs due to the accumulation of calcium salts to it. It becomes harder and continues to grow, due to which the lumen of the arteries noticeably narrows. The patient has severe symptoms associated with insufficient blood supply to organs, and sometimes parts of the body (when peripheral atherosclerosis occurs). Ischemia of the brain, myocardium, kidneys and intestines occurs, the risk of occlusion (blockage) increases significantly. In patients who have suffered such a condition, post-infarction atherosclerosis, gangrene of the extremities, and necrosis of the tissues of internal organs are often observed.

It is noteworthy that at the initial stages, the early signs of atherosclerosis are ignored, although in the early stages the disease can be successfully contained by taking a complex of medications. At stages 2 and 3 of the disease, the treatment of atherosclerosis is more complicated. It requires not only the stabilization of cholesterol levels, but also the restoration of the functions of internal organs and systems.

Symptoms

There are no specific symptoms of atherosclerosis. Clinical manifestations of pathology are always complex and directly depend on which organs suffered from insufficient blood supply.

With the defeat of the cerebral arteries, the following symptoms occur:

deterioration of short-term memory - the patient remembers what happened in the distant past, but forgets the events that took place a few minutes ago;
sleep disturbances - the patient has problems falling asleep, suffers from insomnia, wakes up several times at night;
neurological disorders - mood swings, exacerbation of character traits, irritability are combined with regular headaches that are not relieved by conventional painkillers.

Symptoms increase gradually, which is why they are not always perceived as something threatening. At the final stage, they acquire especially acute features: the patient suffers from a constant feeling of fatigue, cannot lead his former way of life and serve himself because of persistent memory impairment. There is a loss of interest in life, apathy. Most people suffering from the disease become depressed.

Symptoms may resemble manifestations of heart and lung diseases, since against its background there is:

shortness of breath, reduced breathing;
general weakness and rapid fatigue during physical exertion;
dull pain behind the sternum;
cardiac arrhythmias of the type of angina pectoris.

Often, taking over-the-counter heart drugs (Validol, Nitroglycerin, Corvalol) with such symptoms does not bring relief.

In terms of symptoms, it resembles tumor processes in the organs of the abdominal cavity and small pelvis. In this case, patients complain of the following discomfort:

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paroxysmal pain in the abdomen of unclear localization, which are not associated with food intake and stool;
flatulence of the intestines, which is not associated with the intake of fiber-rich foods;
frequent tension of the anterior abdominal wall.

As in the case of damage to other vessels, standard drugs (antispasmodics, analgesics, enterosorbents, defoamers, and others) do not have the desired effect.

Atherosclerosis of the renal arteries is also accompanied by nonspecific symptoms. With the defeat of this group of vessels, patients suffer from a severe form of arterial hypertension. Against this background, dull pains in the lower back are observed, which persist during activity and at rest.

Patients complain of pain and heaviness in the legs, which at the initial stage of the disease subside at rest. Along with this, the quality of the skin changes: it becomes pale and dry in the area below the site of the narrowing of the vessel. If atherosclerosis is not treated, trophic ulcers and areas of necrosis form on the limbs closer to the foot, which can then develop into gangrene. Similar symptoms are observed with damage to the arteries of the hands.

It is almost impossible to independently differentiate the disease due to the non-specificity of symptoms. Moreover, narrow specialists also cannot always immediately suspect this pathology, since in clinical practice it is extremely rare for only one group of arteries to be affected: the combination of symptoms can be extremely atypical and unexpected, which makes diagnosis difficult.

Treatment of vascular atherosclerosis

Treatment for vascular atherosclerosis is aimed at restoring and stimulating metabolism (primarily proteins and lipids), reducing cholesterol synthesis in the body and limiting its intake with food. Positive dynamics is observed only with therapy in the initial stages of the disease, while lipid deposits in the arteries do not contain connective tissue and calcifications. With advanced forms of the disease, complex therapy can only guarantee the absence of further progress.

Medicines

The main direction of therapy is taking medications of several groups. Statins play a major role in atherosclerosis. This group of drugs is designed to reduce cholesterol levels in the body by reducing lipid synthesis in the liver and reducing their absorption in the digestive tract. Bile acid sequestrants and fibrates, as well as nicotinic acid derivatives, have properties similar to them.

In addition to the listed drugs, patients with atherosclerotic changes are prescribed additional drugs:

preparations containing Omega-3 - they improve lipid metabolism, reduce inflammation in the walls of arteries, and to a certain extent reduce blood viscosity;
preparations that improve blood circulation in organs and tissues, including those based on medicinal herbs;
drugs to stabilize blood pressure;
sedatives and nootropics, including those based on herbal ingredients.

