UNDERSTANDING ATHEROSCLEROSIS
UNDERSTANDING ATHEROSCLEROSIS ARTERIES Arteries are blood vessels that carry oxygenated blood to all the organs of the body. Arteries are made up of three important layers: inner (intima), middle (media), outer (adventitia). Arteries that carry oxygenated blood to the heart muscle are called coronary arteries. The intima is the innermost layer that lines the inside of the artery.
The media is the thick layer made up of mostly smooth muscle. The adventitia is the outermost covering that protects the artery from its surrounding. Healthy arteries are strong and elastic, allowing blood to flow freely through its lumen (internal space).
ATHEROSCLEROSIS Atherosclerosis is a disease that over time causes the formation of fatty plaque build-up (atheroma) within the walls of an artery. An atheroma develops when there is damage to the intima layer of the artery, allowing white blood cells (WBC) to enter the artery wall (A). The atheroma is prone to rupture and clotting, which may further limit the blood flow through the lumen (C).
Once inside the artery wall, WBCs transform into foam cells, and begin to collect fat and cholesterol.overtime, this form a lump called an atheroma (B). This plaque may grow larger as muscle cells, fibers, calcium and cell debris are deposited. The atheroma is prone to rupture and clotting, which may further limit the blood flow through the lumen (C). Once inside the artery wall, WBCs transform into foam cells, and begin to collect fat and cholesterol.overtime, this form a lump called an atheroma (B). This plaque may grow larger as muscle cells, fibers, calcium and cell debris are deposited.
THROMBOSIS Thrombosis is the formation of a clot within a blood vessel. It commonly occurs as a result of atherosclerosis. As a plaque grows in an injured artery, it may become unstable, cracking the intima layer. Blood clotting cells attach to the injured site in an attempt to repair the break in intima. A thrombus (clot) may develop quickly and grow to block the entire artery lumen.
In some cases, the thrombus may break away from the injured site and travel downstream until it becomes lodged in a smaller artery known as thromboembolism. If it blocks the blood flow in a smaller artery, the lack of oxygen will cause damage to surrounding tissue.
THROMBOSIS
COMMON SITES Atherosclerosis may occur in large and mediumsized arteries anywhere in the body and reduce blood flow to the organs served by that artery. Common conditions caused by atherosclerosis include: Carotid artery disease - The carotid arteries bring oxygenated blood to the brain; a thromboembolus may occur and become lodged in a smaller vessel of the brain causing a stroke. Coronary artery disease (CAD) - The coronary arteries bring oxygenated blood to the heart muscle; blocked coronary arteries may cause chest pain and a heart attack.
Peripheral arterial disease (PAD) This condition is caused by blockage of the arteries to the limbs, most often the legs; it leads to pain and dangerous infections of nearby tissues.
PERIPHERAL ARTERY DISEASE
ANGIOPLASTY Angioplasty is the procedure used to reopen coronary arteries that have become blocked by plaque. This procedure may be used to treat coronary or peripheral artery disease. A catheter is guided into the blocked artery. Next a wire tipped with a deflated balloon is slipped through the catheter and extended into the narrowed coronary artery.
Then the balloon is inflated, compressing the fatty plaque and stretching out the artery. The balloon may be inflated or deflated several times to widen the opening, improving blood flow. Angioplasty does not remove the atheroma, only flattens it so that the artery lumen is opened and adequate blood flow can resume.
ENDARTERECTOMY This is a surgical procedure used to remove plaque from an artery. It is commonly used to treat severe carotid artery disease. During this operation, a specially trained surgeon opens the carotid artery and removes the plaque through a small incision. The artery is then stitched backup. In some instances, the plaque may have severely damaged the artery s integrity. In this case, the surgeon may replace the damaged artery with a vein from the leg. This type of surgery is routinely practiced by a specialized cardiologist.
CORONARY ARTERY BYPASS GRAFT A coronary artery bypass graft (CABG) is a procedure commonly used when coronary artery disease has affected multiple cardiac vessels. The bypass creates a detour around the blockage.this surgical procedure typically is referred to as single, double, triple or quadruple bypass, indicating the number of vessels bypassed. Typically, the left anterior descending artery (LAD), right coronary artery (RCA), left circumflex artery (LCX), and or the first diagonal of the LAD are bypassed.
During the surgical procedure, the surgeon takes a healthy blood vessel from the chest wall or leg to use as the bypass graft. It is attached to the aorta and below the blockage on the artery. This creates a new and unobstructed path for blood to bypass the blocked area and brings oxygen-rich blood to the heart muscle. This procedure is typically performed on multiple blocked coronary arteries at the same time.
CORONARY BYPASS GRAFT
FACTS Keep your arteries healthy and help reduce your chances of developing atherosclerosis by following these simple tips: Do not smoke to prevent nicotine from further damaging your lungs and arteries. Exercise regularly to maintain healthy body weight, which lowers your blood pressure, and improves circulation, lessening the chance of injuring artery walls.
Eat a heart-healthy diet that includes fruits, vegetables, and whole grains and avoids trans-fat, cholesterol, and salt. Manage stress with muscle relaxation and deep breathing exercises to help your body naturally control stress.
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