Non-sedentary atherosclerosis of the arteries
Author Ольга Кияница
- 1 Description of non-stenotic atherosclerosis of arteries
- 2 Non-steroidal atherosclerosis of the brachiocephalic arteries: what is it?
- 3 Non-stenotic atherosclerosis of the lower limb arteries
- 4 Non-stenotic atherosclerosis of the carotid arteries
- 5 Diagnosis of non-sedentary atherosclerosis of arteries
- 6 Prevention of non-non-carotid arteriosclerosis
Non-steroidal atherosclerosis (NSA) is, it can be said, initial atherosclerosis, that is, the first stage of the development of atherosclerotic disease. During its formation, incomplete overlapping (no more than 50%) of the lumen of the vessel by an atherosclerotic plaque is determined. Symptoms of the disease do not appear immediately, which is why the treatment is often carried out with a delay.
Among all progressive diseases of the cardiovascular system, atherosclerosis is the most common, which is why the number of strokes and heart attacks has so increased.
Diagnosis of non-sedentary atherosclerosis is based on laboratory tests, as well as instrumental methods of investigation (MRI, CT, ultrasound). Timely therapy can improve the quality of life of the patient and prevent the occurrence of severe consequences.
Video: Atherosclerosis | Circulatory System and Disease | NCLEX-RN | Khan Academy
Description of non-stenotic atherosclerosis of arteries
At the heart of the development of non-sedentary atherosclerosis is an elevated level of cholesterol in the blood. In this case, the unhealthy concentration of fat-like substance should be observed for a long time, then the most sensitive in the body of a particular person, the vessels begin to inflammate from the inside. This leads to deposition in the place of damage to calcium, triglycerides, macrophages and other components of blood, which leads to the formation of atherosclerotic (ateromatous) plaque.
Atherosclerosis affects vessels of different caliber, but non-sedentary atherosclerosis most often affects large trunk arteries.
The main difference between non-sedentary atherosclerosis of the arteries from the stenosis
At first, pathological deposits appear as a plaque on the inner wall of the vessel, but with the progression of the disease, the plaque thickens and is increasingly blocking the lumen of the artery. In the case when the atheromatous formation overlaps less than 50% of the vessel, then they speak of non-steroidal atherosclerosis of the arteries.
For a stenotic form of atherosclerosis , blocking of the vessel is more than 50% typical. This condition is considered more dangerous as it can quite quickly lead to the end of the blood supply to a specific area of the human body. But it is important to know that any non-sedentary atherosclerosis for some time, in the absence of treatment, becomes a stenosing form of the disease. Precisely in this is the danger to the health and life of the patient.
Types of disease
It has been noted above that atherosclerosis can affect various vessels, therefore, several types of non-sedentary forms of this disease are emitted. Most often affected:
- brachiocephalic arteries;
- arteries of the lower extremities.
Depending on the location of the site of the defeat, this or that clinical picture arises. Also, the types of diseases may require a separate approach to diagnosis and treatment.
Non-steroidal atherosclerosis of the brachiocephalic arteries: what is it?
The blood flows to the brain through three major blood vessels:
- Sleep artery
- Left subclavian artery.
- Brachiocephalic arteries (brachiocephalic barrel).
Any of these vessels may be subject to an atheromatous transformation, with the symptoms and treatment of the disease may be slightly different.
The brachiocephalic trunk (or brachiosternal trunk) is a thick section of the vessel located before division into the right general carotid artery and right subclavian artery.
Thus, if the atherosclerotic plaque is formed in the brachiocephalic trunk, blood supply to the cerebrum along the right subclavian artery and the common carotid artery is disturbed. The latter in the area of the thyroid cartilage is divided into the outer and inner.
Signs of non-sedentary atherosclerosis of the brachiocephalic arteries
As a result of narrowing of the brachiocele by an atherosclerotic plaque, an appropriate clinic develops:
- Darkening in the eyes.
- Bad coordination.
- Weakness and fatigue.
In severe cases, there is encephalopathy and a stroke with marked psychoneurological disorders (loss of vision, change in sensitivity or movement on one side). A similar condition can lead to disability or death.
Non-steroidal atherosclerosis of the brachiocephalic arteries: treatment
In the absence of stenosis of the brachiocephalic barrel, the disease is usually treated with medication. In particular, the following are used:
- Statins - contribute to lowering "bad" cholesterol (LDL) by more than 60%. Additionally, help to trigger normal triglycerides and increase the concentration of "good" cholesterol (HDL). Long-term administration of statins can significantly reduce the risk of developing atherosclerosis complications. Examples of drugs from the statin group are atorvastatin (Lipitor), fluvastatin (Lescol), lovastatin (AltoPrev, Mevacor), pivastatin (Lival), pravastatin (Pravachol), rosuvastatin calcium (Krestor), simvastatin (Zocor).
- Fibrates - they are prescribed for the purpose of reducing the level of triglycerides, which, like cholesterol, contribute to the development of atherosclerosis. Examples of drugs from the group of fibrates: gemfibrozil (Lopid), fenofibrate (Antar, Fenoglyde, Lipofen, Lofibre, Trikor, Triglyde, Trilipix).
