Vascular atherosclerosis: causes, signs of pathology, treatment. The connection between atherosclerosis and psychosomatics

According to data provided annually by the World Health Organization, the incidence and development of heart and vascular pathologies is steadily increasing. One of these diseases is vascular atherosclerosis, which kills people every hour or causes disability.

Patients faced with a similar diagnosis are concerned with the question: “How quickly does vascular atherosclerosis develop, what are its causes and can it be cured?”

Vascular atherosclerosis (to be defined briefly) is a disease that affects the main and peripheral vessels. He was assigned a code according to the international classification of diseases ( ICD code 10 - І 70). World statistics states that the active development of the disease is observed after 50 years. Most often in pathological process arteries that have an elastic and muscular-elastic structure of the vascular wall are involved.

The main prerequisite for the development of the disease is fat metabolism disorder, arising under the influence of a number of reasons. The biochemistry of the blood changes - the concentration of cholesterol in the plasma begins to increase, which does not tend to spontaneously decrease. The optimal balance between the atherogenic (LDL) and antiatherogenic (HDL) fractions of cholesterol is disrupted, which contributes to the development of pathological changes affecting the vascular bed.

Severin E. S. described the biochemical aspects of vascular atherosclerosis in more detail in his book “Biochemistry of Atherosclerosis.”

The development of the disease goes through several stages - the presence of clinical manifestations. In patients with atherosclerosis, atherosclerotic plaques (accumulations of fat) are deposited inside the blood vessels, which are prone to proliferation. All these changes lead to the walls of the vascular bed becoming thinner and their basic functions being disrupted. The mechanism of development of dystrophy is characteristic of the advanced stage of vascular atherosclerosis.

The National Society for the Study of Atherosclerosis (NOA) classifies the disease as an internal medicine and views it as a medical and social problem. This is confirmed by statistics on mortality rates in the world and in Russia.

Atherosclerosis is the main cause of heart disease vascular diseases that can lead to death

Symptoms taking into account localization and stage of development

The symptoms of the disease depend on which vessels are affected by atherosclerosis and the stage of its development. With the development of pathology, the vessels that carry blood to the organs (arteries, arterioles, capillaries) are primarily affected. Atherosclerotic deposits do not form in the lumen of the veins - this is explained by the structure of the walls of this section of the vascular bed.

As the disease develops, it goes through several successive stages:

1. First stage. Primary pathological changes occur within a short time after the concentration in the blood plasma significantly increases total cholesterol. The vascular endothelium begins to secrete active substances, which are designed to neutralize excess fat molecules circulating in the systemic circulation. Over time, the compensatory capabilities of the inner layer of blood vessels are exhausted. The endothelium becomes thin, pronounced edema forms, and microcracks appear. Against the background of these negative changes, the vessels become defenseless against the settling of fatty particles on their walls in the form of spots or stripes that are not visible to the naked eye.
2. Stage of sclerotic changes. Over time, spots and streaks of fat begin to accumulate cellular elements on their surface connective tissue. Thus, an atheromatous plaque appears. The capsule covering the fatty core of the plaque is quite loose. It is prone to the appearance of microtraumas, which is dangerous due to the loss of the nucleus and its entry into the bloodstream. A fat embolus can cause complications of atherosclerosis such as vascular thrombosis.
3. Recalcification stage. At this stage, the growth of intravascular pathological neoplasms continues. The capsule of the fatty core begins to actively accumulate calcium salts, which contributes to its hardening. Over time, plaques grow, leading to significant stenosis or complete obstruction of the lumen of the affected area of ​​the vascular bed. The result of this is acute or chronic ischemia of tissues and organs to which damaged vessels carry blood.

Clinical manifestations on early stages This vascular pathology is absent or only slightly expressed. The first signs of atherosclerosis appear at the stage of sclerotic changes. Then the patient begins to present characteristic complaints, which are formed depending on the localization of the pathological process. It has been established that peripheral atherosclerosis occurs much less frequently in women than in men.

The atherosclerotic process can affect parts of the thoracic and abdominal aorta. For a long time the disease goes undetected. The first signs of aortic atherosclerosis are debilitating burning pain in the chest, which can radiate to the spinal column, upper floors abdominal cavity. This pain differs from angina pectoris in that it can last up to several days and is wave-like.

Abdominal injury main artery characterized by the presence of constant pain in all levels of the abdominal cavity, excessive gas formation, and disturbances in defecation. If the pathological process involves that part of the aorta where it branches into the right and left iliac arteries, patients are bothered by pain in the legs, a feeling of numbness, swelling, necrotic changes in the soft tissues of the distal parts lower limbs.

Vascular atherosclerosis is dangerous due to its complications, which are often fatal.

Most Negative consequences diseases:

• cerebral stroke (ischemic, hemorrhagic),
• myocardial infarction (focal, transmural),
• necrotic changes in soft tissues (gangrene of the lower extremities);

If qualified assistance is not provided in a timely manner, these complications often lead to death!

From point of view psychosomatics, there is a metaphysical theory of the occurrence of vascular atherosclerosis. For example, Oleg Torsunov believes that atherosclerotic vascular damage occurs due to stiffness of thoughts, lack of gentleness in character, and a person’s closedness to the outside world. Valery Sinelnikov writes in his book that atherosclerosis appears as a result of disruption of the energy channels through which waves of joy should flow to the human mental body. Exactly lack of joy, but not wrong image life leads to illness.

Diagnostics: how to check blood vessels for atherosclerosis

Atherosclerosis of the arteries can be diagnosed in a patient only after he has undergone a complete examination.

The first step is to consult a doctor. All specialists during training in medical universities passed the department of faculty therapy, where the main attention was paid to a thorough study of the medical history. Therefore, the doctor must ask the patient in detail about the complaints, detailing them as much as possible. After verbal contact, the specialist examines the patient for visible pathological changes and measures blood pressure.

Next comes the stage laboratory diagnostics. The patient passes lipid profile, which allows you to identify lipid imbalances, because dyslipidemia and atherosclerosis are inextricable concepts. The doctor should also check clinical analysis urine. This is necessary in order to understand whether there are problems with the kidneys or not. It is also standard procedure to submit general analysis blood.

The final stage - instrumental methods diagnostics In cardiology, ultrasound is considered the most informative method, which allows you to identify vascular atherosclerosis. For this purpose, the Doppler mode is used, with the help of which a visual assessment of blood flow is carried out and areas of the vascular bed covered by the atherosclerotic process are determined. The angiography method is used to study the coronary and cerebral vessels.

How to treat atherosclerosis

Patients suffering from vascular atherosclerosis are concerned with the question: “Is the disease curable?” Modern medicine believes that it is impossible to completely cure atherosclerosis, but stopping its progression is quite possible. Treatment of vascular atherosclerosis is a long process that should begin immediately after identifying the pathology. The World Health Organization has developed clinical recommendations on methods of treating this pathology.

Atherosclerosis is a fairly common chronic disease characterized by its own progression. Atherosclerosis, the symptoms of which appear against the background of damage to the middle and large arteries due to the accumulation of cholesterol in them (which determines the cause of this disease), it becomes the cause of circulatory disorders and a number of serious risks provoked by this disorder.

general description

With atherosclerosis, atherosclerotic plaques form on the walls of blood vessels (their basis is body fat in combination with expanding connective tissue). Because of these plaques, narrowing of blood vessels occurs and their subsequent deformation. These changes, in turn, lead to disruption of blood circulation, as well as damage to internal organs. Large arteries are mainly affected.

