Atherosclerosis is on the list of life-threatening diseases, although at first glance it may seem different. It does not have a rapid development, the symptoms can be blurred and take images of other pathologies.
In reality, atherosclerosis slowly but surely affects all the arteries of the body one by one, gradually narrowing the lumen of blood vessels and blocking the blood flow. This leads to chronic ischemia, impairs function and stops the work of the organs.
The spread of atherosclerosis in the body
Most often, atherosclerosis affects the arteries of the systemic circulation - the aorta, the vessels of the lower extremities, and the arteries of the brain.
With the defeat of the arterial vessels of the legs, the following symptoms appear: numbness and coldness of the feet, the inability to determine the pulsation in the lower legs, and with extensive lesions and in the groin, an unpleasant tingling of the skin during exercise. When the process is running on the front side of the leg (since there is less muscle layer and, accordingly, few vessels, ischemia develops more rapidly), a trophic ulcer is formed, which can develop into either gangrene or a cancer process. Gangrene is the death of limbs, ultimately resulting in blood poisoning and death.
Aortic affection is characterized by a variety of symptoms, due to its large extent in the human body - from the left ventricle of the heart to its branching in the femoral arteries.
The process can be localized in:
- Coronary vessels are a life-threatening condition that can lead to myocardial infarction. It is clinically very similar to angina pectoris - pressing and squeezing pain in the chest, shortness of breath, weakness, anxiety, fear or nervousness. The distinguishing feature is the duration of pain for several hours and its resistance to nitroglycerin, in contrast to angina pectoris;
- With the defeat of the abdominal aorta, in particular the mesenteric arteries, atherosclerosis takes the form of a dysfunction of the gastrointestinal tract of food poisoning type: nausea, vomiting, abdominal pain, a violation of the chair in the form of constipation or diarrhea. Symptoms do not stop antispasmodics and increase with time;
When arteries are blocked at the level of branching in the pelvic region, symptoms of a lesion of the femoral arteries are observed.
Initial manifestations of brain artery lesions
Atherosclerosis of cerebral vessels and brachiocephalic trunk has quite specific symptoms, which manifests itself only at the final and almost irreversible stage of the disease.
The first harbingers of the disease are chronic fatigue and weakness, which can last for months and sometimes even years. At the same time, a person always finds excuses for them, such as: banal fatigue at work, constant stress, or fluctuations in weather conditions.
Over time, the patient feels constantly irritated, because the nervous system works in a state of permanent tension in conditions of chronic oxygen starvation, as the vessels are constantly filled with plaques.
At this stage, the disease is often found accidentally during routine check-ups or when blood is given for lipids.
In 90% of cases, atherosclerosis moves to the next stage of development - when the level of contraction reaches more than half of the lumen. Then the symptoms become more pronounced and exacerbated.
They also add dizziness during physical exertion and at rest, pain in the head and neck, flickering of the flies and the presence of dark spots before the eyes, tinnitus. It is associated with hypoxia of such brain structures as the vestibular apparatus, optic nerve and cerebellum.
In parallel with this, the patient gradually develops a depressive state that relatives can notice. The so-called brain symptoms, specific signs of damage to the brain tissue, are slowly increasing.
With more extensive lesions of the cerebellum, disorders in the motor sphere and coordination begin. This is manifested by tremor of the limbs or uncontrolled trembling, shaking the head, sharp movements of the hands.
The next suffers speech center. Speech becomes slurred, confused, with hesitations. This attracts the attention of the environment, making the patient feel uncomfortable, and can stimulate him to consult a doctor.
Main symptoms of brain dysfunction
If the treatment is not started at this time, the last stage develops.
It is characterized by decreased memory, gradual, but total over time. At first, this is manifested by forgetting names and dates, then events and people are forgotten, and at the end dementia develops.
This is a serious condition, especially for relatives and close people, as dementia leads to a complete loss of personality.
A person cannot perform basic household activities - from tying shoelaces to eating, the self-care skill is lost.
This stage in most cases is not regressive and ends with a stroke - ischemic or hemorrhagic.
An ischemic stroke is formed as a result of a vessel occlusion with an atherosclerotic plaque, a sharp oxygen starvation and ischemia with necrosis occur.
A hemorrhagic stroke is caused by a rupture of the affected vessel, which leads to massive bleeding and soaking the brain tissue with blood, which leads to impaired brain function.
Also, any stroke leads to cerebral edema, which is manifested by the displacement and penetration of the brain structures, in particular the brain stem. It is there that the vital centers are located, which are responsible for heartbeat, breathing and swallowing. Without them, a person dies in a matter of minutes.
That is why cerebral atherosclerosis should be detected at the stage of initial symptoms and medication should be started so that serious consequences do not develop.
Diagnostic criteria for atherosclerosis
Setting the correct diagnosis always begins with a patient survey.
The causes of the development of pathology are risk factors, their identification and elimination contributes to slowing the progression of the disease.
The list of key questions includes the identification of risk factors.
