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and   means › . Arteriosclerosis (from the Greek ›  ›. meaning › .          A                 !                 "    #  $     %  &                                         '      $   ("                  M)   %  '                    "               "    Atherosclerosis 3  Atherosclerosis is the build up of a waxy plaque on the inside of blood vessels. In Greek. Atherosclerosis is often called arteriosclerosis. ›  means .

. and fibrin. Atherosclerosis can also occur in the arteries of the neck. a stringy material that helps clot blood. is a type of arteriosclerosis or hardening of the arteries. Arteriosclerosis can occur in several forms. causing kidney failure or gangrene and amputation. It can cause a stroke if it completely blocks the brain (carotid) arteries. The plaque formation process stimulates the cells of the artery wall to produce substances that accumulate in the inner layer. It is characterized by plaque deposits that block the flow of blood. and arms. including atherosclerosis. causing the sudden formation of a blood clot (thrombosis). cholesterol. waste products from the cells. thighs. Atherosclerosis is a type of arteriosclerosis that affects only the inner lining of an artery.) is a general term for hardening of the arteries. an elastic membrane that allows the artery to expand and contract. The inner layer of the artery wall thickens. and a layer of connective tissue. and blood flow and oxygen delivery are decreased. calcium. and by diseases such as diabetes. Arteriosclerosis is a broad term that includes a hardening of the inner and middle layers of the artery. Atherosclerosis can cause a heart attack if it completely blocks the blood flow in the heart (coronary) arteries. An artery is made up of several layers: an inner lining called the endothelium. a progressive process responsible for most heart disease. Fat builds up within these cells and around them. 3    Atherosclerosis. Plaques can rupture or crack open. and they form connective tissue and calcium. by high blood pressure. a layer of smooth muscle. kidneys. It can be caused by normal aging. the artery's diameter is reduced. Plaque is made of fatty substances.

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yY High blood pressure-Blood pressure of 140 over 90 or higher makes the heart work harder. Second hand smoke may also increase risk. The role of triglycerides. and over time. however. It is thought that atherosclerosis is caused by a response to damage to the endothelium from high cholesterol. sex. Non-modifiable risk factors are heredity. diabetes. age are at increased risk. and cigarette smoking. both weakens the heart and harms the arteries. or sudden death. Blood triglyceride levels above 400 mg/dL have been linked to coronary artery disease in some people. in the blood. eggs. . yY High triglycerides-Most fat in food and in the body takes the form of triglycerides. The high rate of severe hypertension among African-Americans puts them at increased risk. atherosclerosis. yY 6besity-Excess weight increases the strain on the heart and increases the risk of developing atherosclerosis even if no other risk factors are present. but it usually takes decades to cause symptoms. Most diabetics die from heart attacks caused by atherosclerosis. and age. obesity. yY In the carotid (brain) arteries: Sudden dizziness. heredity. loss of speech. and low levels of high-density lipoproteins (HDL cholesterol). Risk factors that can be changed: yY Migarette/tobacco smoke-Smoking increases both the chance of developing atherosclerosis and the chance of dying from coronary heart disease. yY In the renal (kidney) arteries: High blood pressure that is difficult to treat. High- risk levels of low-density lipoprotein (LDL cholesterol) begin at 130-159 mg/dL. A person who has all three of these risk factors is eight times more likely to develop atherosclerosis than is a person who has none. These risk factors are all modifiable. yY In the femoral (leg) arteries: Disease of the blood vessels in the outer parts of the body (peripheral vascular disease) causes cramping and fatigue in the calves when walking. Physical inactivity. yY Age-Risk is higher in men who are 45 years of age and older and women who are 55 years of age and older. high blood pressure. Its exact cause is still unknown. and diet affect cholesterol. weakness. These substances are the targets of much current research. The more HDL ("good") cholesterol. are not nearly as harmful as LDL cholesterol. sex. comes from foods such as meat. Age. a soft. or stroke at an early 0he progression of atherosclerosis. High levels of the amino acid homocysteine and abnormal levels of protein-coated fats called lipoproteins also raise the risk of coronary artery disease. Triglycerides. in forming atherosclerotic plaques is unclear. and obesity are also risk factors for atherosclerosis. Symptoms differ depending upon the location of the atherosclerosis. yY Physical inactivity-Lack of exercise increases the risk of atherosclerosis.   Atherosclerosis can begin in the late teens. and other animal products and is produced in the liver. yY Sex-Before age 60. the less likely is coronary artery disease. heart attack. yY High blood cholesterol-Mholesterol. the risk is equal among men and women. Total blood cholesterol is considered high at levels above 240 mg/dL and borderline at 200-239 mg/dL. Some people experience rapidly progressing atherosclerosis during their thirties. men are more likely to have heart attacks than women are. others during their fifties or sixties. or blindness. yY Diabetes mellitus-The risk of developing atherosclerosis is seriously increased for diabetics and can be lowered by keeping diabetes under control. High levels of triglycerides are often associated with diabetes. Atherosclerosis is complex. Risk factors that cannot be changed: yY Heredity-People whose parents have coronary artery disease. yY In the coronary (heart) arteries: Mhest pain. another fat that circulates in the blood. After age 60. waxy substance.