Let's take a closer look at the picture of this disease. First of all, we note that the occurrence and subsequent formation of atherosclerosis depends on the following factors:

• the state in which the vascular walls are located;
• relevance of the genetic hereditary factor;
• disorders in fat (lipid) metabolism.

Cholesterol, originally noted, is a fat; it helps ensure a number of different functions in our body. In other words, it can be considered as a building material used in cell walls. In addition, cholesterol is a component of vitamins and hormones, which ensure adequate functioning of the body. Approximately 70% of the total amount of cholesterol is synthesized in the liver, while the remaining part enters the body through food.

Note that cholesterol in the body is not in a free state; it is included in specific complex compounds of fats and protein - lipoproteins. Lipoproteins, in turn, enable its transfer from the liver to tissues through the bloodstream. If cholesterol in the body is in excess, then from the tissues it is sent to the liver, and this is where the excess amount is utilized. Disruption of the functioning of this mechanism leads to the development of the disease we are considering, that is, atherosclerosis.

In the development of atherosclerosis, the main role is played by low-density lipoproteins, abbreviated as LDL. They ensure the transportation of cholesterol from the liver to the cells, and such transportation is subject to a strictly defined amount, otherwise exceeding the level determines a serious risk for possible development against this background of atherosclerosis.

As for the reverse transport of cholesterol from tissues to the liver, it is ensured by high-density lipoproteins, which in abbreviated form defines them as HDL, a separate class of anti-atherogenic lipoproteins. They ensure cleansing of the surface layer of cells from excess cholesterol. The risk of developing atherosclerosis occurs when reduced level HDL cholesterol and with elevated LDL levels.

Let's dwell on age characteristics atherosclerosis. Thus, it can be noted that the initial type of changes within the walls of arteries (their medium and large caliber) are noted already at a young age. Subsequently, they evolve, during which they transform into fibroadenomatous plaques, which, in turn, often develop after the age of 40 years. This atherosclerotic vascular lesion is relevant in approximately 17% of cases in patients under 20 years of age, in 60% in patients under 40 years of age, in 85% in patients aged 50 years and older.

In the future, the picture of the disease looks like this. The arterial wall undergoes penetration into its base by fibrin, cholesterol and a number of substances, due to the influence of which an atherosclerotic plaque is formed. Being in excess quantity, cholesterol, when exerted accordingly, causes the plaque to increase in size, which creates an obstacle to adequate blood flow through the vessels in the area of ​​the formed narrowing. Against this background, blood flow decreases and inflammation develops. Blood clots also form; they can subsequently break off, thereby posing a significant danger to the vessels that are vital in our body. This is due to the possibility of their blockage, which, in turn, will deprive the organs of the blood supply they require.

Causes of atherosclerosis

The causes of atherosclerosis can be very different, they are also equated with risk factors for the development of atherosclerosis, which indicates that compliance with these factors increases the risk of possible development of atherosclerosis in patients. In general, such risk factors can be divided into two main groups depending on the nature of the patient’s exposure to them. Thus, the causes of the development of atherosclerosis can be modifiable and unmodifiable (modifiable and non-modifiable).

Unchangeable (non-modifiable) reasons as can be determined from their name, it is impossible to change with one or another measures of influence (including medical ones). The following can be identified as such factors:

• Floor. This factor is considered as an independent risk factor in considering the picture of the development of atherosclerosis. Atherosclerosis in men develops approximately 10 years earlier, which is known based on certain statistical data on this matter when compared with female morbidity. In addition, before reaching the age of 50, the risk of developing this disease in men is four times higher than in women. Upon reaching the threshold of 50 years of age, the incidence in both sexes is equalized. This feature is explained by the fact that in female body from this period specific hormonal changes, and the protective function provided by estrogen disappears (here, as you can understand, we're talking about about menopause and a gradual decrease in the intensity of secretion of these estrogen hormones).
• Age. As the reader may have already noticed, with age the risk of developing the disease we are considering increases. Accordingly, the older the person, the greater this risk. And, of course, it is also impossible to influence this factor, which is why it is considered in this particular group. It should be noted that in general, atherosclerosis as a disease is often compared with the aging of the body, that is, as one of the manifestations of this process. This is explained by the fact that atherosclerotic changes after moving beyond a specific age period are determined in absolutely all patients. And, as already noted, from the age of 45-50 the risk of such changes especially increases.
• Genetic predisposition. This risk factor is also unchanged when considering atherosclerosis. Thus, those patients whose immediate relatives are diagnosed with one or another form of it are especially susceptible to this disease. It is generally accepted that genetic predisposition (also known as heredity) also acts as a factor that determines the relative acceleration of the development of atherosclerosis (before reaching the age of 50). Meanwhile, in people whose age exceeds 50 years, the heredity factor in practice determines a slight influence on the development of atherosclerosis; therefore, a clear statement regarding the early development of this disease, if it is present in relatives, cannot be given.

Changeable (modifiable) reasons, in turn, are characterized by the fact that the patient can influence them. This may include lifestyle adjustments, treatment, etc. Let us highlight separately the options that are relevant for the disease in question:

• Arterial hypertension. This reason (factor) is independent in considering the development of atherosclerosis. The peculiarity of the effects of hypertension is that against its background there is an increase in the intensity of saturation of arterial walls with fats, which, in turn, is considered as initial stage in the development of the main manifestation of atherosclerosis, atherosclerotic plaque. At the same time, atherosclerosis, due to which the elasticity of the arteries is subject to change, is a factor that increases the risk of developing hypertension in a patient.
• Smoking. This factor is a serious aid for the development of many diseases, and atherosclerosis is no exception. With long-term smoking, the risk of developing the hypertension discussed above, as a predisposing factor in the development of atherosclerosis, increases, which already makes it possible to trace the chain of changes that are relevant in this case. In addition, smoking also contributes to the development of coronary heart disease ( coronary disease heart) and hyperlipidemia, which also accelerates the development of atherosclerosis in smokers. The basis of influence is based on the negative impact that the components have tobacco smoke directly onto the vessels.
• Obesity. Another, no less significant factor contributing to the development of atherosclerosis. Again, obesity predisposes not only to the development of atherosclerosis itself, but also one of the factors we have already listed, arterial hypertension, which in any case, as one can understand, connects this factor with the disease we are considering. Additionally, we note that obesity is one of the main factors in the development diabetes mellitus, which also plays an important role in considering the modifiable factors that interest us.
• Diabetes. The relevance of this factor for patients significantly increases the risk of developing atherosclerosis (about 5-7 times). This high risk is explained by the relevance of the violation metabolic processes(in particular this applies to fats), which provokes the development of atherosclerotic changes in blood vessels.
• Hyperlipidemia (dyslipidemia). This factor implies a violation in the metabolism of fats, which determines its no less significant role in terms of considering the factors that provoke atherosclerosis. It should be noted that all of the above factors are directly related to dyslipidemia, that is, with each of them, the problem of impaired fat metabolism is relevant. The main role in the development of atherosclerosis (as well as other types of diseases associated with the cardiovascular system) is given to the following forms of fat metabolism disorders: increased cholesterol levels, increased triglyceride levels and increased levels of lipoproteins in the blood.
• Nutritional features. The development of atherosclerosis is particularly influenced by the presence of a significant amount of animal fats in diet products.
• Physical inactivity (sedentary lifestyle). This factor also plays an important role in the development of atherosclerosis, including the development of the previously listed conditions (diabetes mellitus, arterial hypertension, obesity). Due to reduced physical activity, as you might guess, the metabolic processes of carbohydrates and fats are disrupted, which, accordingly, increases the risk of developing the listed disorders and atherosclerosis in particular.
• Infections. The infectious nature of the development of atherosclerosis began to be considered relatively recently. Based on the ongoing research, it was found that cytomegalovirus and chlamydial infections can be considered as two options representing this point in its connection with atherosclerosis.

