Posted on September 13th, 2023
Atherosclerosis: What Is It?
Healthy arteries are like healthy muscles.
They are flexible, strong, and elastic. Their inside lining is smooth so that the flow of blood through them is unrestricted.
Atherosclerosis describes the condition in which fatty deposits accumulate in and under the lining of the artery ,walls. The name comes from the Greek word ather, meaning "porridge," because the fatty deposits are soft and resemble porridge.
Blood cells called platelets ften clump at microscopic sites of injury to the inner wall of the artery. At these sites, fat deposits also collect. Initially, the deposits are only streaks of fat-containing cells but, as they enlarge, they invade some of the deeper layers of the arterial walls, causing scarring and calcium deposits. Larger accumulations are called atheromas or plaques and are the principal characteristic of atherosclerosis.
The greatest danger from these deposits is the narrowing of the channel through which the blood flows. When this occurs, the tissues (heart muscle, brain, muscles of the legs, or others) that the artery supplies will not receive their full quota of blood. Pieces of the fatty deposits also may be dislodged, travel with the blood flow, and finally obstruct an artery at some distant point.
The term arteriosclerosis means hardening of the arteries (from the Greek sklerosis for "hardening"). This often accompanies atherosclerosis and is not clearly separated from it. The walls of the artery become more rigid and often contain calcium deposits. Sometimes, the arteries in the forearms can be felt and may resemble small, hard pipes. In combination with atherosclerosis, arteriosclerosis also may lead to weakening and enlargement of an artery, a condition called an aneurysm.
Atherosclerosis may be discovered in the course of a routine physical examination.
During your physician's stethoscope examination of your neck, abdomen, or groin area, he or she may hear a blowing sound (a bruit) if a narrowing and roughening of the lining of the arteries at one or more of these points causes turbulence of the blood flow. He or she also will estimate the amount of blood flow by feeling for pulsations in the arteries at the wrists, legs, and feet. A decrease in pulsations is a reason to suspect partially obstructed blood flow.
More elaborate tests of circulation using sound waves often help in establishing the presence and degree of decreased blood flow. A CT scan or ultrasound scan of the abdomen often is used to identify a suspected aneurysm of the aorta in the abdomen.
Another test for locating the sites of plaques that narrow blood vessels is arteriography. In this test, a dye that shows on X-rays is injected into a catheter inserted through an artery in the groin, and several X-rays of the organ or limb are taken. In many cases, the diagnosis is not suspected until the artery is completely obstructed and you have experienced a stroke, heart attack, or arterial thrombosis in some other organ or extremity.
To some extent, the body can protect itself from narrowing of a particular artery by developing, with time, additional arterial connections that detour blood around the narrowed point. This is called collateral circulation.
If you have a significant amount of atherosclerosis in one part of your body, you are more likely to have some degree of impairment of arterial circulation in another part. For instance, the person who has poor arterial circulation in the legs may be vulnerable to angina or a heart attack because of some harrowing of the coronary arteries.
Arteriosclerosis of the Extremities:
Signs and Symptoms
• Leg pain, especially in the calves and feet, which develops during activity and resolves shortly after the activity is stopped (intermittent claudication)
• Numbness or pain in the foot or toes when at rest
• Ulcers or gangrene on the foot or toes
The effects of arteriosclerosis are most likely to appear first in your legs or feet. In one of its forms, arteriosclerosis obliterans, the major arteries that deliver blood to your legs and feet become narrowed and blood flow decreases. Smaller blood vessels assume some of the load, but the physical activity of walking a block or two can produce cramps in your legs or feet; the cramps disappear within a few minutes after you discontinue the exercise. This sequence of walk-pain-rest is also termed intermittent claudication.
When some of the blood vessels actually become blocked (occluded), your foot may become pale, cold, and painful. Sometimes the final blockage develops gradually and your foot becomes vulnerable to even minor injury and infection.
1 Gangrene consists of the actual death of tissue and usually appears as a spot or area of black, shrunken skin near the tips of your toes or about your heel. If the blockage occurs suddenly, as when a fragment of plaque or a clot lodges at a fork of your leg artery (commonly, at your knee), there is sudden and severe pain as well as paleness and coldness below the level of the blockage.
The limitation in blood supply often will cause inflammation and damage to the nerves (neuritis), which is manifested by burning, pain, and numbness.
These circulation problems are common in persons with diabetes; they also may have diabetic neuropathy. The decreased sensation that often accompanies diabetic neuropathy makes the person more likely to injure the affected foot.
The key aspect to diagnosis is the nature and timing of your discomfort. Does the pain occur only with exercise? Is it relieved by rest? Does it recur when activity is resumed?
If so, your physician may suspect arteriosclerosis of your extremity.
Your physician may take your blood pressure in the affected extremity. Other tests, including an ultrasound scan of the area, also may be ordered. Angiography (an X-ray examination during which a dye is injected into the artery that supplies the affected area) will tell your physician exactly where the blockage is and whether surgical repair can be attempted.
How Serious Is Arteriosclerosis of the Extremities?
For many people, arteriosclerosis of the leg is not a serious problem. For most, conservative care will prevent severe disability or loss of a limb; among diabetics, the problem occurs somewhat more often. Poor arterial circulation can blunt sensation to heat or cold, making you more susceptible to both burns and freezing. Take care in applying items such as a hot water bottle or heating pad to cold feet. In addition, do not expose your foot to freezing temperatures. If gangrene develops, surgical amputation may be necessary.
Acupuncture is an effective treatment for atherosclerosis. Researchers from the Qian’an Hospital of TCM (Traditional Chinese Medicine) investigated the efficacy of acupuncture for the treatment of carotid artery related atherosclerosis. The study compared two types of acupuncture treatments with drug therapy. One acupuncture protocol produced significantly greater positive patient outcomes than drug therapy.