Medicines are selected individually, taking into account the results of the diagnosis and the presence of concomitant diseases.

Diet

Drug therapy must be accompanied by compliance, since it is not effective to treat vascular atherosclerosis with drugs alone: without limiting the intake of lipids with food, they will not be able to have a pronounced effect on the body.

Exclude from the patient's menu:

high-fat animal products, including meat, lard, milk, sour cream and cream, butter;
solid vegetable and animal fats;
sweets, muffins, chocolate and cream cakes, ice cream;
alcoholic and low-alcohol drinks;
strong coffee and tea.

The basis of the diet should be vegetables and fruits rich in fiber, cereals (oatmeal, buckwheat, rice), white meat (chicken and turkey breasts), seafood and sea fish, natural low-fat yogurt or kefir, egg whites or quail eggs, skim milk. Bread and pastries can be eaten if they are made from wholemeal flour.

In addition to a set of certain products, the method of cooking plays a special role. The preferred cooking method is boiling, steaming, baking in parchment and stewing in your own juice. Nutrition should be fractional: the portion size should not exceed 200 ml, and the number of meals ranges from 5 to 7 times a day.

Surgical intervention

If there is a high risk of blockage of the arteries and the development of a heart attack or stroke, the treatment of atherosclerosis is continued using surgical methods. There are 4 effective methods for restoring blood flow:

- open surgery on the arteries, during which the cholesterol plaque is removed along with part of the inner lining of the vessel;
endovascular dilatation of arteries- expansion of the lumen with balloon catheters;
endovascular stenting- expansion of the lumen of the arteries with the help of a spiral or mesh cylinder (stent);
coronary artery bypass grafting- creation of a new blood supply channel bypassing the damaged section of the artery.

A successful surgical intervention does not mean that the patient has completely got rid of the problem. After the operation, he will have to take medication and diet.

How to identify atherosclerosis - diagnostic methods

For modern medicine, the diagnosis of atherosclerosis is not a difficult task, especially if the patient has clear clinical signs of the disease. Initial conclusions are made on the basis of an oral questioning of the patient and a general examination. In favor of the disease testify:

swelling of soft tissues;
trophic changes in the skin on the limbs;
low weight;
the presence of wen on the body;
change in the pulsation of the arteries;
high or unstable blood pressure.

Since it is impossible to diagnose atherosclerosis only on the basis of complaints and anamnesis, a comprehensive examination is carried out, which includes:

blood tests for low-density lipoproteins, triglycerides and cholesterol;
vascular angiography;
kidneys, carotid and coronary arteries, vessels of the lower extremities and aorta.

Also, the diagnosis of atherosclerosis may include an examination using MRI and CT. With the help of these examination methods, organ damage due to tissue ischemia is diagnosed. Of no small importance is the rheovasography of the lower extremities, which makes it possible to detect a decrease in the rate of blood flow in them. This type of diagnosis is useful in the beginning of the disease, since it can be difficult to detect atherosclerosis by the previously announced methods at this stage of progression.

Complications in atherosclerosis

With atherosclerosis and dyslipidemia, patients are at risk of many complications, because almost all organs and systems suffer from insufficient blood circulation. Conventionally, they can be divided into 3 groups:

Vascular insufficiency caused by malnutrition and gas exchange in the tissues of internal organs: such complications of atherosclerosis can be represented by dystrophic and necrotic changes that inevitably affect the functionality of organs and systems. With brain damage, the consequences of such processes can be progressive dementia, loss of vision, hearing, memory, and profound disability. With damage to the vessels of the heart, patients develop coronary disease, which also leads to profound disability. Damage to the arteries that feed the internal organs (kidneys, intestines, liver) results in multiple organ failure or organ necrosis. Atherosclerosis in the legs is complicated by gangrene.

Detachment of cholesterol plaques or the formation of blood clots with subsequent blockage of blood vessels: such complications of atherosclerosis occur rapidly and are catastrophic (not without reason in medicine there are the terms "brain catastrophe" and "heart catastrophe"). As a result of such processes, myocardial infarction and acute ischemic stroke develop. The result is paralysis and loss of many habitual functions. More than 70% die in the first year after plaque rupture occurs.

Thinning of the vessel wall with its subsequent protrusion outward - the development of an aneurysm: this complication can develop for a long time and go unnoticed. With stress, physical and emotional overstrain, which are often accompanied by jumps in blood pressure, the wall of the artery can burst. The rupture of an aneurysm leads to profuse internal bleeding, and in 80% of cases ends in death.