Atherosclerosis: stages

As we have already highlighted, the pathological process relevant for atherosclerosis is concentrated within the walls of the arteries. This, in turn, leads to the gradual destruction of the affected wall. In accordance with the degree of damage and its characteristics, 3 stages of atherosclerosis are determined, successive in their manifestation, and we will consider them below.

• Stage I. As part of its manifestation lipid stains form. This implies the impregnation of arterial walls with fat molecules; the localization of impregnation is noted only within limited areas of the walls. These areas appear as yellowish stripes concentrated along the entire length of the affected artery. The features of this stage are characterized by the fact that the symptoms of atherosclerosis as such do not manifest themselves, and in general there are no specific disorders that could be used to determine the relevance of the circulation disorder in the blood arteries. Acceleration of the formation of lipid spots can occur due to the influence of the modifiable factors discussed above in the form of obesity, arterial hypertension and diabetes.
• Stage II. This stage is also defined as the stage of liposclerosis, characterized by the development of atherosclerosis to a stage in which inflammation of lipid spots occurs, which leads to the accumulation of cells in their cavities immune system. In particular, they are making attempts to cleanse the arterial wall of fats that have managed to be deposited on it (in some cases, these can be microbes). Against the background of a prolonged inflammatory process, the fats deposited on the arterial wall begin to decompose, and at the same time the germination of connective tissues occurs in it. It leads to formation of fibrous plaque, which defines this stage. The surface of such a plaque is in a slightly elevated position relative to the inner surface of the affected vessel, thereby narrowing its lumen and disrupting blood circulation.
• Stage III. This stage is the final stage in the development of atherosclerosis; it is characterized by development of a number of complications, directly related to the development of fibrous plaque. In addition, it is from this stage of the disease that its symptoms begin to appear. This stage is defined as the stage of atherocalcinosis. The progression of plaque deformation at this stage is determined by the compaction that is relevant to it, as well as the deposition of calcium salts in it. The nature of the manifestation of an atherosclerotic plaque can determine both its stability and gradual growth, due to which it will continue to deform the lumen of the artery and narrow it. Against the background of this last option, the development of a progressive form of chronic disturbance in the blood supply of the organ that is fed by the artery that has undergone such damage will be provoked. This also causes a significant risk of occlusion formation ( acute form blockage), in which the lumen of the vessel is blocked either by a thrombus or an element of plaque disintegration, as a result of which the blood supplying organ or limb undergoes another type of damage against this background - in the form of the formation of an area of ​​necrosis (infarction) or gangrene.

Atherosclerosis: symptoms

The aorta (abdominal and thoracic sections), mesenteric, coronary and renal arteries, as well as arteries of the brain and lower extremities are predominantly affected by atherosclerosis.

As part of the development of the disease, its asymptomatic (or preclinical) period and the clinical period are distinguished. The asymptomatic period is accompanied by increased content beta-lipoproteins in the blood or increased levels of cholesterol in it, while symptoms, as can be understood from the definition of this period, are absent.

As for the period of clinical manifestations, they are relevant when the arterial lumen is narrowed by 50% or more. This, in turn, determines the relevance of the three main stages of the period: the ischemic stage, the thromonecrotic stage and the fibrotic stage.

Ischemic stage characterized by the fact that it disrupts the blood supply to a certain organ. As an example, we can highlight the picture of the course of this stage, in which myocardial ischemia against the background of atherosclerosis coronary vessels manifests itself as angina pectoris. Thrombonecrotic stage characterized by the addition of thrombosis of arteries that have undergone changes. Atherosclerosis of the coronary arteries in this case can, in its course, reach complications in the form of myocardial infarction. And finally fibrous stage, which is characterized by the proliferation of connective tissue that occurs in organs that are ineffectively supplied with blood. Again, when considering atherosclerosis of the coronary arteries at this stage, one can distinguish the transition to the development of such a pathology as atherosclerotic cardiosclerosis.

As for the specific manifestations of atherosclerosis, its symptoms are determined based on what type of arteries is affected. Below we will look at the main options for the course of this disease.

Atherosclerosis of the aorta: symptoms

Atherosclerosis of the aorta is the most common manifestation of atherosclerosis; accordingly, it is detected in most patients. Atherosclerosis can affect its various parts, on the basis of which, in turn, the symptoms of the disease and its prognosis are determined.

As you probably know, the aorta is the largest vessel in our body. It starts from the heart (left ventricle), then branches, thereby forming many small vessels that spread to the tissues and organs of our body. The aorta consists of two main sections, which are located in anatomically different areas. These sections are the abdominal and thoracic aorta.

The thoracic aorta in the aorta is the initial section; it provides blood supply to the upper part of our body; accordingly, these are the organs of the chest, neck, head and upper limbs. As for the abdominal aorta, it is the final section; blood supply through it is provided to the abdominal organs. In turn, its final section is divided into two main branches, which are the left and right iliac arteries, through which blood flows to the lower extremities and pelvic organs.

In atherosclerosis of the aorta, the lesion that is relevant for this disease covers either the entire aorta along its length, or its individual areas. Symptoms in this case are also determined depending on where exactly the pathological process is localized and how pronounced the changes that arose in the walls of the aorta under its influence became.

The most dangerous complication caused by aortic atherosclerosis is an aortic aneurysm. With an aortic aneurysm, a certain section of the artery expands, which is accompanied by thinning of the vessel wall and increased risk rupture of the artery, which in turn can lead to life-threatening bleeding.

Atherosclerosis of the thoracic aorta: symptoms

There are no symptoms for a long time. Often, atherosclerosis of this department develops along with such forms of the disease as atherosclerosis of the coronary arteries of the heart (i.e., coronary arteries), as well as atherosclerosis of cerebral vessels.

The manifestation of symptoms is observed mainly at the age of 60-70 years, which is explained by the significant damage to the aortic walls by this time. Patients complain of burning pain in the chest area, systolic blood pressure increases, swallowing becomes difficult, and dizziness is common.

As less specific manifestations symptoms may be noted early aging, which is combined with early appearance gray hair. At the same time, an abundance of hair growth is noted in the area of ​​the ears, a characteristic light stripe appears along the outer edge of the iris, and wen appears on the skin of the face.

Atherosclerosis of the abdominal aorta: symptoms

This form of the disease is diagnosed in almost half of the cases of all possible variants of its manifestation. Similar to the previous form, for a long time it may not manifest itself at all.

Atherosclerosis of the area under consideration acts as the cause of the development in patients of such a pathology as abdominal ischemic disease. It, similar to IHD (coronary artery disease), is characterized by the fact that it leads to disruption of blood supply against the background of vascular damage by atherosclerosis, which is particularly important for those organs that these vessels nourish.

