ATHEROSCLEROSISBy Sanzhar ZhetkenevBy Sanzhar Zhetkenev

Definition• The term atherosclerosis, comes from the Greek atheros (“gruel” or

“paste”) and sclerosis (“hardness”), defines the formation of fibrofatty lesions in the intimal lining of the large and medium-size arteries such as the aorta and its branches, the coronary arteries, and the large vessels which are supply for the brain.

Risk Factors

• The cause or causes of atherosclerosis have not been determined with certainty.

• Epidemiologic studies have identified predisposing risk factors:• Unchangeable risk factors

• Age• Male gender

• Men are at grater risk than are premenopausal women, because of the protective effects of natural estrogens.

• Family history of premature coronary heart disease• Several genetically determined alterations in lipoprotein and cholesterol

metabolism have been identified.

Causes

• Lifestyle:• Hyperlipidemia

• The presence of hyperlipidemia is the strongest cause for atherosclerosis in persons younger than 45 years of age.

• Both primary and secondary hyperlipidemia increase the risk.• Cigarette smoking• Hypertension

• High blood pressure produces mechanical stress on the vessel endothelium.

• It is a major cause for atherosclerosis in all age groups and may be as important or more important than hypercholesterolemia after the age of 45 years.

• Diabetes mellitus• Diabetes elevates blood lipid levels and otherwise increases the

risk of atherosclerosis.• Insufficient physical activity• A stressful lifestyle• Obesity

Pathology

• The lesions associated with atherosclerosis are of three types:• The fatty streak• The fibrous

atheromatous plaque

• Complicated lesion

• The latter two are responsible for the clinically significant manifestations of the disease.

Response-to-injury hypothesis

• 1. Chronic endothelial injury • 2. Accumulation of lipoproteins • 3. Monocyte adhesion to the endothelium• 4. Platelet adhesion• 5. Factor release • 6. SMC proliferations and ECM production. • 7. Lipid accumulation

SymptomsAtherosclerosis symptoms depend on which arteries are

affected. For example:• Atherosclerosis in heart arteries, have symptoms

similar to those of a heart attack, such as chest pain (angina).

• Atherosclerosis in the arteries leading to brain, have symptoms such as sudden numbness or weakness in your arms or legs, difficulty speaking or slurred speech, or drooping muscles in your face.

• Atherosclerosis in the arteries in arms and legs, produces decreased blood flow is called peripheral artery occlusive disease (PAOD).have symptoms such as leg pain when walking

• Sometimes atherosclerosis causes erectile dysfunction in men.

Treatments and prevention

• Thrombolytic therapy. If you have an artery that's blocked by a blood clot, your doctor may insert a clot-dissolving drug into your artery at the point of the clot to break it up.

• Bypass surgery. Your doctor may create a graft bypass using a vessel from another part of your body or a tube made of synthetic fabric. This allows blood to flow around the blocked or narrowed artery.

• Lifestyle changes can help prevent or slow the progression of atherosclerosis.

• Stop smoking. • Exercise most days of the week. • Eat healthy foods• Manage stress• manage the condition of high cholesterol, high blood pressure,

diabetes or other chronic disease

References• http://www.nhlbi.nih.gov/health/health-topics/topics/

atherosclerosis• http://www.webmd.com/heart-disease/what-is-

atherosclerosis