The only way to avoid such dangerous consequences of the disease is to consult a doctor if symptoms appear that may indicate vascular atherosclerosis. After the diagnosis is made, it is important to strictly follow the recommendations of the doctor, lead a healthy lifestyle and take the medicines prescribed by the specialist. Subject to such conditions, the patient can live to a ripe old age and maintain a high quality of life.

Video: atherosclerosis

Systemic damage to arteries of large and medium caliber, accompanied by accumulation of lipids, proliferation of fibrous fibers, endothelial dysfunction of the vascular wall and leading to local and general hemodynamic disorders. Atherosclerosis can be the pathological basis of coronary artery disease, ischemic stroke, obliterating lesions of the lower extremities, chronic occlusion of mesenteric vessels, etc. The diagnostic algorithm includes determining the level of blood lipids, performing ultrasound of the heart and blood vessels, and angiographic studies. With atherosclerosis, drug therapy, diet therapy, and, if necessary, revascularizing surgical interventions are carried out.

ICD-10

I70

General information

Atherosclerosis is a lesion of the arteries, accompanied by cholesterol deposits in the inner membranes of the vessels, narrowing of their lumen and malnutrition of the blood-supplying organ. Atherosclerosis of the vessels of the heart is manifested mainly by attacks of angina pectoris. Leads to the development of coronary heart disease (CHD), myocardial infarction, cardiosclerosis, vascular aneurysm. Atherosclerosis can lead to disability and premature death.

With atherosclerosis, arteries of medium and large caliber, elastic (large arteries, aorta) and muscular-elastic (mixed: carotid, arteries of the brain and heart) types are affected. Therefore, atherosclerosis is the most common cause of myocardial infarction, coronary artery disease, cerebral stroke, circulatory disorders of the lower extremities, abdominal aorta, mesenteric and renal arteries.

In recent years, the incidence of atherosclerosis has become rampant, outstripping the risk of disability, disability and mortality such causes as injuries, infectious and oncological diseases. With the greatest frequency, atherosclerosis affects men older than 45-50 years (3-4 times more often than women), but occurs in younger patients.

The mechanism of development of atherosclerosis

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) spots. For the deposition of fats in the vascular wall, microdamage to the walls of arteries and local slowing of blood flow play an essential role. Areas of branching of vessels are most susceptible to atherosclerosis. The vascular wall loosens and swells. Enzymes in the arterial wall tend to dissolve lipids and protect its integrity. When the protective mechanisms are exhausted, complex complexes of compounds are formed in these areas, consisting of lipids (mainly cholesterol), proteins, and their deposition occurs in the intima (inner shell) of the arteries. The duration of the lipid spot stage is different. Such fatty spots are visible only under a microscope, they can be detected even in infants.

II stage- liposclerosis. It is characterized by growth in areas of fatty deposits of young connective tissue. Gradually, an atherosclerotic (or atheromatous) plaque is formed, consisting of fats and connective tissue fibers. At this stage, atherosclerotic plaques are still liquid and can be subjected to dissolution. On the other hand, they are dangerous, because their loose surface can rupture, and plaque fragments can clog the lumen of the arteries. The wall of the vessel 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.

III stage- atherocalcinosis. Further plaque formation is associated with its compaction and the deposition of calcium salts in it. An atherosclerotic plaque can behave stably or grow gradually, deforming and narrowing the lumen of the artery, causing a progressive chronic violation of the blood supply to the organ fed by the affected artery. At the same time, there is a high probability of acute blockage (occlusion) of the lumen of the vessel by a thrombus or fragments of a disintegrated atherosclerotic plaque with the development of an infarction site (necrosis) or gangrene in the limb or organ supplied by the artery.

This point of view on the mechanism of development of atherosclerosis is not the only one. There are opinions that infectious agents play a role in the development of atherosclerosis (herpes simplex virus, cytomegalovirus, chlamydial infection, etc.), hereditary diseases accompanied by an increase in cholesterol levels, mutations in cells of the vascular walls, etc.

Factors in the development of atherosclerosis

Factors influencing the development of atherosclerosis are divided into three groups: fatal, removable and potentially removable.

