One of the important and common heart diseases is this atherosclerosis. This disease in turn becomes a complication and arises to furthermore diseases. After the age of 40, around half the population is at the risk of suffering from atherosclerosis. The problem is that the disease is silent and becomes violent after some time.

Atherosclerosis is the combination of two words athero and sclerosis. The word athero refers to porridge and sclerosis refers to scarring. This disease is caused by the deposition of cholesterol and calcium salts on the walls of blood vessels.

This blockage narrows the blood vessel and hence the blood supply is reduced, the essential metabolites for the target organ reduce, and ultimately the organ fails. Hence this disease can lead to several severe complications which can be fatal.

The main cause for this disease is obvious, it is obesity. The excess body weight results in the accumulation of cholesterol which can initiate atherosclerosis. The other probable causes are high blood pressure, smoking, diabetes, and inflammation.

The four significant events occurring in the pathogenesis of the disease are mentioned below.

Endothelial cell injury

Lipoprotein deposition

Inflammatory reaction

Plaque formation

The endothelium is the outermost covering of the blood vessels. Since it is in contact with millions of substances every day, there are high chances for it to be injured. The main substances which can injure the endothelium are the toxins obtained from smoke, diabetes, and increased fat. Another important agent is hypertension. All of these can injure the wall initiating the process of atherosclerosis.

The next step involves LDL. This is known as low-density lipoprotein (a combination of lipid and protein). This is termed bad cholesterol because of its nature to block arteries. LDL takes advantage of the injury and tries to gain access by modification. One modification is oxidation through free radicals from toxins. The other modification is glycation in the case of diabetes.

LDL is specific to the body but the modified LDL is non-specific to the body and hence the immune system launches an attack on it. The immune cells ingest them resulting in the formation of “foam cells” and a “fatty streak” on the walls of blood vessels.

Also there is an injury on the endothelium so the immune system sends inflammatory chemicals (mediators) and other immune cells to the target site. The last stage in the pathogenesis is where smooth muscle cells come to action.

They arrive at the site and form a “muscle cap” around the inflammatory cells which ingested the fat, uningested fat, etc., and hence the entire thing is protected and this act even increases the thickness of the block. There are some cases in which the cap can be smooth and the contents can break out.

This is more dangerous since more cells come for inflammation and healing still thickening it or the broken pieces can block some microvasculatures.

This disease does not have symptoms. However, there are symptoms based on region, in the heart, it is chest pain; in the brain, it is stroke and loss of function; limb pain and kidney failure.

This can be diagnosed through blood tests looking for LDL and cholesterol levels; using ECG to assess heart conditions; Doppler ultrasound; angiogram and calcium testing.

The best treatment is to restrict the diet and exercise to reduce the excess fat, lower down the stress and cholesterol levels. Some surgical methods are angioplasty, coronary artery bypass surgery, blood thinners, etc. Research shows that ghee when taken as the only fat source reduces the arachidonic acid levels in the blood by 65%. This chemical is a key inflammator playing a major role in the occurrence of atherosclerosis. But this can become deadly if consumed in excessive amounts.

Results

#1. What type of disease best suits atherosclerosis?


#2. Which term represents the hardening of the arteries?


#3. Select the obvious causes for atherosclerosis?

Select all that apply:


#4. Select the correct order of events 1. Endothelial cell injury 2. Smooth muscle cell formation 3.Inflammation 4.Lipoprotein deposition


#5. What are the modifications that can occur to LDL in case of atherosclerosis?


#6. Which of the following facts is true about LDL?


#7. Which of the following ranges of LDL is considered as risk?


#8. Which facts are true about the progression of atherosclerosis?

Select all that apply:


#9. How many different types of atherosclerosis are present?


#10. Only one factor here is non-modifiable. Find it out.


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