Stenosis occurs when there is a narrowing of an artery. As sonographers, we most commonly see this occur in the carotid arteries. Fatty substances and cholesterol deposits build up along the walls of these arteries and are referred to as plaque. According to Eslami & Pounds (2016), the most common cause of plaque build up in the carotid arteries are smoking, high cholesterol, high blood pressure and diabetes. When this plaque builds up within the walls of an artery it will become atherosclerotic. As atherosclerosis progresses, the plaque will continue to grow and can create a blockage. This is also the same type of plaque that forms in the heart and causes heart attacks. With atherosclerosis and stenosis, the effects of reduced blood flow
After review of the clinical information provided by North Central Bronx Hospital, the Medical Director has denied your admission to North Central Bronx Hospital. It was determined that the clinical information did not justify an inpatient stay. Acute inpatient hospitalization was not medically necessary. You are a 56 year old female with complaints of worsening pressure-like chest pain on the left sided that radiated to your left arm and neck. The symptoms began when you were at rest and woke you from your sleep. Based on the Interqual guideline (a decision based program to determine medical need) criteria to for acute coronary syndrome the clinical guidelines were not met because troponins were negative, there was no diagnostic testing such as a stress test, or documentation of ischemia in the clinical information that was submitted.
An artery is an elastic blood vessel that transports blood away from the heart. There are two main types of arteries: pulmonary arteries and systemic arteries.
LDL or bad cholesterol comes from food that is a high source of cholesterol and/or saturated fats. Plaque forms when bad or LDL cholesterol builds up in your bloodstream and attaches to the arterial wall, as more LDL builds up the plaque becomes larger, this can become a major problem for your cardiovascular system. Because plaque is a substance that has rough edges, it reduces the elastic nature of the artery which means your heart will have to work double-time to pump the necessary blood to all your limbs, that will mean your limbs won’t get the amount of oxygen that they require to function properly. Plaque can also narrow the area blood has to pass through, this means your heart has to work overtime and overall capacity of your cardiovascular system is lowered. When the LDL cholesterol embeds itself in the wall of the artery it than damages the artery then blood pressure expands it which causes an aneurysm. When an aneurysm is too weak there is a high possibility of it bursting, when that happens it leaves the cells in and around that area without oxygen. If that artery is connected to a major vital organ the person will most likely die. When the blood flow is slowed it shows a greater risk for blood clots and although blood clots are natural and important to healing broken blood vessels, if blood clots gather inside the blood vessel this proves to be a serious health risk. The clots have the possibility to get stuck and completely cut off the blood flow to cells, leaving them without oxygen and causing them to die. If a clot gets inside a blood vessel connected to a major organ this could cause the person to die. The heart is fed by the coronary artery, if plaque or a blood clot blocks off blood flow to the heart, the heart ...
Atherosclerosis begins when the inner wall of the artery becomes damaged and cholesterol and fatty plaques begin to lodge in the arteries. Damage to the endothelial wall inside the artery can be caused by hypertension, hyperlipidemia, and hyperglycemia (“Subclinical Atherosclerosis..” 443). When this happens, the immune system responds by sending monocytes to the damaged area. The monocytes turn into macrophages; their job is to eat up the excess cholesterol and unblock the artery. The macrophages are unable to digest all of the cholesterol, and as a result turn in to foam cells. When many macrophages are turned into foam cells, plaque results, and protrudes into the arterial wall, restricting blood flow and raising blood pressure (“Atherosclerosis Growth Process.” 8). If the plaque becomes too large it may break, releasing plaque into the blood. This can cause a great reduction in blood flow or a clot, resulting in stroke or myocardial infarction (“Stroke Risk.” 3).
The preliminary step in myocardial infarction is atherosclerosis. Atherosclerosis does not occur abruptly, it is a gradual and dynamic inflammatory disease which causes the narrowing of lumen due to the deposition of lipid and foam cells. The formation of fatty streak; which will eventually become a plaque causes the vessel lumen to diminish. The plaque will become unstable, rupture and eventually lead to the event of plaque disruption.
Plaque is made up of fat, cholesterol, calcium, and other substances found in the blood. Over time, plaque can build up, harden and narrow the arteries. This limits blood flow throughout the body. PAD occurs if plaque builds up in the major arteries that supply oxygen-rich blood to your legs, arms, and pelvis.