Unremovable factors include those that cannot be eliminated with the help of volitional or medical influence. These include:

Age. With age, the risk of developing atherosclerosis increases. Atherosclerotic changes in blood vessels in one way 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 of atherosclerosis among women by 4 times. After 50-55 years, the incidence of atherosclerosis among women and men levels off. This is due to a decrease in the production of estrogens and their protective function in women during menopause.
Burdened family heredity. Often, atherosclerosis develops in patients whose relatives suffer from this disease. It has been proven that heredity for atherosclerosis contributes to the early (up to 50 years) development of the disease, while after 50 years, genetic factors do not play a leading role in its development.

Eliminable factors of atherosclerosis are considered to be those that can be excluded by the person himself by changing his usual lifestyle. These include:

Smoking. Its influence on the development of atherosclerosis is explained by the negative effect of nicotine and tar on blood vessels. Long-term smoking several times increases the risk of hyperlipidemia, arterial hypertension, coronary artery disease.
Unbalanced nutrition. Eating a large amount of animal fats accelerates the development of atherosclerotic vascular changes.
Physical inactivity. Maintaining a sedentary lifestyle contributes to the violation of fat metabolism and the development of obesity, diabetes mellitus, atherosclerosis of blood vessels.

Potentially and partially removable risk factors include those chronic disorders and diseases that can be corrected through the prescribed treatment. These include:

arterial hypertension. Against the background of high blood pressure, conditions are created for increased impregnation of the vascular wall with fats, which contributes to the formation of an atherosclerotic plaque. On the other hand, decreased elasticity of the arteries in atherosclerosis contributes to the maintenance of elevated 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. Increase the likelihood of atherosclerosis by 5-7 times. This is due to a violation of fat metabolism, which underlies these diseases and is the trigger for atherosclerotic vascular lesions.
Infections and intoxications. 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 removable and potentially removable circumstances can be weakened or completely eliminated. Elimination of adverse factors can significantly slow down and facilitate the development of atherosclerosis.

Symptoms of atherosclerosis

With atherosclerosis, the thoracic and abdominal aorta, coronary, mesenteric, renal vessels, as well as the arteries of the lower extremities and the brain are more likely to suffer. In the development of atherosclerosis, preclinical (asymptomatic) and clinical periods are distinguished. In the asymptomatic period, an increased content of β-lipoproteins or cholesterol is found 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, insufficient blood supply to one or another organ develops (for example, myocardial ischemia due to atherosclerosis of the coronary vessels is manifested by angina pectoris). In the thrombonecrotic stage, thrombosis of altered arteries joins (for example, the course of atherosclerosis of the coronary vessels can be complicated by myocardial infarction). At the stage of fibrotic changes, connective tissue grows 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 atherosclerosis of the coronary vessels are angina pectoris, myocardial infarction and cardiosclerosis, consistently reflecting the stages of circulatory failure of the heart.

The course of atherosclerosis of the aorta is asymptomatic for a 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. The decrease in the elasticity of the walls of the aorta causes an increase in the work of the heart, leading to hypertrophy of the myocardium of the left ventricle.

Atherosclerotic lesions of the abdominal aorta are manifested by pain in the abdomen of various localization, flatulence, and constipation. With atherosclerosis of the abdominal aortic bifurcation, numbness and coldness of the legs, swelling and hyperemia of the feet, necrosis and ulcers of the toes, intermittent claudication are observed.

Manifestations of atherosclerosis of the mesenteric arteries are bouts of "abdominal toad" and a violation of the digestive function due to insufficient blood supply to the intestine. Patients experience sharp pains a few hours after eating. Pain is localized in the navel or upper abdomen. The duration of the pain attack is from several minutes to 1-3 hours, sometimes the pain syndrome is stopped by taking nitroglycerin. There are bloating, belching, constipation, palpitations, increased blood pressure. Later, fetid diarrhea with fragments of undigested food and undigested fat joins.

Atherosclerosis of the renal arteries leads to the development of symptomatic vasorenal arterial hypertension. In the urine, erythrocytes, protein, cylinders are determined. With unilateral atherosclerotic lesions of the arteries, a slow progression of hypertension is noted, accompanied by persistent changes in the urine and persistently high blood pressure. Bilateral lesion of the renal arteries causes malignant arterial hypertension.

Complications of atherosclerosis

Complications of atherosclerosis are chronic or acute vascular insufficiency of the blood-supplying organ. The development of chronic vascular insufficiency is associated with a gradual narrowing (stenosis) of the lumen of the artery by atherosclerotic changes - stenosing atherosclerosis. Chronic insufficiency of blood supply to an organ or part of it leads to ischemia, hypoxia, dystrophic and atrophic changes, proliferation of connective tissue and the development of small-focal sclerosis.