For atherosclerosis, risk factors are:
- Smoking - this takes into account not only the number of cigarettes per day, but also the smoking experience. This characterizes the degree and duration of exposure to irritant substances on the vascular membrane, especially in the elderly;
- The presence or absence of diabetes mellitus - an increase in blood glucose always worsens the prognosis of the disease and is its provoking factor due to the damaging effect on the intima of the arteries. Often leads to disability;
- The degree of obesity, if present. Overweight is a risk factor for many diseases of the endocrine and cardiovascular systems, such as diabetes and hypertension, respectively;
- Improper diet and hypodynamia - in combination often cause obesity. Also, under these conditions, the great vessels become thinner, become fragile and brittle, which can lead to their destruction;
- Alcohol consumption is one of the most dangerous risk factors, because it leads to the appearance of liver disease, which processes harmful cholesterol for vessels into bile acids useful for digestion. Without this, cholesterol plaques form in the arteries of excess lipids, closing the bloodstream. Also, these plaques can come off, causing acute blockage of blood vessels. These are often pulmonary arteries, and this will lead to a pulmonary infarction and respiratory arrest.
Also, the cause of the disease can be burdened heredity. It is worth knowing from the patient whether there have been cases of atherosclerosis in the family, as this disease may be familial in nature.
And to ensure the health of all family members, prevention can be carried out from early childhood.
Auxiliary diagnostic methods
After the interview, the patient must undergo laboratory tests.
To clarify the diagnosis, the doctor prescribes the passage of a whole range of laboratory tests.
After receiving the results of the examination, the doctor will be able to determine the likely degree of development of the pathology and determine the need for instrumental examination.
In the results of laboratory analysis, the doctor can see:
- In the general analysis of blood in atherosclerosis, an increase in the erythrocyte sedimentation rate and an increase in the C-reactive protein are observed. This indicates the inflammatory process that develops in the body;
- In the biochemical analysis of blood attention will attract lipidogram. It shows the relationship between lipid fractions. The normal amount of total cholesterol is about 5 mmol / l. with the development of atherosclerosis, this figure increases significantly and the higher it is, the more the progress of the disease is launched. Also pay attention to the ratio between low and high density lipoproteins. Normally, the first should be no more than 3 mmol / l, and the second - not less than 1 mmol / l. ideally, the more high-density lipoproteins, the better, since they have the ability to bind "bad" cholesterol and remove it from the body;
Then go to the instrumental methods of examination to confirm or refute the diagnosis.
The simplest and most budgetary way is radiography. It can reveal calcified plaques in the vessels of the brain. However, this method has significant drawbacks - firstly, it is the inaccuracy of the image. Secondly, if calcium did not have time to be deposited in the plaque, then the defeat will not appear on the film. Therefore, at present this method is used only in extreme cases.
A more detailed method is contrast angiography. It consists in the introduction of a contrast agent into the bloodstream and display on the screen of the patency of blood flow. Although invasive, it is considered fairly safe in modern medicine.
In addition, an ultrasound examination of cerebral vessels is used, in particular, in the Doppler mode, it helps to detect the presence or absence of plaques without penetration into the body.
This method is considered the gold standard in the diagnosis of atherosclerosis due to its high availability and safety.
Atherosclerosis treatment with pills
In the treatment of atherosclerosis, different methods are used, depending on the stage and course of the disease.
The possibility of lowering cholesterol through diet and physical exertion at home is always considered, because in 20% of cases the disease can be reversed using only these methods.
However, if such an approach is ineffective, medications are prescribed.
The drugs used belong to different groups of drugs, but as a result of the combined effect a good therapeutic effect is achieved.
Such means are:
- Drugs that reduce cholesterol, breaking the process of its biosynthesis in the body. These are statins and fibrates that inhibit the development of mevalonate in the liver. Statins are well tolerated as a primary therapy, have few side effects. They are prescribed to all patients with risk factors and complications such as angina, high blood pressure, myocardial infarction or stroke to get rid of their symptoms.
- If there are contraindications to taking statins, for example, individual intolerance, then sequestrants of bile acids are assigned, which reduce cholesterol by removing bile acids through the intestines.
- If there are type 2 diabetes mellitus among concomitant diseases, sugar-reducing tablets are prescribed - these are sulfonamides, which stimulate insulin production in the pancreas, and biguanides, which increase utilization of excess glucose through muscle tissue.
In addition, vitamin therapy is used. Appointment of a natural antioxidant in the form of vitamin E improves blood flow by reducing the oxidation processes in the vascular wall.
Widespread use in the treatment of atherosclerosis has found traditional medicine - decoctions of herbs that act on the body fortifying.
Radical methods are used only in extreme cases.
When the condition deteriorates during medical treatment, the question of surgical correction is raised to improve the patient's condition.
Surgical methods can be used in the detection of the disease in a neglected state in the last stages of development.
Operational methods for the correction of blood circulation in atherosclerosis are:
- Cardiac endarterectomy consists of performing an open procedure on a cut injured brain vessel, as a result of which the atherosclerotic plaque is removed from the artery, after which it is sutured and laid into place;
- Angioplasty is a closed operation, carried out by analogy with the previous one, only without opening the skull. A catheter is inserted into the femoral artery and pulled up to the affected vessel under the control of angiography. Then the atherosclerotic plaque is pulled in the opposite direction;
- Vascular stenting - is to install the frame of hypoallergenic wire in the place of the narrowing of the vessel. It is considered the least traumatic operation of all listed, has a lot of good feedback from patients.
In any case, it is always better to prevent the development of the disease than to treat it by different methods. Therefore, it is necessary to adhere to medical recommendations about a healthy lifestyle and not have bad habits to maintain strength and vitality for many years.
Atherosclerosis of the brain is described in the video in this article.