Arteriosclerosis

Arteriosclerosis is a degenerative disease of the artery wall. It belongs to the organic, structural phenomena. It is angioorganopatija occlusive nature. It is a typical disease of modern man and cililizovanog leads the list of morbidity and mortality rates of fatal complications, particularly in the level of coronary heart disease and cerebral arteries. While previously considered a disease of the elderly, is now a growing number of middle and younger age that are still in full working activity. 

Types of arteriosclerosis

When it comes to atherosclerosis refers to all forms of sclerosis of the artery wall, whether it is a predominantly Atherosclerosis, media sclerosis, diabetic atherosclerosis, or peripheral arteriosclerosis different genesis.

There are different classifications, but they all take account of the anatomical changes and clinical manifestations.

Media sclerosis

Senile hyperplastic,

Monckenbergova medioskleroza with calcifications.

Intimal sclerosis (Atheroscherosis).

Arteriolitic sclerosis (kidney and other visceral organs in hypertension).

Arteriosclerosis obliterans.

Etiopathogenesis

The emergence of atherosclerosis play an important role heredity, constitution, age, sspol, lifestyle and diet.

easily occurs in younger people, it is predominantly a disease of older persons. She favored the modern pace of life, mental stroke and extensive fat diet. It occurs frequently associated with hypertension, diabetes, gout, familial ksantomatozom, hypercholesterolemia, hypothyroidism and essential hyperlipemia miksedemom.

In the beginning of the process, which often occurs already in the second and 3 decade of life, in the deeper layers of the intima precipitated lipoidi, mainly cholesterol and leads to necrosis. In nekortičnim parts of the wall can be deposited and calcium salts, and if necrosis penetrating intimacy creates the atheromatous plates.

Symptoms and diagnosis

The clinical picture

So where is the field of arteriosclerosis develop stronger, we find a variety of symptoms and signs related to these organs. Frequently the arteriosclerotic process in a stronger degree of localization in the aorta, and

is primarily a question of Atherosclerosis of the aorta. It is often combined with coronary artery disease, although it can occur from the beginning as an isolated or predominant clinical picture. Also often associated with changes pomenutitn or herself may develop cerebral vascular syndrome as a reflection of atherosclerosis.

Symptoms

Subjective symptoms are different. Some patients have no symptoms for years. If the image is dominated ateromatoze aorta and coronary sclerosis, various problems occur behind the sternum and the heart area. At first it appears the pressure, then squeezing and burning, especially at work. There may be real aortalgije with burning feeling behind the breastbone that lasts for weeks and months to gain time for effort and frustration.

In the majority of coronary sclerosis leads to the appearance of stenocardia and pectoral angina with precordial pain and a feeling of fear of death. The pain often spreads to the left hand along the ulnar nerve in the neck and shoulder, although it may also have abdominal localization.

Arteriosclerosis of cerebral arteries initially causes a reduced ability of mental concentration and memory, then it may occur headache, vertigo, dizziness and fainting, especially when rapid changes in body position, ambient temperature and the stronger mental and physical effort.

If the changes are mainly in the lower extremities occurs occasionally limping - claudicatio intermittens of muscle ischemia, and if the process was developed in the abdomen can occur Dyspragia intermittens atherosclerotic abdominals.

The physical signs

Auscultation of the heart can be heard accent second the aortic tone, which may have a metallic sound. There may be a systolic murmur over the aorta. Pulse has the character of "pulsus celer," the artery is stiffer, the wall is thicker and can be easily moved. Artery may be elongated, tortuous and uneven due to calcification. Blood pressure can be increased, and in arteriosclerotic myocardiopathy and lowered. It can be changed skin color and skin temperature.

Radiological signs of

X-ray shows more distinct shadow of the aorta. It was expanded and elongirana. Aortic arch is moved upward to a height sternoklarikularnog joint, bulging is left in the form of more pronounced aortic button on whose periphery can see the lime deposits in the form of a thin scythe and the descending aorta is more noticeable.

Heart can be concentric hypertrophic. Aortography and arteriography can provide more visual information about the structure and change the lumen of the artery wall, particularly in cases of obstructive changes and collateral phenomena.

Oscillography pletismografski and signs

In cases with predominant obliteracionim changes, which developed peripheral circulatory insufficiency Oscillograms may show changes. But more important is the morphology of the oscillations of the curve, so we pletismogram gives more information about dikrotičnom wave and the speed of implementation; propagation time is extended, and the pulse wave is often modified, which causes the value inklinacionog time.

Functional signs

The function of the arteries may be affected to varying degrees. The arteries become more rigid, hard, lose their elasticity. Larger arteries are wider, less narrow, and can obliterisati. Sclerotic, elongirane medium caliber arteries become vulnerable to various stimuli and is very narrow and easy to stimuli that are normally wider (paradoxical reaction of the arteries), making it difficult to feed tissues.

Functional testing of the artery allows detection of early appearance of atherosclerosis. Change the color changing limb position (lifting legs upward), reactive hyperemia, which lag behind, or appears as a spot after 10 minutes of holding the elastic cuff deflation, the disappearance of the pulse in the construction of the limbs less than 45 ° indicate arteriosclerotic changes that lead to these functional characters.

Laboratory

There are no easy Typical laboratory analyzes that imply the presence of arteriosclerotic process, it is considered that hypercholesterolemia is one of the most common laboratory findings. It is important to pay attention to the total lipids and their relation to lipidogramu. As a rule, there is a higher index of lipoprotein that normally is beta / alpha to 3

Prognostic significance may have hiperprotrombinemija.

Radio isotopic technique offers fewer opportunities primarily for disorders and occlusion of blood flow through skeletal muscle.

Bacteriological, cytological and histological findings

Histological examination allows early detection of changes in the structure of the artery wall, but the need for these tests are not common.

The minimal diagnostic program

ECG with 12 derivations (3 standard, 3 and 6 unispolarne prekordijalnih at rest and after fatigue, if necessary).Oscilografija forearm and lower leg. Serum lipid levels, radiographs of the heart.

Treatment

First of all, an important prophylaxis. An appropriate pace of life and work with mandatory daily rest or break.Recommended physical activity, physical training and spending time outdoors at least 1-2 days a week. The diet insist on moderation and limit the fat content, especially with an abundance of saturated fatty acids.

The treatment must be used so. antisklerozantna resources: heparinoid ateroid, solvosterol, iodine, novocaine, vitamin A and E, vitamin B12, calcium panganicum, complamin other vazadilatatorna and opoterapijska assets (replacement therapy).

Forecast

It depends on age, degree of changes and complications.

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