Acute occlusion of blood vessels by a thrombus or embolus leads to the occurrence of acute vascular insufficiency, which is manifested by the clinic of acute ischemia and organ infarction. In some cases, an arterial aneurysm can rupture with a fatal outcome.

Diagnosis of atherosclerosis

Initial data for atherosclerosis are established by clarifying the patient's complaints and risk factors. A consultation with a cardiologist is recommended. During a general examination, signs of atherosclerotic lesions of the vessels of internal organs are revealed: edema, trophic disorders, weight loss, multiple wen on the body, etc. Auscultation of the vessels of the heart and aorta reveals systolic murmurs. Atherosclerosis is evidenced by a change in the pulsation of the arteries, an increase in blood pressure, etc.

Data from laboratory studies indicate an increased level of blood cholesterol, low-density lipoproteins, triglycerides. X-ray aortography reveals signs of atherosclerosis of the aorta: its elongation, thickening, calcification, expansion in the abdominal or thoracic regions, the presence of aneurysms. The condition of the coronary arteries is determined by coronary angiography.

Blood flow disorders in other arteries are determined by angiography - contrast radiography of blood vessels. With atherosclerosis of the arteries of the lower extremities, according to angiography, their obliteration is recorded. With the help of ultrasound examination 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. Decreased blood flow can be diagnosed using rheovasography of the lower extremities.

Treatment of atherosclerosis

In the treatment of atherosclerosis, the following principles are followed:

restriction of cholesterol entering the body and a decrease in its synthesis by tissue cells;
increased excretion of cholesterol and its metabolites from the body;
use of estrogen replacement therapy in menopausal women;
impact on infectious agents.

Restriction of dietary cholesterol is made by prescribing a diet that excludes cholesterol-containing foods.

For the medical treatment of atherosclerosis, the following groups of drugs are used:

Nicotinic acid and its derivatives - effectively reduce the content of triglycerides and cholesterol in the blood, increase the content of high-density lipoproteins, which have anti-atherogenic properties. The appointment of nicotinic acid preparations is contraindicated in patients suffering from liver diseases.
Fibrates (clofibrate) - reduce the synthesis of your own fats in the body. They can also cause liver dysfunction and gallstone disease.
Bile acid sequestrants (cholestyramine, colestipol) - bind and remove bile acids from the intestine, thereby lowering the amount of fat and cholesterol in the cells. When used, constipation and flatulence may occur.
Drugs of the statin group (lovastatin, simvastatin, pravastatin) are the most effective for lowering cholesterol, since they reduce its production in the body itself. Statins are used at night, because cholesterol synthesis increases at night. May lead to liver dysfunction.

Surgical treatment for atherosclerosis is indicated in cases of high risk or development of arterial occlusion by a plaque or thrombus. On the arteries, both open operations (endarterectomy) and endovascular operations are performed - with dilatation of the artery using balloon catheters and installation of a stent at the site of narrowing of the artery, which prevents blockage of the vessel.

With severe atherosclerosis of the heart vessels, threatening the development of myocardial infarction, coronary artery bypass grafting is performed.

Forecast and prevention of atherosclerosis

In many ways, the prognosis of atherosclerosis is determined by the behavior and lifestyle of the patient himself. Elimination of possible risk factors and active drug therapy can delay the development of atherosclerosis and improve 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, it is necessary to stop smoking, eliminate the stress factor, switch to low-fat and low-cholesterol foods, systematic physical activity in proportion to one's abilities and age, and normalization of weight. It is advisable to include in the diet products containing fiber, vegetable fats (linseed and olive oils), which dissolve cholesterol deposits. The progression of atherosclerosis can be slowed down by taking cholesterol-lowering drugs.

Characterized by the deposition of lipids ( fatty substances) and proteins on the walls of the arteries, as a result of which the diameter of the vessels narrows. Such a narrowing of the arteries leads to a deterioration in the blood supply to the organs of the body, and subsequently the affected vessels undergo dystrophic and sclerotic processes.

Women suffer from atherosclerosis less often than men, and the disease itself develops in them, according to statistics, 10-15 years later than in men. Doctors explain such statistics by the difference in the lifestyle of men and women, and besides, estrogen hormones produced by the ovarian appendages are a serious factor in protecting against atherosclerosis for women.

Reasons for the development of atherosclerosis

1. Hereditary factor: if the parents also suffered from atherosclerosis.
2. Improperly balanced diet, excessive amounts of fat in the foods consumed.
3. Insufficiently mobile lifestyle, lack of physical activity.
4. Frequent psycho-emotional stress.
5. Violation of the functioning of blood vessels due to previous infectious diseases.
6. Hypertension ( high blood pressure).
7. smoking.

