Atherosclerosis is a disease that is accompanied by systemic damage to the large and medium arteries. It is characterized by the accumulation of lipids, the growth of fibrous fibers, the dysfunction of the endothelium of the walls of blood vessels. The result of the development of atherosclerosis can be local and general hemodynamic disorders. IHD, ischemic stroke, obliterating lesions of the lower extremities, chronic occlusion of mesenteric vessels have atherosclerosis as a pathological basis. In this article, we consider the stages of vascular atherosclerosis.
Disease Description
Atherosclerosis is a lesion of the arteries, which is accompanied by the process of deposition of cholesterol on the inner shells of blood vessels. As a result, their lumen is narrowed, the blood supply to the organ is disrupted. Atherosclerosis only affects the medium and large arteries of the body of the muscular-elastic and elastic types. The first include arteries of the brain, heart, carotid. The second is the aorta and other large arteries. This explains why atherosclerosis is a common cause of coronary heart disease, circulatory disorders in the lower extremities, cerebral stroke, myocardial infarction.
Diagnosis of the disease
Diagnosis of the disease includes measurement of blood lipid levels, ultrasound examination of the heart and blood vessels, angiographic study. Therapy of atherosclerosis can be of a medicinal nature, can also be expressed in diet therapy. If the need arises, then revascularizing surgery is performed.
Consider the main stages of atherosclerosis. Damage to arteries in atherosclerosis is systemic and occurs as a result of a violation of protein and lipid metabolism inside the walls of blood vessels.
In modern medicine, it is believed that several stages are characteristic of atherosclerosis.
Stage 1: Initial
The initial stage of atherosclerosis is the presence of a fat (lipid) spot. Minor damage to the arterial walls and local blood flow slowdown play a significant role in the process of fat deposition. Most atherosclerosis affects areas in which the vessels branch. Loosening and swelling of the vascular wall occurs. The enzymatic substances of the artery wall dissolve lipids and protect it. However, when resources are depleted, deposition of complex complexes of compounds occurs in these areas, which consist mainly of cholesterol and proteins. The lipid stain stage has a different duration and can be detected even in an infant. What other stages of atherosclerosis emit?
Stage 2: medium
The stage of liposclerosis occurs at the second stage of the development of the disease. It is characterized by the growth of lipid deposits in the areas of arteries. An atherosclerotic plaque is gradually formed, which consists of connective tissue fibers and fats. Atherosclerotic plaques at this stage are still liquid and amenable to dissolution. However, their friability is dangerous, as they can rupture and their parts are able to block the lumen of the artery.
Stage 3: heavy
The appearance of stage 3 vascular atherosclerosis is called atherocalcinosis. With further development, the plaque is compacted, calcium salts are deposited in it. Such a plaque can be stable, but can grow, thereby deforming and narrowing the lumen of the artery. At the third stage, there is a rather high probability of clogging of the artery lumen with a fragment of a plaque that has decayed, or by a formed thrombus. The development of necrosis, as well as gangrene of the limb or organ, which are supplied with blood through the affected artery, is not ruled out.
These stages of atherosclerosis in each person can proceed in different ways, it all depends on its individual characteristics. But still they have common features.
Atherosclerosis development factors are classified by doctors into three large groups.
Fatal factors
The first group is fatal factors. They cannot be eliminated by medical or volitional exposure. These include:
- Age. The risk of developing a disease such as atherosclerosis only increases with age. In one way or another, atherosclerotic changes are observed in all people who have reached the age of 40-50 years.
- Floor. Men, unlike women, begin to suffer from atherosclerosis earlier by about 10 years. At the same time, men are sick 4 times more often. After 55 years, the incidence rate in men and women is roughly compared. This is due to the onset of menopause: the level of estrogen decreases and, accordingly, their protective function decreases.
- Heredity. Quite often, atherosclerosis begins to develop in people whose relatives also suffer from atherosclerosis. Doctors have proven that the factor of heredity contributes to the fact that the disease begins to develop before the age of 50 years.
Removable factors
The second group is removable factors. That is, those that a person himself can exclude if he changes his habitual way of life. These include:
- Random and unbalanced diet. The process of developing atherosclerosis is accelerated if you eat an excessive amount of animal fats.
- Lack of exercise. A sedentary lifestyle causes disturbances in fat metabolism, contributes to the development of diseases such as diabetes mellitus, obesity, arteriosclerosis.
- Smoking. Resins and nicotine adversely affect blood vessels. This explains the effect of such a factor. The risk of coronary heart disease, arterial hypertension, hyperlipidemia is many times greater with long-term smoking.