Symptoms accompanying damage to the abdominal aorta may manifest themselves in the following:

• Stomach ache. Such pain occurs after eating, the nature of the manifestation is paroxysmal, aching. As a rule, they are not too intense and do not have a clear localization. Such pain disappears on its own after a few hours.
• Digestive disorders. In particular, complaints of bloating, constipation and diarrhea (alternating conditions) and decreased appetite are relevant.
• Weight loss. This symptom is progressive and is caused by a persistent form of indigestion.
• Arterial hypertension (high blood pressure), renal failure. High blood pressure is due to the fact that the blood supply to the kidneys is subject to disruption. As for kidney failure, it develops due to the fact that their normal tissues gradually begin to be replaced by connective tissues. This, in turn, determines their gradual necrosis against the background of insufficient blood supply.
• Thrombosis of visceral arteries. This complication is deadly in case of atherosclerosis of the part of the aorta in question; moreover, it requires immediate specialized care medical care. When the vessels that provide blood supply to the intestines become necrosis, the intestinal loops become necrosis, which leads to massive inflammation of organs concentrated in the abdominal cavity and peritoneum (which determines peritonitis). Symptoms of this condition include severe pain that does not disappear when taking antispasmodics and painkillers. In addition, the pain is soon accompanied by a sudden deterioration in general well-being.

Atherosclerosis of cerebral vessels: symptoms

This form of atherosclerosis is no less common; in this case, the intracranial and extracranial vessels supplying the brain are affected. The severity of symptoms is determined based on the degree of damage to these vessels. Due to atherosclerosis of cerebral vessels, activity is gradually inhibited nervous system, may develop mental disorders or stroke.

The first manifestations of symptoms of this form of atherosclerosis are diagnosed at 60-65 years of age in patients, and their interpretation in most cases is reduced only to the manifestations of signs of aging of the body. Meanwhile, such a belief is only partly correct. Aging itself is irreversible physiological process, while atherosclerosis acts as a specific type of disease, the course of which, until it reaches certain limits, determines the possibility of cure, as well as the implementation of certain preventive measures against it.

Now let's move on to the symptoms. The initial manifestations of atherosclerosis of this form are episodic attacks of “ischemic attack”, during which relatively stable neurological symptoms. This particularly includes sensitivity disorders, which can manifest themselves either in a decrease in sensitivity on one side of the body, or in complete loss. There are also movement disorders in the form of paresis (partial loss of muscle strength) and paralysis. In addition, hearing, vision and speech impairments may occur. The listed symptoms, meanwhile, appear within a short period of time, after which they disappear.

With a severe form of cerebral atherosclerosis, a stroke often develops, in which necrosis of a certain area of ​​cerebral tissue occurs. This condition is characterized by a persistent manifestation of the symptoms we have already discussed (loss of sensitivity, paralysis, loss of speech); it is treatable to a small extent.

Other manifestations of the symptoms of atherosclerosis of this form include a disorder of higher nervous activity in one form or another (in particular, this concerns intellectual abilities and memory), changes in character (pictiness, capriciousness, etc.), sleep disturbances, and the development of depressive states.

Lack of adequate treatment can lead to dementia (senile dementia). It, in turn, is a severe and, unfortunately, irreversible manifestation of a decrease in the higher functions inherent in the brain.

Stroke is the greatest danger of this disease. This condition is essentially a condition similar to myocardial infarction, a condition in which tissue necrosis occurs. This condition is accompanied by increased mortality, as well as frequent disability of patients.

It should be noted that in some cases, symptoms indicating atherosclerosis of the cerebral arteries can be quite difficult to differentiate, for example, from the symptoms manifested in hypertensive encephalopathy or from actual disorders of cerebral blood supply due to the development of degenerative spinal diseases (for example, osteochondrosis). In reality, it often happens that patients in the group old age Many of the diseases with which atherosclerosis could be confused are relevant, therefore the diagnosis of this disease determines the need for an integrated approach to this process.

Atherosclerosis of the vessels of the lower extremities: symptoms

Similar to the forms we discussed earlier, atherosclerosis of the lower extremities (atherosclerosis obliterans) does not manifest itself for a long time, and this lasts until blood circulation through the vessels is seriously impaired due to the disease we are considering.

As a classic, one might say, symptom, in this case we consider pain that occurs in the muscles of the lower extremities when walking. This symptom has a definition corresponding to its manifestation - “intermittent claudication” (which is explained by periodic stops while walking due to emerging pain to reduce their intensity). Pain occurs in this case due to the fact that there is a lack of oxygen in the functioning muscles, which, in turn, occurs due to the specifics of atherosclerosis itself.

What is noteworthy is that arterial insufficiency that occurs with this form of atherosclerosis negatively affects not only the functions inherent in the legs, but it also acts as the cause of the development of trophic disorders, in which the nutrition of the lower extremities in particular is subject to disruption. Trophic disorders can manifest themselves in hair loss and skin changes (thinning, pallor). Nails are subject to deformation and become brittle. In severe cases, atherosclerosis of the legs is accompanied not only by muscle atrophy, but also by the formation of trophic ulcers in combination with gangrene.

Arterial insufficiency of the legs manifests itself in accordance with the disorders that determine its main four stages.

• Stage I . In this case, pain in the legs appears only in combination with significant physical activity (for example, this can be walking over long distances (one kilometer or more)).
• Stage II . In this case, the maximum distance for pain to occur is reduced, amounting to no more than 200 meters, after overcoming which, accordingly, pain appears.
• Stage III . Here pain occurs when walking within a distance of no more than 25 meters, or even at rest.
• IV stage . At this stage, patients develop trophic ulcers, gangrene of the lower extremities develops.

Another sign corresponding to the manifestations of atherosclerosis is the disappearance of the pulse noted in the area of ​​the arteries of the lower extremities (this may be the area on the back of the inner ankle, the area of ​​the popliteal fossa or the thigh area).

Thrombosis of the iliac arteries and the terminal part of the abdominal aorta provokes the development of Leriche syndrome.

Leriche syndrome is accompanied by impaired blood circulation, which is relevant for the arteries of the lower extremities, as well as for organs concentrated in the pelvic area. Quite often this syndrome develops against the background of atherosclerosis of the aorta. The manifestations of this pathology are similar to those that occur with atherosclerosis of the vessels of the legs.

In addition, impotence may develop, which, as is understandable, is relevant for men. Obliterating atherosclerosis of the vessels of the lower extremities can act as a serious type of trophic disorder directly affecting the limbs (legs), which can also lead to the development of gangrene, and, ultimately, to the loss of one of them. Accordingly, any warning sign may be a reason to contact a specialist.

Atherosclerosis of the coronary arteries of the heart: symptoms

This form of the disease acts as the main cause of the development of coronary heart disease in patients, which, in turn, develops against the background of impaired blood supply to the heart muscle. Myocardial infarction and angina pectoris are pathologies that directly depend on the degree of development of atherosclerosis affecting the arteries of the heart. Thus, with partial blockage, coronary disease develops (of varying severity of its own manifestation), and with complete blockage, myocardial infarction develops.

Dwelling on the features of the pathology that interests us, which is atherosclerosis of the coronary arteries of the heart, we will highlight the features of the blood supply to the heart. It is provided in particular by two coronary arteries that follow from the aorta. With any disturbance that occurs during blood circulation through the coronary (coronary) arteries, the work of the heart muscle is accordingly disrupted. This, in turn, can trigger a heart attack.