Thallium scanning is usually done after an exercise stress test or after injection of a vasodilator. the test takes 30-60 minutes.    Treatment includes lifestyle changes. Atherosclerosis requires lifelong care. Severe coronary artery disease. like dipyridamole (Persantine). It is performed in a physician's office or an exercise laboratory and takes 15-30 minutes. and images are displayed on a monitor. The patient has been given a contrast dye that makes the heart visible to x rays. and angiography. Thallium is injected. A cardiologist inserts a catheter equipped with a viewing device into a blood vessel in the leg or arm and guides it into the heart. uses sound waves to create an image of the heart's chambers and valves. Radionuclide angiography is usually performed in a hospital's nuclear medicine department and takes 30- 60 minutes. however. An electrocardiogram shows the heart's activity. a drug to enlarge the blood vessels. may cause abnormal heart motion that is detected by echocardiography. Patients who have less severe atherosclerosis may achieve adequate control through lifestyle changes and drug therapy. Echocardiography. radionuclide scans. percutaneous transluminal coronary angioplasty. A device that uses gamma rays to produce an image of the radioactive material (gamma camera) records pictures of the heart. . and coronary artery bypass surgery. A technician applies gel to a hand-held transducer. The test takes about 10 minutes and is performed in a physician's office. presses it against the patient's chest. More definite tests are electrocardiography. Radioactive material is injected into the bloodstream. They are too small and are in motion with the heart. controlling blood pressure. Radionuclide angiography and thallium (or sestamibi) scanning enable physicians to see the blood flow through the coronary arteries and the heart chambers. losing weight (if necessary). Performed in a cardiology outpatient diagnostic laboratory. This technique cannot evaluate the coronary arteries directly. The patient is awake but has been given a sedative. and the scan is done then and again four hours (and possibly 24 hours) later.3  Physicians may be able to make a diagnosis of atherosclerosis during a physical exam by means of a stethoscope and gentle probing of the arteries with the hand (palpation). Motion pictures are taken of the contrast dye flowing though the arteries. Plaques and blockages. Moronary angiography is performed in a cardiac catheterization laboratory and takes from 30 minutes to two hours. cardiac ultrasound. Each scan takes 30-60 minutes. Exercise electrocardiography (stress test) is conducted while the patient exercises on a treadmill or a stationary bike. Moronary angiography is the most accurate diagnostic method and the only one that requires entering the body (invasive procedure). Thallium scanning is usually performed in a hospital's nuclear medicine department. the carotids). if present. low-cholesterol diet. echocardiography or ultrasonography of the arteries (for example. They send impulses of the heart to a recorder. exercise. and not smoking-also help prevent the disease. Ultrasonography is also used to assess arteries of the neck and thighs. lipid-lowering drugs. Many of the lifestyle changes that prevent disease progression-a low-fat. Electrodes covered with conducting jelly are placed on the patient's body. are well defined.