Arterial Disease and Atherosclerosis
The most common arterial disease is atherosclerosis. At South Sydney Vascular Centre, we see patients with or without symptoms of this condition, also described as hardening of the arteries or peripheral artery disease.
Left unchecked, atherosclerosis contributes to risk of heart attack and stroke that can lead to premature death or physical limitations like the ability to walk with ease or perform daily activities.
The basics of Arterial Disease
Fatty streaks are deposited on the smooth lining of the artery and this gradually develops into a plaque composed of lipids, cholesterol, calcium and blood clot. This plaque builds up over time becoming larger and more complex. It projects into the lumen of the artery causing a blockage which hinders the flow of blood.
Arteries are the vessels that carry oxygen rich blood from the heart to all parts of the body. The heart pumps arterial blood which is therefore at high pressure and pulsatile. The arteries divide into smaller and smaller branches until they become capillaries and it is here that oxygen passes out of the blood and into the tissues.
All arteries in the body can be affected by the disease process but some arteries develop worse disease than others. Arteries that are commonly affected are:
These are small arteries which supply blood to the heart muscle itself and if they become blocked a heart attack may occur.
These arteries take blood to the brain and when atherosclerosis develops here it can lead to strokes.
Peripheral Arterial Disease. Muscles needs oxygen to work and if the arteries in the leg become blocked then not enough oxygen can get through to supply enough oxygen to the muscles resulting in a build-up of lactic acid which causes pain. This results in a symptom called intermittent claudication which describes pain in the legs that comes on with exercise and goes away with rest. If the blood flow decreases further then “rest pain” develops at night. This is due to the fact that gravity is not helping blood flow to the feet. Typically a person will wake at about 2am with discomfort or pain in the foot or lower leg and has to get out of bed to walk around to ease the pain. Sometimes these people avoid going to bed and sleep in a chair. A further decrease in blood flow leads to infarction of the tissue on the feet and lower legs with painful ulceration or gangrene. Left without treatment, amputation is required to prevent death.
Arteries to the gut
Mesenteric arteries. There are 3 main arteries that supply blood to the gut. If these arteries become blocked then the gut cannot function effectively and this may lead to severe weight loss and abdominal pain brought on by eating (abdominal angina). In severe cases the tissue of the gut infarcts and dies due to the critical lack of blood supply and in this situation only an emergency operation to remove the dead gut will prevent death.
Atherosclerosis in the renal arteries can lead to severe hypertension but may also cause damage to the kidney tissue resulting in kidney failure. Dialysis is then required as a life saving measure.
Atherosclerosis can also cause weakening of the arterial wall resulting in aneurysm formation or dissection of arteries.