Most often, blood circulation is disrupted due to atherosclerosis of the coronary arteries. In this case, this pathology is accompanied by the formation of dense plaques, due to which the artery wall gradually becomes deformed and destroyed while its lumen narrows (a typical picture of the course of atherosclerosis). Symptoms of atherosclerosis of the coronary arteries correspond to those symptoms that appear with coronary artery disease, but in any case the main cause is atherosclerosis.

The main manifestations of symptoms, accordingly, in this case are the development of angina pectoris and ischemic heart disease; cardiosclerosis and myocardial infarction act as complications of atherosclerosis of the heart vessels. An attack of angina pectoris, which manifests itself in this form of atherosclerosis, is characterized by the following manifestations of symptoms:

• the appearance of burning, pressing pain in the chest area; spreading of such pain to the left shoulder and to the back; occurrence - when stressful situations arise or when physical activity;
• shortness of breath (there is a feeling of lack of air, it is usually accompanied by the above painful attack; in some cases, it becomes necessary to take a sitting position, because when lying down the patient simply begins to choke);
• as possible option In addition to the picture of an attack, the appearance of symptoms such as headache, nausea, vomiting and dizziness.

Treatment of an angina attack is ensured by the patient taking nitroglycerin; moreover, it is this drug that is the main one in considering the emergency relief of an attack.

In case of complications such as myocardial infarction Patients experience intense pain, reminiscent of those that occur with angina pectoris. The difference is that the use of nitroglycerin does not determine the corresponding effect. As additional manifestations of symptoms, severe shortness of breath is noted, the patient may lose consciousness. The manifestation of heart failure is characterized by its own severity.

If a complication such as cardiosclerosis, then heart failure manifests itself gradually, which is accompanied by a decrease in physical activity combined with shortness of breath and the occurrence of swelling.

Determination of specific signs corresponding to atherosclerosis of the coronary arteries can only be done using special diagnostic techniques.

Atherosclerosis of mesenteric vessels: symptoms

This form of atherosclerosis manifests itself primarily from the upper sections belly. The time of onset of symptoms, which primarily consists of the appearance of pain, mainly occurs in the late hours, in particular after dinner. The duration of pain can range from several minutes to up to an hour. As accompanying symptoms, bloating and belching may also occur, and constipation may occur. Pain in atherosclerosis, when compared with the pain syndrome accompanying peptic ulcer disease, is not so long-lasting in its manifestation.

The main symptoms accompanying atherosclerosis in this form include the following manifestations:

• bloating;
• moderate manifestation of pain, determined by palpating the abdominal area;
• slight muscle tension in the anterior area abdominal wall;
• weakening of peristalsis or its complete absence.

The listed manifestations are defined as such a condition as “angina pectoris”. It develops due to a discrepancy between the volume of blood required to provide blood supply to the organs of the digestive system and the actual volume, which, as can be understood, is insufficient for this.

As one of the complications of this form of atherosclerosis, thrombosis developing in the mesenteric vessels can be noted. As a rule, it appears suddenly, accompanied by the following accompanying symptoms:

• constant pain of a wandering or diffuse nature that occurs in the abdomen;
• pain in the navel area;
• nausea, repeated vomiting(with an admixture of bile; blood may also be present, which is noted in this case in the stool);
• constipation, flatulence (gas).

Often, thrombosis of mesenteric vessels results in the development of intestinal gangrene, which, in turn, is accompanied by severe symptoms of peritonitis.

Atherosclerosis of the renal arteries: symptoms

This form of atherosclerosis becomes the cause of the development of a persistent form of ischemia, which, in turn, acts as a factor provoking the development of a consistently high form of arterial hypertension.

Some cases of atherosclerosis of the renal arteries are accompanied by the absence of symptoms. Meanwhile, more often the picture of the disease manifests itself in the form of the development of atherosclerotic plaques with simultaneous narrowing of the lumen of the area renal artery, against which a secondary form of arterial hypertension develops.

If only one of the renal arteries is affected, we can talk about the slow progression of this disease; the leading manifestation of symptoms in this case is high blood pressure. If the spread of the process affects both arteries at once, then this, in turn, causes the development of the disease of a type in which arterial hypertension is malignant, characterized by rapid progression and a serious deterioration in the general condition of the patient.

Associated symptoms may include abdominal pain and pain in the lumbar region. The duration of pain manifests itself in different ways, in some cases it is about several hours, in others - about several days. Nausea and vomiting may also occur.

Diagnosis

The primary diagnosis of atherosclerosis is carried out by a therapist as part of a standard annual examination of the patient in this area. To do this, blood pressure is measured, risk factors that contribute to the development of atherosclerosis are identified, and body mass index is measured.

As a clarifying measure, the following research methods can be used:

• ECG (echocardiography) in combination with ultrasound of the aorta and heart, as well as with special stress tests;
• Invasive research methods (coronary angiography, angiography, intravascular ultrasound);
• Duplex scanning, triplex scanning (blood flow is examined using ultrasound visualization of blood vessels);
• MRI (magnetic resonance imaging), which visualizes atherosclerotic plaques and artery walls.

Treatment

Treatment of atherosclerosis is based on a number of the following principles:

• impact on infectious pathogens;
• implementation of measures replacement therapy(relevant for women during menopause);
• enhancing the removal of cholesterol and its metabolites from the body;
• limiting the intake of cholesterol into the body, reducing the synthesis of cholesterol by cells.

Against this background, the lifestyle is subject to adjustments; an additional diet is prescribed, in which, as you can understand, foods containing cholesterol are subject to maximum exclusion.

As for drug treatment, it is based on taking the following types of drugs:

• nicotinic acid in combination with its derivatives (providing the possibility of reducing cholesterol and triglycerides in the blood, as well as increasing the content of high-density lipoproteins);
• fibrates (drugs of this group reduce the synthesis of the body’s own fats);
• statins (provide the ability to reduce cholesterol in the most effective way by influencing the processes of their production by the body itself);
• sequestrants (ensure the binding and removal of bile acids from the intestines while reducing cholesterol and fats in cells).

Atherosclerosis may require in some cases and surgical treatment, which is important in case of a serious threat or in the development of an acute form of blockage of an artery by a blood clot or plaque. To do this, an endarterectomy (open surgery on the artery) or endovascular surgery (dilatation of the artery, installation of a stent in the area of ​​narrowing, which provides an obstacle to subsequent blockage) can be performed. A severe form of atherosclerosis with damage to the vessels of the heart, against the background of which myocardial infarction can develop, requires coronary artery bypass grafting.

Yandex.Zen

Pneumonia (officially pneumonia) is an inflammatory process in one or both respiratory organs, which is usually of an infectious nature and is caused by various viruses, bacteria and fungi. In ancient times, this disease was considered one of the most dangerous, and although modern treatments make it possible to get rid of the infection quickly and without consequences, the disease has not lost its relevance. According to official data, in our country every year about a million people suffer from pneumonia in one form or another.

) is a disease of the arteries. Feature consists of the deposition of cholesterol inside the blood vessels.

As a result of such clogging, the walls become thicker, the lumen and elasticity decrease and the vessels become clogged.

The strain puts more strain on the heart because it requires more effort to pump blood around the body. The result of the disease is coronary heart disease, necrosis, hypertension, stroke.

