Atherosclerosis is a disease that is accompanied by a systemic lesion of large and medium-sized arteries. It is characterized by the accumulation of lipids, the growth of fibrous fibers, dysfunction of the endothelium of the walls of blood vessels. The development of atherosclerosis can result in 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 will consider the stages of vascular atherosclerosis.
Description of the disease
Atherosclerosis is a lesion of the arteries, which is accompanied by the process of cholesterol deposition on the inner lining of the vessels. As a result, there is a narrowing of their lumen, the nutrition of the blood-supplying organ is disrupted. Atherosclerosis affects exclusively the medium and large arteries of the body of the muscular-elastic and elastic types. The first include the arteries of the brain, heart, carotid. To the second - the aorta and other largearteries. This explains why atherosclerosis is a common cause of coronary artery disease, circulatory disorders in the lower extremities, cerebral stroke, myocardial infarction.
Disease diagnosis
Diagnosis of the disease includes measurement of lipid levels in the blood, ultrasound examination of the heart and blood vessels, and angiographic examination. Therapy of atherosclerosis can be of a medicinal nature, it can also be expressed in diet therapy. If necessary, revascularization surgery is performed.
Consider the main stages of atherosclerosis. Arterial damage 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 atherosclerosis is characterized by several stages.
1 stage: initial
The initial stage of atherosclerosis is the presence of a fatty (lipid) spot. Minor damage to the arterial walls and slowing down of local blood flow play a significant role in the process of fat deposition. Areas in which the vessels branch out are most susceptible to atherosclerosis. Loosening and swelling of the vascular wall occurs. Enzymatic substances of the artery wall dissolve lipids and protect it. However, when resources are depleted, complex complexes of compounds are deposited in these areas, which consist mainly of cholesterol and proteins. The lipid spot stage has a variable duration and can even be detectedin an infant. What are the other stages of atherosclerosis?
Stage 2: Intermediate
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 the arteries. Gradually formed atherosclerotic plaque, which consists of connective tissue fibers and fats. Atherosclerotic plaques at this stage are still liquid and can be dissolved. However, their friability is dangerous, as they can rupture and their parts can block the lumen of the artery.
3 stage: severe
The appearance of stage 3 atherosclerosis of vessels is called atherocalcinosis. With further development, the plaque thickens, calcium s alts are deposited in it. Such a plaque can be stable, or it can grow, thereby deforming and narrowing the lumen of the artery. At the third stage, the probability of blockage of the lumen of the artery by a fragment of a plaque that has disintegrated, or by a formed thrombus, is quite high. It is not excluded the development of necrosis, as well as gangrene of the limb or organ, which are supplied with blood through the affected artery.
These stages of atherosclerosis in each person can proceed differently, it all depends on its individual characteristics. But still they have common features.
Factors for the development of atherosclerosis are classified by physicians into three large groups.
Unremovable Factors
The first group is irremovable factors. They cannot be eliminated by medical or volitional influence. These include:
- Age. The risk of developing a disease such as atherosclerosis only increases with age. To some extent, all people who have reached the age of 40-50 years old have atherosclerotic changes.
- Gender. Men, unlike women, begin to suffer from atherosclerosis earlier by about 10 years. At the same time, men get sick more often 4 times. After 55 years, the incidence rate in men and women is roughly comparable. 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.
Removable factors
The second group is removable factors. That is, those that a person himself can exclude if he changes his usual way of life. These include:
- Messy and unbalanced diet. The development of atherosclerosis is accelerated by eating excessive amounts of animal fats.
- Inactivity. A sedentary lifestyle causes disturbances in fat metabolism, contributes to the development of diseases such as diabetes, obesity, atherosclerosis of the arteries.
- Smoking. Tar and nicotine have a negative effect on blood vessels. This explains the impact of such a factor. The risk of coronary artery disease, arterial hypertension, hyperlipidemia many timesincreases with years of smoking.
Partly Removable
The third group is partially removable and potentially removable factors. These include diseases and disorders that can be corrected with qualified treatment. These include:
- Arterial hypertension. Increased blood pressure contributes to increased impregnation of the vessel wall with fats, and this contributes to the fact that an atherosclerotic plaque begins to form. Conversely, decreased elasticity of the 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 3rd stage of atherosclerosis occurring immediately by an average of 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
The most common is atherosclerosis of the thoracic and abdominal aorta, coronary, mesenteric, renal vessels, brain cells and lower extremities. The stages of atherosclerosis differ in that they can be preclinical (asymptomatic) and clinical. The asymptomatic form is characterized by elevated levels 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, circulatory failure of a certain organ develops, for example, myocardial ischemia may occur due to the fact that coronary vessels have undergone 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 fibrous stage is characterized by the growth of connective tissue in organs that are poorly supplied with blood.
The symptomatology of atherosclerosis depends on which arteries have been affected by the disease. A symptom of atherosclerosis of the coronary arteries is angina pectoris, cardiosclerosis, myocardial infarction.
All stages of aortic atherosclerosis are asymptomatic for a long time, even if they are severe. A symptom is aortalgia (pressing and burning pains behind the sternum, which are given to the arms, neck, back, abdomen). In this case, the duration of aortalgia can be from several hours to several days.
If atherosclerosis has affected the abdominal aorta, it will manifest itself in the form of abdominal pain, flatulence, constipation, swelling and redness of the feet, numbness of the legs, intermittent claudication, necrosis of the toes.
Symptomaticsatherosclerosis of the mesenteric vessels is expressed by attacks of "abdominal toad", a violation of the digestive functions. This is due to a violation of the blood supply to the intestines. Patients begin to experience pain within a few hours after eating. There may be belching, constipation, bloating, high blood pressure. In the future, there is such a symptom as fetid diarrhea, containing fragments of undigested fat and undigested food.
If the renal arteries have undergone atherosclerotic lesions, then symptomatic arterial hypertension develops. Urinalysis reveals elevated levels of red blood cells, protein and casts.
At different stages of atherosclerosis of the brain, the following symptoms appear: reduced memory, physical and mental performance, attention, intelligence. There is dizziness and sleep disturbances. This type of atherosclerosis can also be accompanied by changes in the behavior and psyche of the patient.
The stages of obliterating atherosclerosis, that is, atherosclerosis of the vessels in the lower extremities, are characterized by: pain and weakness in the calf muscles, chilliness of the legs, numbness, trophic disorders, pallor of the extremities.
Treatment
When treating atherosclerosis, doctors try to adhere to the following principles:
- Prescribing a diet that helps limit the intake of cholesterol (effective at stages 1 and 2 of atherosclerosis).
- Stimulating the process of removing cholesterol.
- Estrogen therapy in menopausal women.
- Eliminationpathogens.
Medicines
If the therapy is of a medicinal nature, then the use of the following medications is typical:
- Nicotinic acid, which lowers blood cholesterol levels. Has anti-atherogenic properties.
- Fibrates, which reduce the body's own fat synthesis.
- Bile acid sequestrants that bind and remove these acids from the intestines.
- Statins effectively lower cholesterol levels.
Surgical treatment
If there is a high risk or likelihood of vascular occlusion by a thrombus or plaque, surgical treatment is indicated. Vascular surgeries can be both open and endovascular. If atherosclerosis of the heart vessels threatens the development of myocardial infarction, coronary artery bypass grafting may be prescribed.
The article discusses the main stages of atherosclerosis.
