yogabook / pathologie / arteriosclerosis

arteriosclerosis

Definition

Systemic disease of the arteries with deposition of fats, thrombi, connective tissue, calcium (hydroxyapatite similar to bone) in the vessel walls; intra- and extracellular deposits, fibrosis of the vessel walls lead to reduced elasticity and loss of lumen (stenosis). More precisely: blood lipids are already deposited in the innermost of the three arterial wall layers (from the inside to the outside: intima (tunica intima, interna), media (tunica media), adventitia (tunica externa)) during adolescence, later blood components and thrombocytes are added, these arteriosclerotic plaques (artheromas) are barely visible to the naked eye. Injuries to the arteries as well as bacteria and viruses, but also immune reactions, attract monocytes, which penetrate into the intima and, among other things, allow LDL to enter, but also absorb it, turning them into foam cells, which trigger an inflammatory reaction that also spreads to the media. A connective tissue cap forms over the accumulation of dead foam cells. Plaques also accumulate on the lumen side of the vessels altered in this way. The vessels that are no longer optimal in terms of flow dynamics are the starting point for further changes. Chronic insufficient blood flow and ischemia in 60-year-olds are 80% attributable to arteriosclerosis. If several risk factors are present, the first symptoms can occur as early as the 30th-40th year of life. Heart attack risk of healthy 40-year-olds to 40-year-olds with hypertension, hypercholesterolemia and inhalation smoking: 1:15. Preferred regions of arteriosclerosis: neck, brain, heart, pelvis, leg arteries, vascular branches. Due to the involvement of the vascular branches, the pulse wave reflection also increases, which leads to a faster increase in the
This leads to a faster increase in pulse wave velocity than that caused by physiological aging or the other effects of arteriosclerosis and can be observed diagnostically in the behavior of the two pulse waves.

A different pathomechanism applies to arteriosclerosis of the Mönckeberg type (medial calcinosis).

ICD I70

Cause

1. see above.
2. Chronic renal insufficiency leads to mediasclerosis
3. Hyperthyroidism
4. RA
5. Menopause

Predisposing

– Behavior

1. Inhalation smoking
2. Lack of exercise
3. Stress
4. Noise
5. Particulate matter pollution

– Risk factors

1. Overweight
2. Age
3. male gender
4. familial disposition
5. LDL > 100 mg/dl
6. psychosocial factors such as depression
7. Hyperlipidemia
8. Hyperfibrinogenemia
9. Hyperhomocysteinemia
10. Hypertension
11. Diabetes mellitus
12. Gout

Diagnosis

1. Sono
2. Angiography
3. CT of the coronary and abdominal aorta
4. Laboratory: blood sugar, cholesterol, homocysteine, uric acid
5. Tests and signs:Ratschow’s position test, pain-free walking distance

Symptoms

1. Myalgias
2. Intermittent claudication
3. renal hypertension

Complications

1. HKH
2. Angina pectoris
3. Heart attack
4. Apoplexy (bloodless)
5. vascular dementia
6. paVK
7. Ischemias
8. Loss of yield dimensions
9. erectile dysfunction
10. Impaired kidney function/kidney failure
11. Arterial embolisms due to thrombi formed on plaques
12. Caotissinus syndrome
13. Formation of aneurysms with risk of rupture

Therapy

1. Change of lifestyle
2. Change your diet, e.g. reduce saturated fatty acids in favor of unsaturated ones; fiber from whole grain products, legumes, vegetables lowers LDL cholesterol levels; unsaturated fatty acids instead of saturated ones; avoid hydrogenated fats; antioxidants and vitamins.
3. with elevated triglycerides: Alcohol abstinence
4. Balloon dilatation if necessary
5. Exercise / endurance sports:
6. Stop smoking
7. Weight reduction
8. Medication, e.g. platelet aggregation inhibitors such as ASA, possibly cholesterol synthesis inhibitors
9. Medication for hypertension: ACE inhibitors, diuretics, AT1 receptor blockers, beta blockers, calcium antagonists
10. Stent, bypass surgery if necessary