- Niacin, or nicotinic acid , consuming a large amount of this vitamin helps reduce cholesterol and LDL. The only thing that this drug can cause is the development of various side effects, so it is less commonly used than the two above-mentioned groups.
- Sequestrants of bile acids - means of this group bind bile acids located in the intestine. As a result, the concentration of bile acid decreases, which leads to the normalization of cholesterol levels. Examples of drugs: cholestyramine (Locholest, Prevalite, Questran), colestipolis (Colestid), wheelchairs (WelChol).
If necessary, medicines are used to treat arterial hypertension, diabetes mellitus, thrombosis. For example, the following anticoagulants are used:
- Aspirin is a long-known drug that is really good in liquefying blood. It can reduce the risk of primary heart attacks and strokes by about 25%.
- Clopidogrel (Plavix) - acts similarly to aspirin. This drug is useful for preventing clots from forming within the arteries.
- Ticagrelor (Brilinta) acts like clopidogrel. This drug is less effective if the patient takes more than 100 mg of aspirin per day.
- Prasugrel (an effective medication) - it should be taken orally with or without food, usually once a day or on medical instructions. If necessary, the doctor may advise taking it with a low dose of aspirin.
- Warfarin (Kumadin) - this powerful blood thinner is an anticoagulant. Normally, it is not used to treat atherosclerosis, whereas it is more indicated with atrial fibrillation and deep vein thrombosis.
If surgical intervention is recommended, then an angioplasty type with stenting is recommended . But according to the results of this study, this method of action in arteriosclerotic atherosclerosis is ineffective because it does not prevent the development of a stroke.
Video: Pathogenesis of Atherosclerosis
Non-stenotic atherosclerosis of the lower limb arteries
In the absence of clogging of the vessels, the symptoms are usually absent or slightly expressed. However, when the arteries of the legs become narrow enough to break the supply of nutritious and oxygen-rich blood to the affected limb, lactic acid begins to accumulate in the muscles, resulting in pain during the workout.
Pain associated with exercise in atherosclerosis of the arteries of the lower extremities, called "intermittent lameness". It can be described as fatigue in the leg, muscle spasms, or severe muscle pain.
Similar symptoms can also be detected in venous diseases, arthritis, neuropathy, or spinal diseases, but patients with lameness due to atherosclerosis of the arteries only experience symptoms with physical activity. During the rest of the pain it takes a few minutes. In patients with multiple, strongly blocked arteries, a serious limitation of blood flow can be determined. In such cases, pain arises in the extremities alone, and in severe conditions, untreated ulcers or gangrene appear.
Symptoms that may appear in atherosclerosis of the arteries include :
- Pain in the legs associated with exercise.
- Numbness of legs or feet alone.
- Cold limbs.
- Muscular pain in the hips, caviar or feet.
- Hair loss on the legs.
- Changes in skin color (pallor or blueness).
- Attenuation of the pulse or its absence on limb.
- Walking / Walking.
The diagnosis of non-sedentary atherosclerosis of the lower limb arteries is usually based on a thorough history and physical examination. Arterial Doppler studies are often carried out, which allows you to provide basic research and help determine the degree of vascular occlusion.
When an operation or endovascular treatment is considered, a more detailed visualization will be required to plan the treatment. Although the gold standard for preoperative planning is arteriogram, other less invasive alternative studies, including CT angiography and MRI angiography, are also used.
Non-stenotic atherosclerosis of the carotid arteries
Sleep arteries are large vessels located on both sides of the neck. Under them, blood flows to the face, the brain. As with other arteries, initially, the atherosclerotic attack only slightly overlays the bloodstream, and when the disease progresses, the vessel is completely sealed.
In the absence of stenosis, the symptoms of the disease are practically not determined, but in the future, the condition may noticeably deteriorate. In particular, the same symptoms are manifested as in the case of defeat of the brachiocephalic trunk:
- Blurred vision.
Similar signs indicate that in the brain there is an insufficient amount of blood rich in oxygen and nutrients .
Sometimes the first symptom of the disease is transient ischemic attack (TIA) or stroke, as a small blood clot may form in the area of the vessel affected by atherosclerosis. When such a small clot is displaced, it can penetrate into the brain and shut the artery of a smaller diameter, which affects the blood supply to a certain part of the brain. Depending on the function of the affected tissue, the patient can live or die.
Symptoms of TIA and stroke are similar :
- Paralysis or numbness on one side of the body.
- Blurred vision.
- Problems with speech.
- Difficulty with the reaction.
TIA usually does not last long and does not leave long-term violations. This is due to the very small, temporary occlusion of the small artery. Yet TIA is a warning sign of a stroke that is at risk. A stroke is often associated with irreversible damage to the brain part due to loss of blood supply. It can lead to severe disability or death.
Severe cases of stenosis often require carotid endarterectomy , in which the surgeon makes a cut to remove pathological plaque and any affected part of the artery. At this time, the patient is under general anesthesia.
