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Atherosclerosis and Peripheral Arterial Disease

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AtherosclerosisWhat is Atherosclerosis?

Arteries are blood vessels that carry oxygen and nutrients from your heart to the rest of your body. When fat, cholesterol, and other substances build up in the walls of arteries and form hard structures called plaques, the arteries narrows and hardens. This arterial disease – hardening of the arteries is atherosclerosis. When the arteries are blocked at the leg, the milder forms of presentation are cramps and pain after walking a certain distance. If the condition is severe, with no blood going down, you might end up getting an amputation. For blockage in the kidney arteries, sometimes, patients develop uncontrolled blood pressure. When plaque builds up in the arteries that carry blood to your head, organs, and limbs, this is called Peripheral Arterial Disease (P.A.D).

What causes Atherosclerosis?

Atherosclerosis is a progressive disease that often comes with age as plaque builds up in the arteries. Patients with a family history, diabetes, high blood pressure, high cholesterol and those who smoke have a higher risk of developing this condition.

When the internal wall of an artery is damaged, blood cells and other materials frequently gather at the injured site and accumulate in the internal lining. Gradually, cholesterol and cellular waste products build up fatty deposits and plaques which also accumulates at the injury site. This hardens and narrows the arteries. With peripheral arterial disease, the connecting organs and tissues do not receive sufficient blood to work effectively. Over time, pieces of the fatty deposits and the lining of plaque may break away and go into your blood circulatory system. This may cause blood to clot and obstruct the blood flow to other parts of your body. This may trigger a heart attack or cause the failure of other organs.

Symptoms of Atherosclerosis

Atherosclerosis develop slowly over many years and often have no symptoms until blood flow to part of the body becomes slowed or blocked.

If the arteries to the heart become narrow, blood flow to the heart can slow down or stop. This can cause chest pain, shortness of breath and other symptoms of heart attack. Narrowed or blocked arteries may also show symptoms of peripheral artery disease such as leg pain and cause problems to important organs such as kidney failure.

Diagnosis of AtherosclerosisDiagnosis of Atherosclerosis

Symptoms of narrowed, enlarged or hardened arteries can be found during a physical exam. These include:

  • A weak or absent pulse below the narrowed area of your artery
  • Decreased blood pressure in an affected limb
  • Whooshing sounds (bruits) over your arteries, heard using a stethoscope
  • Signs of a pulsating bulge (aneurysm) in your abdomen or behind your knee
  • Evidence of poor wound healing in the area where your blood flow is restricted

Some health care providers recommend having your first cholesterol test at age 20. Everyone should have their first screening test by age 35 in men, and age 45 in women. If it is suspected that you have atherosclerosis, a number of imaging tests may be used to see how well blood moves through your arteries.

Should I seek treatment for Atherosclerosis?

Lifestyle changes such as quitting smoking, having a healthy diet that is low in fat and cholesterol and exercising can reduce your risk of hardening of the arteries, arterial diseases and venous diseases. Drugs such as medication for cholesterol and high blood pressure may be prescribed to slow down the effects of atherosclerosis. For the older group of patients with a more sedentary lifestyle, they do not walk enough to stress the arterial system. If it is a severe case peripheral arterial disease, gangrene (tissue death) may happen. By then, if the patients get cuts and/or wounds, these wounds don’t heal up and may even end up getting infected. When this happens, the patients may then need to come in for amputations. If the arteries to your heart get blocked, you may get a heart attack. If the arteries to the brain get blocked, you may get a stroke. If your case is severe with blockage affecting the functioning of your muscle or organs, you may need surgery such as Angioplasty or Stent.

Why choose Atherosclerosis treatments by our doctor?

Angioplasty is a complex invasive procedure and it can involve many parts of the human body, as your arteries bring nutrients to important organs such as the kidney. It is important for an experienced surgeon to do the procedure as a deviation from the correct balloon placement may cause damages. As the Regional Proctor (SEA) of Medtronic Endovascular, our doctor has completed many angioplasty procedures for peripheral arterial diseases and often invited overseas to supervise or proctor these complex surgeries. Our doctor uses the latest technology called drug eluting balloons, that were introduced to Singapore and approved by Health Science Authority only two years ago. We are one of the more aggressive surgeons in Singapore using these balloons. The results have been very positive on the patients thus far, with the blockage opening for at least nine to ten months, compared to two to three months in the past.