Unchangeable causes of vascular atherosclerosis

Unchangeable causes of atherosclerosis are those that have no medical impact. These include the following:

1. Age. Once a person reaches a certain age, the chances of developing this disease become too great. Everyone who has crossed a certain level observes changes in the blood vessels. The risk of developing atherosclerosis increases between the ages of 45 and 50 years.
2. Floor. Men are more likely to get this disease than women. But when a person is over 50 years old, the percentage of the disease in relation to men and women becomes the same. This is due to the onset of menopause in women and the disappearance of the protective role of estrogen in men.
3. Genetic predisposition. People whose relatives suffer from atherosclerosis in any form are at particular risk.

Changeable causes?

Modifiable causes of atherosclerosis are those that can be influenced with medication or lifestyle changes. Variable factors include the following:

• Smoking, drinking large quantities of alcohol.
• Poor nutrition, hypertension.
• Obesity, diabetes.
• Dyslipidemia, physical inactivity.
• Infections.

The factors presented have the following effects on blood vessels:

1. Smoking and alcohol have a negative effect on blood vessels. These factors increase the risk of developing the disease several times. If the diet is incorrect and the diet contains a large amount of fatty foods, this can lead to the development of atherosclerosis.
2. Arterial hypertension is the main ally of the disease. At high blood pressure arterial walls are damaged even more. Dangerous pressure– more than 140/90 mm.
3. Obesity can cause atherosclerosis. Women with a waist larger than 88 cm and men with a waist larger than 102 cm are at risk.
4. Diabetes mellitus can increase the risk of developing the disease by 4-7 times. It is accompanied by metabolic disorders in the human body.
5. Dyslipidemia is a disease associated with impaired fat metabolism in the human body. At elevated level cholesterol plays a role in this disease main role, as it leads to problems with the heart and blood vessels.
6. A sedentary lifestyle or physical inactivity will lead to metabolic disorders and an increased risk of developing diabetes and sclerosis.
7. Infections. Studies conducted relatively recently have shown that the main cause of the development of atherosclerosis is chlamydial infection and cytomegalovirus. Many patients have high levels of antibodies.

Nuances of development and its consequences

There are also situations when the disease is discovered only at autopsy, since during life the person had no complaints about the manifestation of such a disease. There are also the opposite cases - when the lumen of the artery narrows with a minor manifestation of the disease.

Also, sometimes the disease can affect all blood vessels. Manifestations of the disease depend on the affected vessel. If affected, a person may soon develop heart failure or coronary heart disease.

Surgical treatment may be required if atherosclerosis begins to spread rapidly. This method will be the most effective. The only drawback is the long recovery time.

Good day, dear readers!

In this article we will look at such a disease of blood vessels as atherosclerosis, as well as its causes, symptoms, prevention and treatment of atherosclerosis, using traditional and folk remedies.

Atherosclerosis– chronic arterial disease, characteristic feature which is the deposition of cholesterol and other fats on the inner walls of blood vessels. Subsequently, this “clogging” causes the walls of the vessels to thicken, the lumen to decrease, their elasticity to be lost, resulting in blockages of the vessels. Due to the deformation of blood vessels, there is a load on the heart, because it needs more effort to pump blood.

The result of atherosclerosis is diseases such as hypertension (hypertension), necrosis, etc.

According to statistics for 2000, in Russia from cardiovascular diseases 800 people die per 100,000 population! At the same time, in France there are 182 people, in Japan 187. Scientists have recognized that the reason for this situation is nutrition and lifestyle. Of course, in the current year 2016, when the spread of GMO products has gained incredible momentum, and indeed quality products Foods cost so much that most people cannot afford them, and mortality continues to rise.

In this regard, it has been established that middle-aged and elderly people are most often susceptible to atherosclerosis, although there have been cases where this disease was identified in children.

ICD

ICD-10: I70
ICD-9: 440

The development of atherosclerosis begins from circulatory system person. U healthy person, blood, circulating in blood vessels, delivers oxygen and nutrients. With a normal diet, cholesterol is also present in the blood.

Cholesterol- organic compound, - natural fatty (lipophilic) alcohol, which is contained in cell membranes ah body. Cholesterol plays an important role in protecting cell membranes, and is also necessary for the production of steroid hormones (cortisol, estrogen, testosterone, etc.), bile acids, as well as the normal functioning of the immune and nervous systems.

Cholesterol is insoluble in water, and accordingly, it cannot independently enter the tissues of the body, therefore, the function of delivering it through the blood to all organs is performed by transporter proteins (apolipoproteins), which are found in complex compounds - cholesterol with other compounds.

Apolipoproteins are divided into 4 groups:

- high molecular weight (HDL, HDL (high density lipoprotein))
- low molecular weight (LDL, LDL, (low density lipoproteins))
- very low molecular weight (VLDL, VLDL, very low density lipoproteins);
- chylomicrons.

Depending on the “address” (body part) of delivery, different of these apolipoproteins perform the function. LDL, VLDL and chylomicrons combine with cholesterol and deliver it to peripheral tissues. But LDL (low-density lipoproteins) are poorly soluble and tend to precipitate. Due to this, cholesterol combined with LDL is called “bad” cholesterol.

Problems begin when an excess of cholesterol in the body, together with LDL, precipitates, which sticks to the walls of blood vessels and forms atherosclerotic plaques.

Here I would also like to note that low-density lipoproteins are counteracted by high-density lipoproteins (HDL), which protect the walls of blood vessels from their negative effects, but HDL, unfortunately, is 2 times less.

Atherosclerotic plaques– formations that consist of cholesterol, other fats, low-density lipoproteins and. They form under the endothelium (the inner surface of blood vessels), in places where it is damaged.

Under the endothelium (between the outer and inner walls of the vessel), i.e. in the thickness of blood vessels, are synthesized various substances, which regulate blood clotting, as well as the health of the blood vessels themselves.
So, as the atherosclerotic plaque grows, the lumen of the vessel narrows, and there is a risk of its rupture, from where a blood clot enters the vessel.

Thrombus- an accumulation of cells, mainly platelets and blood proteins. To put it simply, a thrombus is a clot of coagulated blood that occurs in places where blood vessels are damaged.

A thrombus aggravates the situation by the fact that it further narrows the lumen of the vessel, but the main danger from it is that a piece can come off from it, which, moving further along the vessels, reaches a place where the diameter of the lumen of the vessel is less than the thrombus. Further, in this place a blockage of the vessel occurs, and the tissues and organs “cut off” from the blood supply begin to die.

Of course, the process of development of atherosclerosis described above is a simplified form of explanation, but I hope that big picture I managed to describe it.

Causes of atherosclerosis

At the moment, the causes of atherosclerosis continue to be studied. Let's highlight the most known causes:

- endothelial dysfunction;
— damage to the endothelium by viruses (herpes virus, cytomegalovirus, etc.);
- damage to the vascular wall by chlamydia, mainly Chlamydia pneumoniae;
- abnormalities in the functioning of leukocytes and macrophages;
— primary accumulation large quantity lipoproteins in the thickness blood vessel;
— deviations in the functioning of the antioxidant system;
- an increase in the level of adrenocorticotropic and gonadotropic hormones with age, which leads to an imbalance of hormones necessary for regulating cholesterol.

Among the factors that provoke the development of atherosclerosis are:

— bad habits (drinking alcohol, smoking);
— hypertension (): blood pressure level from 140/90 mm Hg. Art.;
- hyperlipoproteinemia;
- sedentary lifestyle;
- unhealthy diet;
— ;
— ;
— ;
- heredity;
— ;
- homocysteinuria;
- hyperfibrinogenemia;
- postmenopause;
- age;
- metabolic disorders.