Accompanying illnesses

The development of sclerotic processes leads to the fact that the patient develops new, associated with atherosclerosis, diseases that are directly related to poor blood supply in the affected vessels. These are diseases such as angina pectoris ( colloquially - "angina pectoris"), cardiosclerosis, myocardial infarction.

1. The initial stage of atherosclerosis is characterized by a lack of blood supply to organs, as a result of which dystrophic processes in the vessels begin to develop. However, all these functional changes at this stage of the disease are reversible and do not pose a strong threat to health.

2. The next stage is characterized by the fact that, due to a progressive disturbance of blood flow, blood clots begin to form in the cavities of the vessels - blood clots.
The subsequent deterioration of the blood supply leads to the formation of necrosis foci in the vessels ( so-called "necrosis").

3. The sclerotic, last, stage occurs when, due to necrosis, scar compounds are formed in the affected organs. These cicatricial formations are formed, as a rule, by connective tissue.

Clinical picture of atherosclerosis

Clinical signs of the manifestation of the disease are determined by which vessels are affected. That is why, for proper diagnosis and treatment, it is important to differentiate the disease into specific symptom complexes: atherosclerosis of the aorta, atherosclerosis of the arteries of the brain, atherosclerosis of the coronary arteries and others.

In aortic atherosclerosis, most often pain is not manifested. Although there are exceptions: some patients feel chest pain ( the so-called "aortalgia"), which extends to the arms, neck, upper abdomen. Aortalgia has a pressing character, lasts paroxysmal, periodically changing its intensity. Atherosclerosis of the aorta occurs more often than atherosclerosis of other vascular zones.

Atherosclerosis of the vessels of the head is more common in the elderly. Age-related changes in vascular physiology, together with atherosclerosis, lead to permanent hypoxia ( oxygen deprivation of the brain).

Typical general symptoms of oxygen starvation:

Decreased memory.
Decreased level of attention.
Decreased performance.
Frequent fainting spells.

Due to insufficient nutrition of blood vessels, irreversible brain changes begin ( atrophy). Atrophic processes in the brain can lead to senile dementia.

Closing the lumen of the brain vessels with atherosclerotic plaques is fraught with ischemic stroke. The walls of blood vessels become brittle and even the slightest increase in blood pressure can burst - then the blood flows out, penetrates into the brain tissue and impregnates it with itself. This process is called hemorrhagic stroke.

A stroke is manifested by the so-called cerebral symptoms: paralysis, paresis of the arms, legs, face ( paresis - partial loss of mobility, occurring in violation of the motor centers of the brain). Speech becomes slurred, swallowing is difficult.

In some cases, after complex treatment, all impaired functions are restored.

Patients diagnosed with atherosclerosis of the vessels of the legs» make the following complaints about their health: weakness in the legs, when walking - fatigue, lameness, feet and toes feel cold to the touch. With the progression of the pathology, trophic ulcers can form, and even gangrenous processes of necrosis of the fingers.

Treatment of atherosclerosis

Atherosclerosis is a serious disease, so its treatment must be approached with all seriousness. The first step of treatment is the impact on the external risk factors that led to the disease. Normalization of wakefulness and sleep, an active mobile lifestyle, smoking cessation, rational nutrition - such general hygiene measures will help prevent the further development of the disease.

Rational nutrition includes a reduction in the calorie content of dishes, a decrease in the fat content of foods, and the rejection of foods containing cholesterol.
The general rule of nutrition for patients: " Less fat, less sweet, less fried, less salty - more milk, fruits, vegetables».

In parallel, the attending physician may prescribe drugs that inhibit the synthesis of cholesterol in the body and drugs that improve blood circulation in the body.

Prevention of atherosclerosis

Prevention of the atherosclerotic process is extensive. This includes the normalization of the rest regimen, and the rejection of the addiction to smoking, and frequent exposure to the air, and the fight against physical inactivity ( insufficient bodily activity).

It is possible to carry out the prevention of atherosclerosis with the help of folk remedies. Especially useful is apitherapy - a treatment with bee venom. Apitherapy gives amazing results. True, there are some contraindications to the use of apitherapy. In particular, this method is absolutely not suitable for people with allergies.
Periodically, it is necessary to be observed by a doctor and undergo a course of general strengthening and hypocholesterol therapy.

