Patient Care – Adult cardiac, endovascular, and thoracic aortic surgery

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Coronary arteries – The coronary arteries supply blood to the heart muscle. The right coronary artery supplies both the left and the right heart; the left coronary artery supplies the left heart.

Atherosclerosis

Atherosclerosis is a condition in which fatty material is deposited along the walls of arteries. This fatty material thickens, hardens, and may eventually block the arteries.

Atherosclerosis is just one of several types of “arterio”-sclerosis, which is characterized by thickening and hardening of artery walls, but the two terms are often used to mean the same thing.

Alternative Names: Arteriosclerosis; Hardening of the arteries; Plaque buildup – arteries

Causes, incidence, and risk factors:
Atherosclerosis is a common disorder of the arteries. Fat, cholesterol and other substances accumulate in the walls of arteries and form “atheromas” or plaques.

Eventually, this fatty tissue can erode the wall of the artery, diminish its elasticity (stretchiness) and interfere with blood flow. Plaques can also rupture, causing debris to migrate downstream within an artery. This is a common cause of heart attack and stroke.

Clots can also form around the plaque deposits, further interfering with blood flow and posing added danger if they break off and travel to the heart, lungs, or brain. Many physicians now suspect that there is an immune system component to the problem (inflammation may help cause atherosclerosis).

When blood flow in the arteries to heart muscle becomes severely restricted, it leads to symptoms like chest pain.

Risk factors include smoking, diabetes, obesity, high blood cholesterol, a diet high in fats, and having a personal or family history of heart disease. Cerebrovascular disease, peripheral vascular disease, high blood pressure, and kidney disease involving dialysis are also disorders that may also be associated with atherosclerosis.

Symptoms: Atherosclerosis often shows no symptoms until flow within a blood vessel has become seriously compromised. Typical symptoms of atherosclerosis include chest pain when a coronary artery is involved, or leg pain when a leg artery is involved. Sometimes symptoms occur only with exertion. In some people, however, they may occur at rest.

Signs and tests: Atherosclerosis may not be diagnosed until symptoms develop. Prior to complications, atherosclerosis may be noted by the presence of a “bruit” (a whooshing or blowing sound heard over the artery with a stethoscope). The affected area may have a decreased pulse.

Tests that indicate atherosclerosis (or complications) include:

An abnormal difference between the blood pressure of the ankle and arm (ankle/brachial index, or ABI)
Doppler study of the affected area
Ultrasonic Duplex scanning
CT scan of the affected area
Magnetic resonance arteriography (MRA)
Arteriography of the affected area
Intravascular ultrasound (IVUS) of the affected vessels
Cardiac stress testing

Atherosclerosis is a disease of the arteries in which fatty material is
deposited in the vessel wall, resulting in narrowing and eventual
impairment of blood flow. Severely restricted blood flow in the arteries
to the heart muscle leads to symptoms such as chest pain.
Atherosclerosis shows no symptoms until a complication occurs.