Symptoms of atherosclerosis largely depend on the location where it develops, as well as the vessel affected. Let's consider the most popular sites of injury and the accompanying signs of this disease.

Atherosclerosis of the heart

Coronary atherosclerosis. Occurs as a result of damage to the coronary vessels by atherosclerotic plaques. Based on this, the flow of oxygen and nutrients to the heart (myocardium) decreases.

Symptoms of coronary atherosclerosis:

Atherosclerosis of the aorta of the heart. It occurs as a result of damage to the main vessel of the heart, the aorta, by atherosclerotic plaques.

Symptoms of atherosclerosis of the aorta of the heart:

- burning periodic pain in the chest area;
- increase in systolic (upper);
- periodic dizziness;
— premature aging, graying;
- difficulty swallowing food;
- increased hair growth in the ears;
- appearance of wen on the face.

Atherosclerosis of the abdominal region

Atherosclerosis of the abdominal region (cardiac aorta). Occurs as a result of damage to atherosclerotic plaques of the aorta in the abdominal area.

Symptoms of atherosclerosis of the abdominal aorta

Symptoms of cerebral atherosclerosis

Conditionally acceptable products food (minimum quantity): vegetable oil (30-40 g/day), beef and lamb (no more than 90-150 g), egg (no more than 2 pieces per week), whole milk, White bread, pasta.

What not to eat if you have atherosclerosis: butter, hard margarine, animal fat, caviar, egg yolks, brains, kidneys, liver, heart, tongue, meat with visible fat, sausages, ham, frankfurters, duck, goose, sour cream, full-fat milk, cream, full-fat cottage cheese, fatty varieties cheese, curd cheese, processed cheese, ice cream, vegetables (cooked in fat), fruit (candied, sweetened), chocolate, candy, marmalade, marshmallows, jam and preserves.

For the treatment of atherosclerosis, M.I. Pevzner developed a special dietary food — .

In addition, it is necessary to minimize the use of:

- saturated fatty acids;
— ;
— table salt– no more than 8 g per day.

Medicines for atherosclerosis

Medicines for atherosclerosis are used for:

— level correction blood pressure;
— control of diabetes mellitus;
— correction of metabolic syndrome;
— normalization of the lipid spectrum.

Depending on the above goals, they are divided into 4 main groups:

1. Drugs that block the absorption of cholesterol by the walls of blood vessels and organs.
2. Drugs that reduce the synthesis of cholesterol and triglycerides in the liver, as well as their concentration in the blood.
3. Drugs that increase the breakdown and excretion of atherogenic lipids and lipoproteins from the body.
4. Additional drugs.

Group 1: drugs that block the absorption of cholesterol by the walls of blood vessels and organs

IA - anion exchange resins: Gemfibrozil, Cholestyramine. This group of drugs absorb cholesterol and are then removed from the body along with it. The disadvantage is that vitamins and other medications are absorbed along with cholesterol.

IB – plant sorbents:"Guarem", "β-sitosterol". This group of drugs interferes with the absorption of cholesterol by the intestines.

Group 1 drugs can cause dyspepsia.

Group 2: drugs that block the absorption of cholesterol by the walls of blood vessels and organs

IIA (statins): lovastatin (Apexstatin, Mevacor, Medostatin), simvastatin (Vasilip, Zocor, Simvor), fluvastatin (Leskol), pravastatin (Lipostat, Pravachol), atorvastatin (Liprimar ", "Torvacard"), rosuvastatin ("Crestor"). Contraindications: should not be taken by pregnant women, nursing mothers, children, those with liver disease, or in combination with alcohol. Side effects: alopecia, myopathy, dyspepsia, rhabdomyolysis, impotence, hepatotoxicity.

IIB (fibrates): fenofibrate (Traykor), bezafibrate (Bezalip), ciprofibrate (Lipanor). Side effects: dyspepsia, myositis. Fenofibrates are the newest drugs, therefore, in the treatment of atherosclerosis, they are preferred. Fenofibrates are also used in the treatment of type 2 diabetes.

IIC: nicotinic acid (“Enduracin”). Side effects: , itchy skin, dyspepsia. Not recommended for use with diabetes.

IID: probucol (“Fenbutol”). Reduce sterol synthesis.

Group 3: drugs that increase the breakdown and excretion of atherogenic lipids and lipoproteins from the body

Unsaturated fatty acids: Linetol, Lipostabil, Omacor, Polyspamine, Thiogamma, Tribuspamin. Side effects: increased effect of antihyperglycemic drugs.

Group 4: additional drugs

Endotheliotropic drugs (nourish the endothelium): pyricarbate (“Anginin”, “Parmidin”), synthetic analogues of prostacyclin (“Vasoprostan”, “Misoprostol”), E (tocopherol) and C (ascorbic acid).

Important! Before use folk remedies against atherosclerosis, be sure to consult your doctor!

Atherosclerosis in medicine is a disease in which systemic damage to blood vessels (arteries) of large and medium diameter occurs as a result of deposition of lipids on their internal surface. According to statistics presented by the Institute of Therapy, it is this pathology that causes fatal outcome in 3% of all cases recorded in the world. At the same time, such a diagnosis is posthumously recorded in 2% of young people, 25% of elderly people, and up to 39% of elderly people.

According to the same statistics, vascular atherosclerosis is myocardial, stroke, coronary disease and other fatal dangerous pathologies of cardio-vascular system person. Behind last decade this pathology is diagnosed 1.5 times more often, which indicates a rapid deterioration in the health of the planet's population. Age statistics are also worsening - the disease is more often recorded in young people.

The disease atherosclerosis affects mainly large main vessels human body: carotid and cerebral arteries, renal, cardiac and abdominal aortas. The disease is based on changes in metabolic processes, in which excessive accumulation of heavy cholesterol and β-lipoprotein occurs in the blood against the background of a decrease in the amount of phospholipids and proteins. The result of such an imbalance is a systematic change vascular walls passing through several stages. As they occur, the following changes occur:

1. The stage of a lipid (fat) stain, during which swelling and loosening of the epithelium appears on the surface of the vascular wall. At this stage, vascular damage is not fatal; moreover, it is practically impossible to diagnose, since lipid deposits on the damage are located on the inner lining of the arteries in the so-called intima. Localization of lipid stains is mainly in the branches of arteries.
2. The stage of liposclerosis or the proliferation of a lipomatous plaque due to the active formation of connective tissue in the affected area. At this stage, it is quite easy to eliminate such neoplasms, since drugs for the treatment of atherosclerosis easily dissolve still soft plaques. On the other hand, it is at this stage of the development of the disease that there is a high probability of a fragment being torn off with subsequent blockage of the lumen of the arteries. This stage of atherosclerosis is characterized by a change physical characteristics vascular wall - it becomes less elastic and is easily traumatized.
3. The stage of atherocalcinosis or thickening of the atherosclerotic plaque due to its saturation with calcium salts. At this stage, pathological changes reach their peak - deposits grow and limit blood flow due to deformation of the vascular walls. At this stage, atherosclerosis of the arteries is expressed by the formation of foci of necrosis or gangrene on the limbs and organs that feed the damaged vessel.

In addition to the changes described, the main cause of atherosclerosis may be infection with the herpes virus, cytomegalovirus, chlamydia, mutation of epithelial cells of the circulatory system, hereditary pathologies, provoking changes in lipid metabolism. Despite the initial causes of atherosclerosis, the disease in any case goes through all the stages described above.

