Arteriosclerosis

Arteriosclerosis is a type of vascular disease where the blood vessels carrying oxygen away from the heart (arteries) become damaged from factors such as high cholesterol, high blood pressure, diabetes and certain genetic influences. The arteries thicken and become stiff which can sometimes restrict blood flow to other organs and tissue. Arteriosclerosis can manifest itself in four different ways:

• Coronary artery disease (CAD) - a buildup of plaque inside a coronary artery
• Peripheral artery disease (PAD) - narrowing of the arteries in the legs, arms or pelvis
• Carotid artery disease (CAD) - narrowing of the carotid arteries, which carry blood to the head and aorta
• Aortic aneurysm - an abnormal enlargement in the aorta (the body’s largest blood vessel)

Arteriosclerosis-related disease that involves the buildup of plaque in the coronary, peripheral, or carotid arteries is also known as atherosclerosis.

Mild cases of arteriosclerosis do not typically have symptoms, however, regular checkups with your primary care physician or cardiologist are important. If left untreated, arteriosclerosis can trigger a heart attack or stroke.

A heart attack or stroke can occur quickly and are medical emergencies. Watch for symptoms and call 911 immediately.

Symptoms of a stroke:

• Confusion or difficulty talking or understanding others
• Dizziness, loss of balance, or lack of coordination
• Severe headache
• Weakness or numbness in the face, arm, or leg, usually on one side of the body
• Vision problems in one or both eyes

Heart attack symptoms:

• Chest discomfort (pain, pressure, or tightness) that can be mild or severe
• Cold sweat
• Discomfort in the arm, shoulder, or jaw

Your doctor can screen for preliminary signs of arteriosclerosis during a physical exam. You may be asked about your medical history and your physician may listen to your arteries with a stethoscope. They will listen for an abnormal whooshing sound called a bruit which may indicate poor blood flow due to the buildup of plaque.

If you have symptoms or risk factors for developing arteriosclerosis, your doctor may order other tests, such as:

• Ankle-brachial index: This test compares the blood pressure between your ankle and arm using a blood pressure cuff and ultrasound
• Cardiac imaging tests: These tests include X-ray, CT, MRI, PET, and doppler ultrasound scans that assess the health of your heart and blood vessels
• Cerebral angiography: This minimally invasive test allows your doctor to see how blood circulates through your blood vessels
• Coronary calcium scan: This is a CT test that shows calcium deposits in the coronary arteries and scores your risk of heart disease
• Heart function tests: These tests include electrocardiogram and echocardiogram
• Stress tests: These tests include stress electrocardiogram and echocardiogram to evaluate how your heart functions when it is working hard

For patients who are diagnosed with forms of arteriosclerosis such as coronary artery disease, peripheral artery disease, and carotid artery disease, there are several treatment options available Treatment options are divided into two categories:

• Medical therapy involves the use of medications such as aspirin, beta blockers, and cholesterol lowering drugs
• Revascularization therapy procedures include coronary stenting and coronary bypass surgery

The most feared complication from coronary artery disease is a heart attack because they usually involve the sudden closure of the coronary artery. When a heart attack occurs, restoring blood flow to the closed blood vessel as quickly as possible is critical. Penn Medicine physicians typically treat heart attacks with a cardiac catheterization procedure called balloon angioplasty.

During balloon angioplasty, thin tubes are threaded into the blood vessels and a tiny balloon is inflated to open the closed artery. A coronary stent is then placed in the vessels to restore blood flow. Penn Medicine has a greater than 95 percent success rate with such angioplasty/stent procedures.

The best treatment for arteriosclerosis-related diseases is prevention. To help keep plaque from accumulating in your arteries:

• Control your blood pressure
• Manage risk factors like diabetes
• Exercise regularly
• Don’t smoke
• Maintain a healthy diet

If you are worried about your risk for developing arteriosclerosis, talk to your doctor about a lifestyle plan that is best for you and any recommended preventive medications.