The basis of the vascular wall is muscle fibers, it is covered on the outside by a connective tissue adventitia membrane, from the inside - by the endothelium, which, together with the underlying thin layer of connective tissue, forms the inner shell of the vessel - the intima.

The endothelium has a barrier function and repels cellular elements from itself, therefore, intravascular thrombosis does not normally occur. If the structure of the intima is disturbed, leukocytes migrate to the site of damage, and lipoproteins precipitate from the bloodstream - the process of atherosclerotic plaque formation begins.

Causes and signs of atherosclerosis

There is no unified theory of the development of atherosclerotic lesions, however, most scientists and clinicians consider damage to the vascular endothelium and a decrease in its barrier function to be the starting point for plaque formation. The damaged area of the inner lining of the artery becomes a target for atherogenic factors.

Elevated blood levels of atherogenic low-density lipoproteins also contributes to the progression of atherosclerotic lesions. At the initial stage, the damaged intima is impregnated with lipoproteins - an atheromatous spot is formed - the initial stage of plaque formation.

Nonlinear blood flow is normally observed in the places where the arteries branch, and when they spasm and increase blood pressure, it can occur anywhere. In this case, favorable conditions are created both for damage to the endothelium and for the deposition of lipoproteins.

Risk factors for atherosclerosis

Atherosclerosis is a polyetiological process. This means that for the occurrence of a lesion, a combination of several unfavorable factors is necessary, and not just one trigger.

In this case, they often talk not about the causes, but about the risk factors for the disease. These include:

Smoking- nicotine provokes vasospasm and adversely affects the barrier properties of the endothelium. In addition, chronic nicotine intoxication leads to a change in the ratio of atherogenic and non-atherogenic lipoproteins in the peripheral blood, which is an additional cause of plaque formation.
Irrational nutrition, alcohol abuse and a sedentary lifestyle can lead to causes of lipid metabolism disorders and obesity, and also provoke an increase in blood pressure. The combination of increased low-density lipoprotein content and increased pressure gives impetus to the onset of atherogenesis.
Emotional overload in combination with reduced physical activity: stress response (preparation of the body for intense physical activity). If this mechanism is not implemented, the action of stress hormones is too long and causes damage to the endothelium.
Gender and age: female sex hormones prevent damage to the vascular wall, so atherosclerotic vascular lesions in women often occur after menopause. In general, the likelihood of developing the disease increases with age.
Heredity: some structural features of the endothelium and fat metabolism, inherited, create favorable conditions for the formation of atherosclerotic plaques.

Classification

Depending on which factor is primary, the hemodynamic and metabolic forms of atherosclerosis are distinguished. In the first case, vascular disorders are primary (structural abnormalities, inferiority of the endothelium,), in the second - metabolic disorders (increased levels of low-density lipoproteins, hyperglycemia).

Depending on the period of the flow, there are three phases:

The initial phase (preclinical) proceeds without symptoms. Changes in the lining of the vessels are already taking place, but they are not sufficient to disrupt the function of an organ or tissue. At this stage, atherosclerosis can be detected by laboratory parameters, so a biochemical blood test for lipoprotein content is included in the list of studies that are mandatory when undergoing a preventive medical examination.
The phase of extended clinical manifestations, which, in turn, is divided into:
- ischemic- the formed plaque partially blocks the lumen of the vessel, while the blood supply to the tissues suffers; with increased load, ischemic damage becomes apparent; in relation to coronary vessels - this;
- thrombonecrotic- an overgrown atheromatous plaque is easily injured, provoking vessel thrombosis, while the blood supply to the tissue is completely stopped, and it can become necrotic; an example of clinical manifestations at this stage is either, dry gangrene or mesenteric thrombosis.
The sclerotic stage is characterized by a persistent narrowing of blood vessels and a gradual connective tissue degeneration of the tissue, for example, cerebro- or cardiosclerosis.

Depending on the activity of the course of the atherosclerotic process, there are:

progressive atherosclerosis - the formation of new or growth of formed atheromatous plaques continues, clinical manifestations gradually worsen, the risk of complications is high;
stabilized atherosclerosis - the development and formation of new plaques stops, clinical manifestations remain unchanged or regress, the risk of complications is low;
regressing atherosclerosis - clinical symptoms subside, general condition and laboratory blood counts improve.

What are the main symptoms of atherosclerosis?

At the initial stages, the formation of an atherosclerotic plaque is asymptomatic, vascular patency disorders are not so strong as to cause clinical manifestations.