Risk factors and groups

Experts identify several population groups for which risk factors for atherosclerosis are most relevant:

1. By age - persons over 40-50 years old.
2. By gender, men are more susceptible to the disease than women.
3. Heredity - the risk of atherosclerosis is higher in those whose relatives have this diagnosis.

The listed factors are irresistible and cannot be changed by man. In medicine they are given the definition of “irremovable”.

The second group of factors that provoke the occurrence of atherosclerosis are called potentially removable. These include systemic pathologies that lead to changes in the functions of the cardiovascular system. Their negative impact can be avoided if the patient takes the medications recommended by the doctor.

Conditionally avoidable factors include:

1. Arterial hypertension.
2. Dyslipidemia or increased blood cholesterol levels.
3. Intoxication with infectious agents.
4. Diabetes.
5. Obesity.

Removable factors of atherosclerosis include mainly an unhealthy lifestyle and bad habits: smoking, alcoholism, physical inactivity and an unbalanced diet. They provoke the occurrence of diseases that, if left untreated, are complicated by atherosclerosis. Such factors significantly accelerate the progression of the disease and increase the risk of death from atherosclerosis.

Symptoms of the disease

Clinical signs of atherosclerosis appear only with active progression of the disease, when the lumen of the blood vessel narrows by 50 percent or more. In general, the symptoms depend on which vessels have undergone pathological changes.

Manifestations of atherosclerosis of the aorta

If the pathological process occurs in the aortic arch and its branches, patients experience symptomatic hypertension. This type of atherosclerosis is accompanied by a syndrome of circulatory insufficiency of the brain and upper shoulder girdle. The disease is accompanied the following symptoms and clinical manifestations:

• an increase in systole indices against the background of normal or reduced dystoly indices;
• headaches and dizziness;
• fainting states;
• paresthesia and feeling of weakness in the hands

If affecting blood vessels the process began in the abdominal aorta, the main symptoms of atherosclerosis are a weakening of blood pulsation in the femoral and popliteal arteries, disruption of the functioning of some internal organs (more detailed symptoms will be discussed later).

Since treatment of atherosclerosis in such phenomena does not begin immediately, the disease can be complicated by aneurysm of various parts of the aorta. The following symptoms occur:

• in case of damage to the ascending aorta - prolonged aching or squeezing pain in the chest, arising and fading gradually;
• with damage to the aortic arch - hoarseness, difficulty breathing, displacement of the larynx;
• with damage to the descending aorta - pain in the chest and back, a feeling of compression of the esophagus.

Aortic dissection is accompanied by intense pain in the chest and epigastric region. The patient suffers from lack of air and severe weakness due to a critical drop in blood pressure.

Aortic dissection is considered a deadly condition. The survival rate for it is less than 50%, and only if medical care is provided in a timely manner.

Manifestations of atherosclerosis of mesenteric vessels

When mesenteric vessels are damaged, it is important to recognize the typical signs of pathology in time, since this type of atherosclerosis manifests itself clinically similar to an exacerbation of peptic ulcer disease. Objectively, the patient can observe:

• bloating;
• absence or significant weakening of peristalsis;
• pain when trying to palpate the upper abdomen;
• slight tension in the abdominal wall.

The main symptoms of atherosclerosis of the abdominal vessels are pain that occurs after eating. Pathology can be differentiated by the lack of effect from taking medications intended to normalize digestion. In this case, taking nitroglycerin quickly stops the attack.

If treatment is not timely, atherosclerosis of this type ends with sudden thrombosis, which is accompanied by wandering or localized abdominal pain, stool retention, and vomiting mixed with bile and blood. An incorrect diagnosis and delayed treatment can lead to intestinal gangrene.

Manifestations of atherosclerosis of the renal arteries

When the renal artery is damaged, the disease is accompanied by a sustained increase in blood pressure. Clinical course atherosclerosis is smooth, without sharp exacerbations. If renal vein thrombosis occurs, the patient may experience pain in the lower back and abdomen, and signs of dyspepsia.

Manifestations of atherosclerosis of leg vessels

Atherosclerotic changes in the lower extremities are manifested by intermittent claudication syndrome, paresthesia and a feeling of coldness in the extremity. An external examination of the legs may reveal the following signs of the disease:

• weakening of pulsation;
• trophic ulcers on the fingers, legs or heels;
• paleness of the skin;
• thinning and dry skin.

Vein thrombosis, which occurs against the background of atherosclerotic changes, leads to increased pain and the appearance of greatly enlarged veins in the legs.

Manifestations of cerebral atherosclerosis

For a disease such as atherosclerosis, the classification includes damage to cerebral vessels. This type of disease is expressed by a significant deterioration in the functioning of the central nervous system, which is expressed by:

• decreased performance;
• deterioration of attention and memory;
• decreased intelligence;
• sleep disturbance;
• dizziness.

The patient may also experience headaches. At the same time, significant changes occur mental state. This subtype of atherosclerosis is dangerous due to complications such as stroke.

Manifestations of atherosclerosis of the coronary arteries

If the coronary arteries are damaged, the patient complains of pain in the chest, a feeling of weakness and fatigue. During an exacerbation of the disease, a feeling of numbness in the left arm and shortness of breath occurs. The attacks are accompanied by fear of death, confusion or complete loss of consciousness. The danger of this type of pathology is the high risk of death due to myocardial infarction.

Diagnosis of vascular atherosclerosis

When visiting a clinic, the attending physician collects anamnesis and ascertains the patient’s complaints, on the basis of which an initial picture of the disease can be drawn up. To clarify the diagnosis, the following types of diagnostics are used:

• auscultation of coronary vessels;
• blood pressure measurement;
• laboratory blood tests;
• aortography and coronary angiography;
• angiography;
• Ultrasound examination and ultrasound.

Additionally, consultation with a cardiologist, neurologist or psychiatrist may be required.

Methods of treating the disease

The main treatment for vascular atherosclerosis consists of taking medications and changing the patient's lifestyle. First of all, the patient is prescribed a complex medicines, the action of which is aimed at reducing cholesterol in the blood and reducing tissue hypoxia (especially with damage to the coronary and cerebral vessels). The following applies:

• drugs nicotinic acid in the form of tablets and injections;
• bile acid sequestrants;
• statins;
• fibrates.

The listed groups of drugs for atherosclerosis are prescribed in accordance with the presence of indications and contraindications, and the dosage is calculated on an individual basis.

A strict diet that involves reducing the amount of animal fats can also improve the patient’s condition. Nutrition must comply with the principles of treatment table No. 10c. For uncomplicated disease, diet No. 5 is used.

If there is a high probability of occlusion of the affected vessels, surgical treatment is indicated for patients:

• endarterectomy - open surgical intervention;
• endovascular therapy - minimally invasive operations on the arteries.

During these procedures, stents are placed in the artery or the artery is dilated using balloon catheters. If the coronary vessels are damaged, coronary artery bypass grafting is performed.

Prevention measures

Atherosclerosis is extremely rarely diagnosed in people whose medical history is not aggravated by metabolic diseases. However, even they are at risk, since atherosclerosis can only be prevented by following a healthy lifestyle. The risk of this disease can be significantly reduced by giving up bad habits, normalizing nutrition and increasing physical activity. In the presence of progressive atherosclerosis, it is recommended to strictly follow the doctor’s recommendations regarding the use of medications.