Coronary artery disease (CAD) is the most common type of multifactorial chronic heart disease. It is a consequence of plaque buildup in coronary arteries. The arterial blood vessels, which begin out smooth and elastic become narrow and rigid, curtailing blood flow resulting in deprived of oxygen and nutrients to the heart [1].
Coronary heart disease is defined by the hardening of the epicardial coronary arteries. The buildup of plaque in the arteries slowly narrows the coronary artery lumen. In order to better understand the physiology of the disease, it is important to first know the basic anatomy of the human heart. The aorta, located in the superior region of the heart, branches off into two main coronary blood vessels, otherwise known as arteries. The arteries are located on the left and right side of the heart and span its surface. They subsequently branch off into smaller arteries which supply oxygen-rich blood to the entire heart (Texas Heart Institute, 2013). Therefore, the narrowing of these arteries due to plaque buildup significantly impairs blood flow throughout the heart.
Atherosclerosis is the culprit behind coronary heart disease (CHD) and stroke, which is the most common cause of death worldwide and in the United States10. Among the modifiable risk factors of CHD and stroke is the serum low density lipoprotein level (LDL)8, 11. Several randomized clinical trials have established that reducing the serum LDL level results in a reduction in the future risk of CHD and stroke in a linear relationship, in one study it was estimated that reducing the LDL by 1 % would reduce the risk by 1.7 %.1-4, 7, 9, 13
Atherosclerosis is the most common cause of CAD. Atherosclerosis is a progressive disease characterized by fat deposits in the arteries causing them to block the normal passage of blood. No one is quite sure how atherosclerosis develops. The plaque consists mostly of cholesterol, phospholipids and smooth muscle cells. They also reduce the size of the lumen of the affected artery which impairs the blood flow of this artery and later on could form a thrombus that will completely occlude the vessel. “Unfortunately, signs and symptoms of atherosclerosis usually don’t develop until at least 70% of an artery’s lumen has become obstructed. Angina is almost always the first symptom to appear.”(Journal: The killer behind CAD,2010). Modifiable factors that could prevent the occurrence of CAD include cigarette smoking, obesity, physical inactivity, atherogenic diet like diet high in cholesterol, use of contraceptive and hormone therapy replacement. “Women continue to ...
Coronary heart disease occurs when some of the arteries that carry blood to the heart muscle become narrowed with fatty deposits. In this condition fatty deposits called plaque, composed of cholesterol (see later) and fats, build up on the inner wall of the coronary arteries. When arteries are narrowed, the heart is not fully supplied with the oxygen and other nutrients it needs. If an artery is completely blocked, a heart attack occurs. Heart disease is very common.
Coronary Heart Disease Coronary heart disease occurs when the coronary arteries become partially blocked from, cholesterol and fat, circulating in the blood. This causes a build up inside the walls of the arteries. This only occurs if the levels of fat and cholesterol are extremely high in the blood that there is a greater chance that it will be deposited onto the artery walls. If the arteries become completely blocked, the patient will have a myocardial infarction, commonly known as a heart attack.
Cardiovascular disease is developed by a build-up of fatty deposits on the inner walls of the blood vessels, which typically takes years to accrue (World Health Organization). The development of the fatty-acid deposits can occur due to an unhealthy diet, physical inactivity, tobacco use, and a harmful intake of alcohol. The behavioral risk factors listed above account for about 80% of cardiovascular disease, with the other 20% being cause by fixed risk factors (age, gender, race).
of fatty substances on the inside wall of the arteries). It is not caused by
Etiology Myocardial infarction occurs when the coronary arteries are blocked by a blood clot. It is commonly known as a “heart attack”. The heart needs its own constant supply of oxygen and nutrients to work properly. Two coronary arteries deliver oxygenated blood to the heart, and if one of these two arteries fails or becomes blocked, then a portion of the heart will not acquire the necessary oxygen. This clot could be because of CAD (coronary artery disease), which happens when the inner walls of the coronary arteries thicken because of buildup of cholesterol, fatty deposits, calcium among other elements that are carried in the blood (Boston Scientific, 2009).