Circulatory disorders in tissues begin at the stage of fibrosis and plaque calcification, and signs of atherosclerosis are determined by the location of the lesion:

atherosclerosis of the arteries of the brain is manifested by chronic headache, memory impairment, decreased mental performance and concentration; the progression of the process can lead to personality changes and mental disorders; a typical complication that occurs when the lumen of the vessel is completely closed -;
atherosclerosis of the coronary arteries leads to the development of coronary heart disease; clinically, it manifests itself in the form of attacks of severe pain behind the sternum in the region of the heart after physical or emotional stress, as well as a decrease in physical performance; a plaque can completely block the lumen of the coronary artery or provoke its thrombosis - in this case it will develop;
atherosclerosis of the arteries of the abdominal cavity leads to partial or complete ischemia of the mesentery and intestines; in the first case, pain after eating, bloating and stool disturbances are disturbing, in the second case, acute thrombosis of the mesenteric vessels occurs - a condition requiring emergency surgical care;
atherosclerosis of the aorta is manifested by chronic arterial hypertension; with a long course, an aortic aneurysm may occur.

Diagnostics

Based on the patient's complaints and changes identified during the clinical examination, the doctor may suspect the presence of atherosclerosis. To clarify and confirm the diagnosis, laboratory and instrumental studies are prescribed:

Blood chemistry for cholesterol content. Using this method, both total cholesterol and the ratio of the level of high and low density lipoproteins are determined. The latter have a high atherogenic potential, therefore, an increase in their level, especially in combination with a decrease in the level of high-density lipoproteins, indicates an active course of the atherosclerotic process.
X-ray methods of research. A chest x-ray is performed if aortic atherosclerosis is suspected, it can be used to judge the degree of its deformation and the presence of calcifications. To study smaller vessels, angiography (coronary angiography, cerebral angiography) is used - obtaining a series of radiographs after intravascular injection of a radiopaque substance. With this study, you can see the localization and size of plaques, as well as assess the degree of narrowing of the lumen of the vessel.
ultrasound more often used to study the vessels of the extremities, it can also be used to detect the presence of plaques and assess the degree of narrowing of the vessel.

Treatment of atherosclerosis

Treatment of atherosclerosis without fail includes lifestyle correction and control of the course of concomitant diseases (diabetes mellitus). If this is not enough, medication is prescribed.

With damage to the vessels of the extremities, the heart or the vessels of the mesentery, it is possible to restore their patency surgically.

Non-drug treatment of atherosclerosis

Diet low in cholesterol. The best option is the Mediterranean diet. The use of olive oil, fish and seafood, herbs, fresh vegetables and fruits is recommended. Fatty meats are excluded, chicken fillet and lean beef are recommended from meat dishes.
Rational physical activity contributes to the normalization of vascular tone, is the best prevention of obesity and arterial hypertension.
Quitting smoking and drinking alcohol, minimizing stressful situations. It is very important to learn how to cope with stress without the use of drugs and psychoactive substances.
Lifestyle correction is the basis of atherosclerosis therapy, without which no drugs and surgical methods will be effective. For treatment, medications are used that prevent the absorption of cholesterol in the digestive tract or accelerate its breakdown. The selection of the drug and dose should be carried out by a doctor.

Surgery

Removal of the affected vessel if the blood supply can be restored due to the compensatory development of collaterals. Most often, these are the arteries of the extremities of medium caliber. The affected vessel is removed at a high risk of thrombosis, thrombus separation and related complications.
Balloon angioplasty or coronary stenting is used in case of damage to the vessels of the heart in order to restore the blood supply to the heart muscle in case of a critical narrowing of the lumen of the supplying artery.

Prevention

The only reliable way to prevent atherosclerotic vascular disease is healthy lifestyle. Studies have shown that the first cholesterol spots can appear on the walls of blood vessels already in childhood, so prevention should begin from childhood.

You can prevent complications with already developed atherosclerosis if you take prescribed drugs and follow the recommendations of your doctor. If there are concomitant diseases, their treatment is also a mandatory measure in the prevention of complications.

Prognosis for atherosclerosis

Subject to lifestyle correction, smoking cessation and timely treatment favorable prognosis: stabilization and even regression of the atherosclerotic process is quite possible. Regression of atherosclerosis is possible only at the initial, preclinical stage. If any major symptoms of atherosclerosis have already appeared, supportive treatment will be lifelong.

When treatment is refused and risk factors persist, the likelihood of complications becomes extremely high. In this case, the prognosis, both for the health and for the life of the patient, is unfavorable.

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