The earliest lesions of arteriosclerosis

Written by Zeng Wei Jie
Cardiology
Updated on September 04, 2024
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The earliest lesion of atherosclerosis is the formation of lipid spots and streaks. The so-called lipid spots are small yellow dots that appear on the arterial intima. Under pathological observation, these are small areas of macrophages containing lipid droplets, forming a cluster of foam cells. As this small yellow dot develops, it gradually turns into a yellow streak made up of layers of macrophages containing lipids. The intima also comprises smooth muscle cells and lipids, as well as an infiltration of T cells, resembling a yellow streak on the intima.

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Written by Zeng Wei Jie
Cardiology
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What tests are used for arteriosclerosis?

If arteriosclerosis is in the early stages, we need to understand the situation with lipids and blood sugar, so lipid and blood glucose tests should be done. Later on, when some atheromatous plaques appear, examinations such as color Doppler ultrasound and cardiac echocardiography can be done to assess blood flow and the degree of narrowing in the vessels. For some severe narrowings, consider conducting a CTA, MRI, or angiography, which can non-invasively understand the lesions of arteriosclerosis. For some patients, if there is a need for interventional treatment, invasive, selective arterial angiography can be performed to understand the condition of the lesions. Therefore, different tests can be chosen at different stages.

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Written by Chen Ya
Geriatrics
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Can arteriosclerosis be cured?

Atherosclerosis can only slow down its further progression and prevent the further occurrence of conditions such as coronary heart disease, cerebral infarction, and lower limb arterial occlusion. This is because it is influenced by many factors, including both modifiable and non-modifiable risk factors. For example, modifiable factors include abnormal blood lipids, hypertension, diabetes, smoking, and overweight obesity, which we can change. However, there are also non-modifiable factors such as age, genetics, and environmental factors. As age increases, the incidence of atherosclerosis significantly rises. Its pathological changes generally begin in childhood or adolescence, with symptoms becoming more apparent as age progresses.

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Written by Zeng Wei Jie
Cardiology
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How is arteriosclerosis treated?

To treat arteriosclerosis, we differentiate treatments based on the severity of the condition. For early-stage patients, we emphasize the control of lipids, blood pressure, and blood sugar to potentially slow the progression of arteriosclerosis. For patients who have already suffered damage to target organs, such as cerebral infarction, myocardial infarction, renal artery stenosis, or mesenteric artery stenosis, treatment might significantly rely on medication, and could possibly require the use of stents or even surgical bypass procedures. For the general population, we emphasize primary prevention, which includes a reasonable diet, appropriate exercise, and a balanced mental state to effectively prevent the disease.

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Written by Zeng Wei Jie
Cardiology
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Risk factors for arteriosclerosis

The etiology of atherosclerosis is not yet fully understood, but the main risk factors include age and gender. The older the age, the higher the probability of occurrence, and the probability in men is higher than in women. Abnormal blood lipids, with the main treatment target being low-density lipoprotein, hypertension, smoking, glucose tolerance abnormalities, and obesity are all possible risk factors. Additionally, we cannot ignore family history; if there is a history of early-onset coronary heart disease in the family, then this risk factor is also very high. Moreover, personality is related, with Type A personalities being more prone to atherosclerosis. Dietary habits are also related; patients who often eat high-calorie, high-animal-fat, high-cholesterol foods are prone to develop the condition. There are also patients taking oral contraceptives, who are likely to develop atherosclerosis.

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Written by Zeng Wei Jie
Cardiology
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What medicine is used for arteriosclerosis?

Commonly, some medications used to adjust blood lipids are employed, primarily to lower low-density lipoprotein levels, and some are also aimed at achieving target levels for triglycerides. These include statins, fibrates, and niacin. For some patients, antiplatelet drugs might be necessary to prevent acute thrombus formation and avoid acute incidents. For those who have already formed a thrombus, thrombolytic drugs can be used within a certain time window for some patients. For patients with coronary artery accumulation leading to angina, vasodilators, receptor blockers, or calcium channel antagonists might be used to alleviate the symptoms of angina.