Heart Conditions

Atherosclerosis and Plaque

Atherosclerosis is the narrowing of an artery caused by a build-up of plaque – a waxy substance made of fat, cholesterol, calcium and other substances.

What causes atherosclerosis?

Arteries are blood vessels that move oxygen-rich blood throughout the body. If these arteries become narrowed by plaque, blood flow can be partially or totally blocked. This can cause serious health problems, including heart attack and stroke.

Atherosclerosis can affect any artery in the body, including the arteries that supply blood to the heart, brain, arms, legs and kidneys. Various health conditions can develop depending on which arteries are affected.

The exact cause of the buildup of plaque isn’t known, but risk factors for atherosclerosis include smoking, high blood pressure and high cholesterol.

What are the symptoms of atherosclerosis?

Often, you may not notice any symptoms of atherosclerosis until an artery becomes severely blocked. However, depending on where the blocked artery is in your body, you may experience varying symptoms.

For example:

Atherosclerosis in the coronary arteries, which supply oxygen-rich blood to the heart, may cause the following symptoms:

• Angina (chest pain)
• Shortness of breath
• Arrhythmia (abnormal beating of the heart)

Atherosclerosis in the carotid arteries, which supply oxygen-rich blood to the brain, may cause symptoms of a stroke, includes:

• Sudden weakness, paralysis or numbness in the face, arms or legs
• Trouble speaking and seeing
• Difficulty breathing
• Confusion
• Dizziness or loss of balance
• Loss of consciousness

Atherosclerosis in the peripheral arteries, which supply oxygen-rich blood to the pelvis, arms and legs, can cause the following symptoms:

• Numbness
• Pain
• Infection

Atherosclerosis in the renal arteries, which supply oxygen-rich blood to the kidneys, can cause the following symptoms as it progresses:

• Fatigue and difficulty concentrating
• Changes in frequency of urination
• Loss of appetite
• Nausea
• Numbness or swelling in the hands or feet

How is atherosclerosis diagnosed?

During a physical exam, your doctor will use a stethoscope to listen for an abnormal sound in the affected artery. Your doctor may also check to see whether any of your pulses are weak or absent, which can signal a blocked artery.

The following tests may also help to diagnose atherosclerosis:

• Angiography
• Ankle/Brachial Index
• Blood tests
• Chest X-ray
• Computed Tomography (CT) scan
• Echocardiography
• Electrocardiogram (EKG)
• Magnetic resonance imaging (MRI)
• Positron emission tomography (PET)
• Stress testing

How is atherosclerosis treated?

Treatment options for atherosclerosis include medication, lifestyle changes, and surgery.

Lifestyle changes include:

• Following a healthy diet to reduce high blood pressure and high cholesterol
• Being physically active
• Quitting smoking
• Maintaining a healthy weight
• Managing stress and coping with emotional difficulties

If your case of atherosclerosis is severe, your doctor may recommend one of the following medical procedures to reduce your risk of heart attack or stroke:

• Coronary angioplasty
• Coronary artery bypass grafting
• Carotid endarterectomy