Atherosclerosis Diagnosis & Treatments
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540.829.4400Feeling chest pain and pressure in your chest is scary. These are signs of atherosclerosis, a build-up of plaque on the walls of the arteries that send blood to your heart. Plaque makes it harder for blood to get to where it should go.
About half of Americans ages 45-84 have atherosclerosis but don't know it. It's important to know if you're at risk. If not treated, atherosclerosis can lead to a heart attack or stroke.
At UVA Health, you’ll have a team of experienced doctors, surgeons, nurses, and more. They work to make sure you get the most innovative and effective treatments.
Atherosclerosis Diagnosis & Treatment at UVA Health
Most people are diagnosed after developing symptoms. But you can be screened and treated for risk factors.
These tests help us find atherosclerosis:
- Angiography
- Cardiac catheterization
- Ultrasound
- Electrocardiogram (ECG)
Treatment depends on the area of the body most affected. At UVA Health, you'll find the following treatment options.
Treating Atherosclerosis
If you have atherosclerosis, there are steps you can take to treat it. See your options for atherosclerosis treatment in this quick primer from UVA Health. See the
How Well Do You Know Your Heart? Part 3: Atherosclerosis Treatment Transcript There are many ways to treat atherosclerosis. Medication lowers cholesterol, stops clotting, and controls blood pressure. Catheters can help open the artery to improve blood flow without surgery. Surgery unblocks the artery or makes new routes for blood flow when catheters can't be used. At risk? Discuss screenings with your provider.
Medication Lowers Your Risk
Medication can lower your risk factors. They can help to:
- Stop blood clots from forming
- Control blood pressure
- Lower cholesterol
- Improve blood flow through narrowed arteries
Catheter-Based Procedures Open Blood Vessels
Your surgeon puts a long, flexible tube, called a catheter, into a heart artery. These procedures include:
- Balloon angioplasty: A balloon-tipped catheter presses plaque against the wall of the artery; increases blood flow
- Stenting: A wire mesh tube keeps a damaged artery open
- Atherectomy: Your surgeon cuts away and removes plaque so blood can flow more easily
Surgery Reverses the Damage
At UVA Health, our surgeons are highly skilled in surgical options. These include:
- Arterioplasty: Repair of an aneurysm, usually done with synthetic tissue
- Bypass: We create an alternate route for blood flow
- Endarterectomy: Improving blood flow by removing the lining of a blocked artery; most often performed on:
- Carotid arteries in the neck that send blood to the brain
- Aorta
- Iliac and femoral arteries of the legs
- Renal arteries that send blood to the kidneys
Unblocking Narrowed Arteries
Cardiologist Michael Ragosta, MD, walks us through the causes, symptoms, and treatment plans for atherosclerosis.
Atherosclerosis is a disease of the arteries, and therefore it can affect any artery in your body. The most likely arteries affected are the arteries to your heart, the arteries going to your brain or the carotid arteries, and the arteries in your abdominal aorta going to your legs. Atherosclerosis is essentially a degenerative condition, and it involves the development of plaque in the wall of the vessel, but as it develops and progresses, it encroaches on the artery and therefore can cause narrowing of the artery and therefore limit blood flow. There are a lot of causes of atherosclerosis. There's not one thing that causes it, so it really is a disease or a condition that has many factors, and we call those risk factors, and they include diabetes, hypertension, high cholesterol, smoking, and family history. Most patients that have atherosclerosis will describe a family history, but it's not a very strong predictor and it doesn't doom you to having coronary disease or atherosclerosis.
It's important to note that you can have a lot of atherosclerosis throughout with no symptoms, and so the lack of symptoms doesn't mean you don't have this condition. It's really only until arteries get narrowed severely that it leads to some of the symptoms that you can develop. So starting with the heart, patients can develop chest pain, they can develop shortness of breath and symptoms related to the blocked arteries. If you have atherosclerosis in your leg arteries, then you may develop pain or discomfort in your calves, in your thighs or in your hips when walking. And then finally, it can affect the arteries going to the brain. So those would cause symptoms that are worrisome for stroke, and that would include things like slurred speech, transient weakness, or numbness, difficulty with their vision.
Medications are really the first line treatment, and those medications are designed to help reduce cholesterol and to stabilize the disease process. Then there are more aggressive treatments that are used, we call them revascularization, and those are to restore the blood flow, and there's a lot of different surgical options. Those surgical procedures are more aggressive, there's more risk involved, and they are reserved for patients who essentially fail medical therapy or have very severe advanced disease that requires restoration blood flow. So the advantage of UVA is we really have a multidisciplinary approach to the treatment, management, and diagnosis of atherosclerosis. We work together very collaboratively, and so since this condition affects multiple vascular beds, you therefore need the input of multiple different specialties.
Your chance of getting atherosclerosis goes up with age: 45 and older in men; 55 and older in women. You also have a greater risk if you have:
- Family history of atherosclerosis
- High cholesterol
- High blood pressure
- Poor diet
- Smoking
- Diabetes
- Obesity
- Lack of physical activity
- Metabolic syndrome
What Is Atherosclerosis?
Atherosclerosis develops when a sticky substance called plaque builds up inside your arteries. Atherosclerosis is also known as "hardening" of the artery. It causes arteries to narrow and slow or even stop blood flow.
Atherosclerosis can cause serious problems. Depending on which blood vessel is affected, atherosclerosis can lead to:
- Coronary artery disease — Loss of blood to areas of the heart
- Stroke — Loss of blood to areas of the brain
- Peripheral vascular disease — Loss of blood to legs and other extremities
Repeat damage to the inside wall of an artery causes blood clots. These can decrease blood flow or completely close off the artery.
A clot could also break into clumps and block off smaller arteries.
A heart attack occurs when heart tissue supplied by the artery receives no oxygen.
Long-term atherosclerosis can also cause arteries to weaken or bulge. This can cause an aneurysm.
Symptoms of Atherosclerosis
If you have early atherosclerosis, you may not have any symptoms. For many, the earliest symptom is chest pain.
Later symptoms depend on where atherosclerosis forms. For example:
- Coronary arteries of the heart may cause symptoms of heart disease. This includes chest pain.
- Arteries to the brain may cause symptoms of a stroke. These include weakness, vision problems, speech problems, or headaches.
- Arteries in the lower extremities may cause pain in the legs or feet and trouble walking.