Less invasive treatment is angioplasty of the carotid artery and stenting . During this procedure, the catheter is carried out from the incision in the groin to the closure where the balloon inflates to open the artery. After this, a stent is placed, allowing the vessel to expand and keep it open.
Diagnosis of non-sedentary atherosclerosis of arteries
After collecting complaints and objective examination, the doctor usually assigns laboratory tests in the general type and biochemical analysis of the blood, lipid profile, after which it is necessary to perform instrumental diagnostics, which determines the exact state of the vessels.
- Ultrasonic examination of the carotid artery
This method of diagnostics includes ultrasound Doppler examination. During this test, sound waves are used to create real-time images of arteries and to detect contractions or stenosis. Doppler is a special ultrasound technique, non-invasive and safe, which can help detect areas of improper blood flow in the arteries.
- Computer tomographic angiography (CT angiography, KTA)
The KTA is performed using a computer tomograph to obtain a detailed image of the arteries from any part of the body, including the neck. The study is especially useful for those patients who are implanted with pacemakers or stents.
- Magnetic resonance angiography (MRA)
This non-invasive test gives information similar to KTA, while the patient receives a minimum of ionizing radiation.
- Cerebral angiography
Also known as intra-arterial digital angiography (IADSA). Cerebral angiography is a minimally invasive test, during which the catheter is directed to the artery in an interesting area of study. Contrast material is introduced through the tube, and images are taken with X-rays.
Prevention of non-non-carotid arteriosclerosis
Methods for preventing non-hypertensive atherosclerosis of the arteries are the same as for other forms of the disease.The best way to prevent atherosclerosis is to make a choice in favor of a healthy heart. As a result, it will be possible to minimize damage and inflammation in the arteries.
The main recommendations for the prevention of atherosclerosis:
- Need to control blood pressure . Many people believe that high blood pressure can not especially harm their health, but in fact it acts incredibly destructively if it is not treated and the situation is allowed to take its course. A good example is a strong current rushing along the bends of a river and washing away the banks. Similarly, the blood flow during a chronically high blood pressure hits the arterial mucosa, which leads to the launch of an atherosclerotic process.
- It is important to stop smoking. Smoking is a major risk factor for cardiovascular diseases and atherosclerosis. This is the best way to increase blood pressure and fill the bloodstream with chemicals that destroy the arteries. Although there is no doubt that you should quit smoking if this habit still exists, it probably will not be easy to do. Quitting smoking is a major change in life. The doctor can give advice on how to quit smoking as effectively as possible.
- Should limit sugar intake as much as possible . Many people, especially those with type 2 diabetes, are at greater risk of cardiovascular disease. This is due to the fact that excess glucose (sugar) in the blood combines with proteins to form the final products of glycation or AGE - another element that can damage the vascular endothelium. Worse, too much insulin can also lead to inflammation. Since a higher blood glucose level means that the body releases more insulin, a high sugar diet is a double blow to the vessels, especially when it comes to atherosclerosis and heart disease. Therefore, you should avoid eating sugar as much as it turns out. Instead, it is better to stick to a low-glycemic anti-inflammatory diet.
- It is necessary to eliminate the stress factor . When a person is under stress, the sympathetic nervous system stimulates the production of cortisol and other hormones that enter the bloodstream. As a result, the body is preparing for a seemingly inevitable problem. Although random bursts of cortisol do not pose a risk to the cardiovascular system, prolonged exposure to stress contributes to the development of inflammatory reactions in the body.Therefore, it is important to protect yourself from negativity by finding ways to manage and reduce daily stress levels.In particular, you can use meditation, yoga, massage or other similar techniques.
- Grounding practice . Grounding fills the human body with free electrons. These electrons help to neutralize the positively charged free radicals that accumulate in various tissues and can damage the walls of the arteries. It has been proven that grounding has a balancing effect on the nervous system. The easiest way to benefit from grounding is to walk barefoot on grass or sand.
- It is useful to take nutritional supplements . Turmeric and fish oil have anti-inflammatory properties that can help keep arteries healthy. CoQ10 can also be used for both energy support and antioxidant effects.
Yet the question continues to bother many, can atherosclerosis be reversed? According to many clinicians, yes. To some extent, atherosclerotic plaque can be stopped and reversed. However, it is a long process. It takes time and a serious commitment to a healthy lifestyle, including diet and supplementation, to clear the vessels of the pathological deposits.
Atherosclerosis is a complicated disease that, in the absence of arterial stenosis, almost never manifests itself. To prevent the disease, it is important to eat properly, adhere to optimal physical activity, not to smoke and not to consume alcohol. It is also necessary after the 40 years to regularly undergo medical examinations in order to be able to identify in a timely manner dangerous diseases.
When setting the diagnosis of non-sedentary atherosclerosis of the arteries, they must prescribe medication with appropriate lifestyle correction. The diligent performance of medical recommendations allows you to prevent complications such as heart attacks and stroke.
Video: Treatment of Atherosclerosis: Therapy Goals & Lifestyle Measures – Vascular Medicine | Lecturio