Partially removable
The third group is partially removable and potentially removable factors. These include diseases and disorders that can be corrected with the help of qualified treatment. These include:
- Arterial hypertension. Increased blood pressure contributes to increased impregnation of the vascular wall with fats, and this contributes to the formation of atherosclerotic plaque. And, on the contrary, the reduced elasticity of arteries resulting from atherosclerosis contributes to an increase in blood pressure.
- Dyslipidemia. The leading role in the development of atherosclerosis is played by disorders of fat metabolism, which are expressed in an increase in the level of lipoproteins, triglycerides, cholesterol.
- Diabetes mellitus, obesity. These factors increase the likelihood of the onset of the 3rd stage of atherosclerosis immediately on average 6 times. This can be explained by impaired lipid metabolism, which underlies these diseases and is the main cause of atherosclerotic lesions.
- Intoxication, infectious lesions. Toxic and infectious agents can have a damaging effect on the walls of blood vessels.
Symptoms of Atherosclerosis
Most often, atherosclerosis of the thoracic and abdominal aorta, coronary, mesenteric, renal vessels, brain cells and lower extremities occurs. The stages of atherosclerosis differ in that they can be preclinical (asymptomatic) and clinical. The asymptomatic form is characterized by an increased content of β-lipoproteins or cholesterol in the blood. In this case, there are no symptoms of the disease. Atherosclerosis passes into the clinical form when the lumen of the vessels narrows by about 50%. The clinical form has three stages, namely ischemic, thrombonecrotic, fibrous.
At the ischemic stage, the development of circulatory failure of a certain organ occurs, for example, myocardial ischemia may occur due to coronary vessels undergoing atherosclerotic damage. In this case, ischemia manifests itself in the form of angina pectoris.
At the thrombonecrotic stage, thrombosis of the affected arteries occurs. The fibrotic stage is characterized by proliferation of connective tissue in organs that are poorly supplied with blood.
Symptoms of atherosclerosis depend on which particular arteries have undergone the disease. Symptoms of coronary atherosclerosis are angina pectoris, cardiosclerosis, myocardial infarction.
All stages of aortic atherosclerosis are asymptomatic for a long time, even if they are severe. Symptom is aortalgia (pressing and burning pains behind the sternum, which are given to the hands, neck, back, stomach). In this case, the duration of aortalgia can be from several hours to several days.
If atherosclerosis affects the abdominal aorta, then this will manifest itself in the form of abdominal pain, flatulence, constipation, swelling and hyperemia of the feet, numbness of the legs, intermittent claudication, and necrosis of the toes are possible.
Symptoms of atherosclerosis of mesenteric vessels are expressed by attacks of "abdominal toad", a violation of digestive functions. This is due to a violation of the blood supply to the intestines. Patients begin to experience pain several hours after eating. Perhaps the appearance of belching, constipation, bloating, high blood pressure. In the future, a symptom such as fetid diarrhea containing fragments of undigested fat and undigested food.
If the renal arteries have undergone atherosclerotic lesions, symptomatic arterial hypertension develops. A urinalysis reveals an elevated level of red blood cells, protein, and cylinders.
At different stages of cerebral atherosclerosis, the following symptoms appear: memory is reduced, physical and mental performance, attention, intelligence. Dizziness and sleep disturbances occur. This type of atherosclerosis can also be accompanied by changes in the patient's behavior and psyche.
The stages of atherosclerosis obliterans, that is, atherosclerosis of the vessels in the lower extremities, are characterized by: pain and weakness in the calf muscles, coldness of the legs, numbness, trophic disorders, pallor of the limbs.
Treatment
When treating atherosclerosis, doctors try to adhere to the following principles:
- Prescribing a diet that helps limit cholesterol intake (effective at stages 1 and 2 of atherosclerosis).
- Stimulation of the process of removing cholesterol.
- Estrogen therapy during menopause in women.
- Elimination of pathogens of infection.
Medicines
If therapy is of a medicinal nature, then the use of the following medications is typical:
- Nicotinic acid that lowers blood cholesterol. It has antiatherogenic properties.
- Fibrates, allowing to reduce the synthesis of own fats in the body.
- Sequestrants of bile acids that bind and remove these acids from the intestine.
- Statins that effectively lower cholesterol.
Surgery
If there is a high threat or likelihood of vascular occlusion with a thrombus or plaque, surgical treatment is indicated. Vascular surgery can be either open or endovascular. If atherosclerosis of the heart vessels threatens the likelihood of developing myocardial infarction, coronary artery bypass grafting can be prescribed.
The article discusses the main stages of atherosclerosis.