Atherosclerosis

Atherosclerosis narrows and thickens the arteries due to the buildup of plaque in the artery walls. Plaque buildup occurs when the cell layers in the inner walls of the arteries (endothelium), which are responsible for maintaining smooth blood flow, are damaged.

Plaque that causes atherosclerosis consists of cholesterol, fat, calcium, and fibrin (substances in the blood). The plate can be transported by the bloodstream to cause blood clots or clots on the surface of the plate. This causes blood and oxygen circulation from the arteries to the body's organs to be blocked.

Although classified as a heart disorder, atherosclerosis can actually occur in the arteries of any part of the body, such as the brain, kidneys or feet, and can cause health problems in this area.

The onset of atherosclerosis can begin in childhood and develop slowly. Harmful symptoms only appear when the patient reaches the age of 50 or 60 years. However, this disease can be prevented and treated with lifestyle changes,
Symptoms of atherosclerosis
The symptoms of atherosclerosis will only be felt when the arteries have been very narrowed and will obstruct the flow of blood to the tissues or organs of the body. Symptoms that appear depend on the location of atherosclerosis, including:

• Atherosclerosis of hands and feet; cause pain when walking (claudication).
• Atherosclerosis in the kidney; causes kidney failure and high blood pressure.
• Cardiac atherosclerosis; causes chest pain (angina).
• Aerosklerosis in the brain; resulting in weak or stiff hands and feet, difficulty speaking, weakening of facial muscles, or temporary loss of vision in one eye.

Causes of atherosclerosis
The exact cause of atherosclerosis is not yet known, but the disease starts when there is damage or injury to the inner lining of the arteries (endothelium). Damage can be caused by:

• Cholesterol levels, triglycerides and high blood pressure.
• Diabetes or insulin resistance.
• Diseases that cause inflammation, such as arthritis, infection or lupus.
• Smoking habit.
• Obesity.

In addition to the causes mentioned above, someone whose family member has a history of atherosclerosis is also suspected of being at high risk of suffering from the same disease.

Diagnosis of atherosclerosis

The diagnosis can begin with a physical examination. Circulatory disorders can be characterized by weak pulse, low blood pressure in the affected leg, and scarring in the wound. Physical examination results must be strengthened by several additional examinations, including:

Blood test, to see cholesterol and blood sugar levels.
Comparison of leg and arm blood pressure index to check the condition of blocked arteries in the hands and feet.
Electrocardiogram (ECG), to check heart activity that might show signs of a previous heart attack.
Doppler ultrasonography, to see arteries blocked with sound waves.
Exercise test or treadmill check, to check the heart's electrical activity and blood pressure during physical activity.
Scans, including magnetic resonance angiogram (MRA) and CT scan to check the condition of the arteries.
Angiogram and cardiac catheterization, which is an examination of the condition of the heart arteries by injecting contrast substances (dyes) into the arteries so that they can be seen through photo R

Treatment of atherosclerosis

Treatment of atherosclerosis can be done in three ways: lifestyle modification, treatment and surgery.

Changes in daily lifestyle are the main things to do. Patients are encouraged to exercise more often to improve the health of their heart and blood vessels and reduce consumption of foods high in fat and cholesterol.

In addition to lifestyle changes, drug administration is also important to prevent worsening of atherosclerosis. Among others are:

• Medication to prevent blood clots that clog arteries. Drugs that can be given are antiplatelet and anticoagulant agents, such as aspirin.
• Hypotension Medication. Medications that can be given are beta-blockers, calcium channel blockers and diuretics to increase urine flow.
• Drugs that reduce bad cholesterol (LDL), such as statins and fibrous acids.
• An inhibitor of the angiostensin enzyme (ACE inhibitor). This drug can relieve the development of atherosclerosis by lowering blood pressure and preventing narrowing of the arteries.
• Other drugs control medical conditions that cause atherosclerosis, such as diabetes medications.

In cases of severe atherosclerosis, surgical intervention must be carried out. Among others are:

• Bypass, to overcome the blockage or narrowing of blood vessels. This operation is done by bypassing blocked blood vessels using blood vessels from other parts of the body or tubes of synthetic material so that blood continues to flow.
• Fibrinolytic therapy to treat artery blockage due to blood clots
• Stenting and angioplasty. The purpose of this procedure is the same as bridging, which is to overcome the narrowing or blockage of the arteries. In this procedure, the doctor will install two catheters and a small tube to keep the arteries open.
• Endarterectomy to remove fat deposits in narrowed artery walls.
• Arterectomy to remove plaque and arteries.

Complications of atherosclerosis

Complications that can occur due to atherosclerosis are as follows:

• Momentary ischemic attack (mild stroke / TIA) and stroke, when atherosclerosis occurs in an artery that is close to the brain organ.
• Gangrene (dead tissue), when atherosclerosis occurs in the hands and feet, results in impaired blood flow.
• Chronic kidney disease, when atherosclerosis occurs in the arteries leading to the kidneys.
• Aneurysm or dilation of blood vessels in artery walls.
• Heart attack, heart failure and angina pectoris when atherosclerosis occurs in the heart arteries.

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