OverviewWhat is atherosclerosis?Atherosclerosis is a disease that happens when plaque builds up on the inside walls of your arteries. Arteries are blood vessels that deliver blood and oxygen from the heart to the rest of the body. Show
Plaque is a sticky substance made of fat, cholesterol, calcium and other substances. As plaque builds up, your arteries become hard and narrow. What’s the difference between atherosclerosis and arteriosclerosis?Atherosclerosis is a type of arteriosclerosis, which is any hardening of the arteries. Your arteries can become hard or stiff for many different reasons. One reason is plaque buildup. That’s what atherosclerosis refers to. But the two terms are often used to mean the same thing. How can hardening of the arteries affect my body?Hardening of your arteries can cause several problems. Narrow or blocked arteries can’t deliver enough blood, oxygen and nutrients to the rest of your body. Blockages can eventually lead to tissue death or infection in your arms, legs or other parts of your body. A piece of plaque can break free and then get stuck somewhere in your body, causing damage. Also, a blood clot can form in a narrow artery. It can eventually loosen and travel through the artery. Atherosclerosis may begin when you’re a child, and worsens over time. Atherosclerosis can lead to serious health problems and medical emergencies, including:
What are the stages of atherosclerosis?There are several stages of atherosclerosis (described below). Each stage involves changes in your artery wall. These changes are so tiny that you can’t see most of them without a microscope. But they add up to cause serious damage to your artery. The stages of atherosclerosis happen over many years. And they often go undetected. Atherosclerosis involves gradual plaque buildup inside your artery. Eventually, the plaque can rupture and trigger a blood clot. Stage 1: Endothelial damage and immune responseAtherosclerosis begins when damage occurs to the inner layer of your artery wall. This layer is called the intima. The surface of your intima is lined with endothelial cells. This thin lining, called the endothelium, is the barrier between your blood and your artery wall. Many things can harm your endothelium. The most common culprits include:
Once your endothelium is damaged, several things happen:
Stage 2: Fatty streakA “fatty streak” is the first visible sign of atherosclerosis. It’s a yellow streak or patch formed from dead cells at the site of endothelial damage. Here’s how it forms:
All the dead foam cells form a bulge underneath your endothelium. This “fatty streak” is the beginning of plaque formation. Stage 3: Plaque growthMore dead foam cells and other debris continue building up at the site of the fatty streak. The fatty streak slowly gets bigger and forms into a larger piece of plaque. Your artery’s smooth muscle cells form a layer on top of this plaque. This is called a fibrous cap. The fibrous cap covers the plaque. It prevents bits of plaque from breaking off into your bloodstream. Meanwhile, the plaque keeps growing. It gains calcium, which makes it harder. For a while, your blood still has enough room to pass through. That’s because your artery wall expands outward to make space for the plaque. But it can only expand outward so far. As the plaque gets too big, the opening of your artery becomes narrower and narrower. There’s less room for your blood to flow through. The plaque may stay stable for a long time. But eventually, it can rupture. Stage 4: Plaque ruptureIn this final stage, the plaque ruptures and causes major problems in your body. At this point, the plaque has been in your artery for a long time — perhaps many years. It has grown in size and taken up more space in your artery. But the fibrous cap has kept the plaque from breaking open until this point. When the fibrous cap breaks open, the plaque inside comes into contact with your blood. This can trigger a blood clot to form. This blood clot (known as a “thrombus”) blocks your blood flow and leads to a heart attack or stroke. Researchers are still learning how these ruptures happen and who’s at risk. A thin fibrous cap may be more likely to rupture than a thicker one. The size of the plaque itself may not matter as much. In some cases, smaller plaque bulges lead to a heart attack. What causes atherosclerosis?Damage to your artery’s inner lining (endothelium) causes atherosclerosis to begin. The damage usually occurs slowly and over time. Risk factors for atherosclerosisSome conditions can raise your risk of developing atherosclerosis. These include:
What are the symptoms of atherosclerosis?Atherosclerosis often doesn’t cause any symptoms until an artery is very narrow or entirely blocked. Many people don’t even know they have the condition until a medical emergency, such as a heart attack or stroke. You may start noticing symptoms if your artery is more than 70% blocked. The blockage causes your blood flow to slow down. As a result, your body isn’t getting enough oxygen. Some early warning signs include:
If you have a blood clot or sudden blockage, you may have a heart attack or stroke. Symptoms of a heart attack include:
Women and people designated female at birth (DFAB) may also experience shortness of breath, fatigue and insomnia. These symptoms might begin days, weeks or even months before the heart attack. The blood clot or blockage can also lead to a stroke. Symptoms of a stroke include:
Atherosclerosis usually doesn’t cause symptoms until your artery is severely blocked. But some people experience early warning signs days or weeks before a medical emergency. Diagnosis and TestsHow is atherosclerosis diagnosed?To determine whether you have atherosclerosis, your healthcare provider will start with:
What tests diagnose atherosclerosis?Your healthcare provider may order additional tests to diagnose atherosclerosis and plan the best treatment for you. These tests include:
What specialists might I need to see for atherosclerosis?If you have atherosclerosis, your healthcare provider may recommend you see a specialist, such as:
Management and TreatmentHow is atherosclerosis treated?Treatment for atherosclerosis may involve lifestyle changes, medications and surgical procedures. Your healthcare provider will work with you to choose the best options. Common treatment goals include:
Your healthcare provider also may prescribe medications to:
Some people with advanced atherosclerosis might require surgical procedures, such as:
Can atherosclerosis be reversed?Atherosclerosis can’t be reversed. But your healthcare provider will help you manage your atherosclerosis so it doesn’t get worse or lead to complications. Research continues to explore new treatments that may be able to reverse atherosclerosis. PreventionWhat are the risk factors for atherosclerosis?Anyone can have atherosclerosis. But some people have a higher chance of developing it. Some risk factors you can’t change. These non-modifiable risk factors include:
Some medical conditions raise your risk for atherosclerosis, including:
Lifestyle factors also play a role. These factors include:
How can I prevent or lessen atherosclerosis?You may not be able to prevent atherosclerosis. But you can reduce your risk and lessen the effects of the disease. Some steps you can take include:
Outlook / PrognosisWhat is the outlook for people with atherosclerosis?Medical advancements have helped improve the outlook for people with atherosclerosis. With early diagnosis and treatment, people with atherosclerosis can live healthy, active lives. But the disease can cause health emergencies and even death. That’s why it’s important to know your risk factors and work with your healthcare provider to reduce your risks. Living WithWhen should I seek immediate medical attention?If you have any signs of a heart attack or stroke, seek immediate medical attention. How can I best learn to cope with atherosclerosis?Learning that you have atherosclerosis can cause fear and stress. It might help to:
A note from Cleveland Clinic Atherosclerosis is a disease that happens when plaque builds up on the inside walls of your arteries. High blood pressure, high cholesterol, diabetes and other conditions can increase your risk. It’s important to get a checkup every year to catch and manage any related conditions. Healthy lifestyle choices, medications and surgical procedures can prevent complications of atherosclerosis. If you have atherosclerosis, remember you’re not alone. This is one of the most common heart problems people face. And your healthcare provider is ready to help you manage your condition so you can live a long and healthy life. What is the major cause of CAD?CAD is caused by plaque buildup in the walls of the arteries that supply blood to the heart (called coronary arteries) and other parts of the body. Plaque is made up of deposits of cholesterol and other substances in the artery.
Is CAD the same as arteriosclerosis?CAD happens when the arteries that supply blood to heart muscle become hardened and narrowed. This is due to the buildup of cholesterol and other material, called plaque, on their inner walls. This buildup is called atherosclerosis.
Why is atherosclerosis a major cause of coronary heart disease?Coronary heart disease (CHD) is usually caused by a build-up of fatty deposits (atheroma) on the walls of the arteries around the heart (coronary arteries). The build-up of atheroma makes the arteries narrower, restricting the flow of blood to the heart muscle. This process is called atherosclerosis.
Is atherosclerosis a risk factor for CAD?This process is called atherosclerosis. It's typically no cause for concern. However, too much buildup can lead to a blockage, obstructing blood flow. There are a number of risk factors, common red flags, that can contribute to this and ultimately lead to coronary artery disease.
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