Artem has a doctor of veterinary medicine degree.
The Buildup of Plaque
It's important to brush and floss your teeth every day and undergo routine dental exams for so many reasons. One of these reasons is to help remove dental plaque, the stuff that can harden into the nasty-looking tartar on your teeth.
Unfortunately for us humans, plaque can build up in other places in our body. For instance, the nervous system can have a buildup of plaque in Alzheimer's disease or the cardiovascular system can endure plaque buildup as well. Of course, the name is the same, but the cause and consistency of the plaque is different. This lesson will discuss plaque buildup in your cardiovascular system and the many terrible things it can do to us.
Atherosclerosis & Arteriosclerosis
Plaque buildup in our cardiovascular system is associated with atherosclerosis. This is a condition where plaque (a combination of cholesterol, fat, calcium, white blood cells and other substances) builds up underneath the inner lining (the endothelium) of an artery and restricts the flow of blood. Atherosclerosis is a type of arteriosclerosis. Arteriosclerosis is a term for the thickening and hardening of arterial walls.
Let's just think about this for a minute. I hate to make this example, but it'll drive the point home nonetheless. Fat buildup virtually anywhere and on anyone restricts movement of blood or otherwise. If you've ever seen a fat cat moving about, you'll notice how they just aren't jumping nor running around like they used to. Sorry to all the cat lovers out there, by the way.
Fat can also build up within cells and restrict cellular processes, resulting in organ malfunction. Fatty substances can obviously also build up within arteries as per atherosclerosis - namely, plaque builds up in the tunica intima (the inner layer) of the arterial wall after its endothelium is damaged due to any number of risk factors I'll outline in just a bit.
As the fatty deposit grow, the arterial lumen, the open space where blood flows, will narrow. As it narrows, blood cannot make it through the narrowed open space properly, resulting in poor oxygen delivery to the tissues supplied by those arteries. This is technically called ischemia, the inadequate supply of blood to a tissue or organ due to obstructed or constricted vasculature.
What's worse is that these plaques predispose a person to the formation of blood clots that can further narrow or completely block the artery, or the blood clot or plaque itself can break off and block an artery somewhere else in the body.
All in all, these slowly forming plaques remind me of a mountain roadway that has half the lanes blocked by a slowly creeping mudslide coming off the side of the mountain. As the mudslide creeps further and further onto the road, the traffic making it past the mudslide decreases in quantity. Eventually, this type of blockage may result in a person's death. People who smoke, are obese, and have diabetes, high blood pressure, high cholesterol, or a family history of this condition are most at risk for developing atherosclerosis.
Coronary Artery Disease
The major reason for death as a result of atherosclerosis is something known as coronary artery disease, aka coronary heart disease. This is a condition where coronary arteries, the arteries supplying your heart with oxygen, become constricted as a result of atherosclerosis. Don't get me wrong, the plaques can affect large and medium-sized arteries all over the body, but it's especially dangerous when the coronary arteries are affected.
There's a couple of things that occur when the blood flow to the heart is restricted, resulting in oxygen deprivation to the heart muscle (myocardial ischemia). The first is called angina pectoris, or simply angina. This is chest pain as a result of myocardial ischemia that may precede a second important sequence of coronary artery disease due to atherosclerosis, a myocardial infarction, or a heart attack. And I think we all know what a heart attack can result in.
Diagnosis & Treatment
Coronary artery disease, and by extension atherosclerosis, can be tested for using things such as an echocardiogram. This procedure helps a doctor visualize the heart and gives a cardiologist the ability to assess whether certain parts or functions of the heart have been compromised due to atherosclerosis.
Something known as an exercise stress test can be performed as well. This is when a person uses a treadmill while doctors monitor and measure blood pressure and an EKG. An EKG, or electrocardiogram, is something that measures the electrical activity of the heart. Abnormalities found on this test can help point in the direction of coronary artery disease.
Another test that can be used is called coronary angiography. This is where a special dye is injected into the arteries. Any blockages or narrowing can be much better appreciated using this technique.
Just think of it as adding food coloring to the blood; it makes it that much easier to see blood flowing about just like food coloring makes it much easier to see water. The arteries are kind of like a straw. If you take a transparent straw and use it to drink some water, you're not really going to see the water moving about. If you color the water, you will. If you pinch the straw and block it, like how plaque would block an artery, you'll be able to tell where the water is blocked. That's what a coronary angiography helps us do.
Other techniques used to detect coronary artery disease include CT scans and MRIs. Once diagnosed, there are several treatment strategies that can be undertaken.
- Nitroglycerin, which is a medicine that helps to dilate the narrow coronary arteries.
- Beta blockers, drugs that decrease blood pressure and slow down the heart rate. If the heart slows down, it doesn't need as much oxygen to function, which is good since little is getting through in cases of coronary artery disease.
- Blood thinners such as aspirin.
- Calcium-channel blockers, which are medications that reduce blood pressure, among other things.
- Statins, which are cholesterol-reducing medication.
Those are the medical techniques. In some cases, surgical intervention is necessary. One possibility is by way of inserting a catheter into the narrowed section of the artery. Then, a balloon (you read that right) is inflated to expand the artery and a stent is left in place to prop up the walls for the future. The procedure where a balloon is used to open up a blood vessel is known as an angioplasty.
Another possible surgical procedure is known as coronary artery bypass surgery. This is when a blood vessel is taken from another part of your body and is used to help blood flow around the blockage.
Going back to our mudslide example, think of it as an off-ramp and road built right before the blockage. The off-ramp and its following road then go around the blockage and reconnect to the original road on the other side to allow for proper traffic flow.
All that trouble, all those medicines and surgeries, when it can be prevented! Eat right, don't smoke, exercise, and do all the other things your doctor tells you to and you just might avoid all that plaque buildup.
Remember that this plaque buildup in our cardiovascular system is associated with atherosclerosis. This is a condition where plaque (a combination of cholesterol, fat, calcium, white blood cells and other substances) builds up underneath the inner lining (the endothelium) of an artery and thereby restricts the flow of blood. Atherosclerosis is a type of arteriosclerosis. Arteriosclerosis is a term for the thickening and hardening of arterial walls.
Plaque buildup can result in ischemia, the inadequate supply of blood to a tissue or organ due to obstructed or constricted vasculature.
When these fatty deposits happen in our coronary arteries, we term it coronary artery disease, aka coronary heart disease. This is a condition where coronary arteries, the arteries supplying your heart with oxygen, become constricted as a result of atherosclerosis.
This can lead to angina pectoris, or simply angina. This is chest pain as a result of myocardial ischemia that may precede a second important sequence of coronary artery disease due to atherosclerosis, a myocardial infarction, a heart attack. And I think we all know what a heart attack can result in.
Treatment for coronary heart disease to try and prevent a heart attack includes angioplasty, coronary bypass surgery, and medications such as statins, nitroglycerin, calcium channel blockers, and the like.
Upon completing this lesson, you will be able to:
- Describe what atherosclerosis and arteriosclerosis are
- Define ischemia and coronary artery disease
- Explain what leads to angina and myocardial infarction
- Identify ways that coronary heart disease is detected and treated
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