Atherosclerosis; Arteriosclerosis; Plaque buildup - arteries

Hardening of the arteries does not cause symptoms until blood flow to part of the body becomes slowed or blocked.

If the arteries to the heart become narrow, blood flow to the heart can slow down or stop. This can cause chest pain (stable angina), shortness of breath, and other symptoms.

Narrowed or blocked arteries may also cause problems and symptoms in your intestines, kidneys, legs, and brain.

A health care provider will perform a physical exam and listen to the heart and lungs with a stethoscope. Hardening of the arteries can create a whooshing or blowing sound ("bruit") over an artery.

Some guidelines recommend having your first cholesterol test at age 20. Everyone should have their first screening test by age 35 in men, and age 45 in women. (Note: Different experts recommend different starting ages.)

A number of imaging tests may be used to see how well blood moves through your arteries.

• Doppler tests use ultrasound or sound waves.
• Magnetic resonance arteriography (MRA) is a special type of MRI scan
• Special CT scans called CT angiography
• Arteriograms or angiography use x-rays to see inside the arteries

Hardening of the arteries cannot be reversed once it has occurred. However, lifestyle changes and treating high cholesterol levels can prevent or slow the process from becoming worse.

In some cases, the plaque is part of a process that causes aweakening of the wall of an artery. This can lead to a bulge in an artery called an aneurysm. Aneurysms can break open (rupture). This causes bleeding that can be life threatening.

See:

• Brain aneurysm
• Abdominal aneurysm
• Chest aneurysm

Genest J, Libby P. Lipoprotein disorders and cardiovascular disease. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 47.

Libby P. The vascular biology of atherosclerosis. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 43.

Hansson GK, Hamsten A. Atherosclerosis, thrombosis, and vascular biology. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 70.