April 11, 22 Author : Victor Gil Mild atherosclerosis usually does not have symptoms. As the disease progresses, symptoms depend on the affected arteries and the acute or chronic course of the disease. Symptoms and complications of atherosclerosis The symptoms of moderate to severe atherosclerosis and the acute cardiovascular events it can lead to depend on the arteries affected , for example the coronary arteries, carotid arteries, or limb arteries. Atherosclerosis in the coronary arteries With the progression of atherosclerosis of coronary arteries symptoms may occur such as: Pain or pressure in the chest (angina) , which at first may only occur in exertion situations, and may progressively worsen; Pain, pressure, heaviness or burning sensation in the sternum region , which may radiate to the neck, back or arms, often accompanied by nausea and vomiting or breathing difficulty. These symptoms may be associated with a myocardial infarction due to acute occlusion of a coronary artery and need emergency medical care . Patient stabilization and immediate transport to an interventional cardiology center allows in many cases a successful resolution. Atherosclerosis in the carotid arteries Carotids are arteries that run along the front of the neck and supply the brain. Partial or total blockage of a carotid artery prevents the brain from receiving the amount of blood it needs. So, if there is atherosclerosis in the carotid arteries: Chronic manifestations may be unspecific, but some cases of dementia , especially in older people, are caused by atherosclerosis. In acute situations , there may be signs and symptoms such as sudden numbness or weakness of the arms or legs, difficulty speaking, temporary loss of vision in one eye, or facial paralysis, i ndicators of a transient ischemic attack (TIA), or a stroke . A stroke can be ischemic or hemorrhagic: Ischemic stroke can originate from the occlusion of a cerebral artery , for example when fragments of a carotid atherosclerotic plaque are released that obstruct it, preventing the arrival of blood to the areas of the brain that artery supplies. Hemorrhagic stroke occurs when the cerebral arteries, which are fragile, burst, flooding an area of the brain with blood. Atherosclerosis in limb arteries Chronic manifestations of atherosclerosis in limb arteries include symptoms and signs of peripheral arterial disease , for example: Pain in the legs when walking, lameness; Decreased blood pressure in the affected limb. Atherosclerosis of limb arteries can also cause sudden occlusion of an artery with: Pain and cooling of the limb; More rarely, tissue death or gangrene. Aneurysms An aneurysm is a bulge formed in the weakened wall of the arteries . It can happen in any artery. Atherosclerosis causes fragility of artery walls and can thus be the cause of aneurysms. In most cases, aneurysms do not cause symptoms. Many are accidentally detected in medical examinations performed for other reasons. If an aneurysm suddenly ruptures, it can cause internal bleeding, usually associated with excruciating pain and in most cases fatal. There are also cases of slow rupture of aneurysms, in which the artery wall is 'drooling' blood. Rupture of an aneurysm is a cardiovascular emergency associated with a high mortality rate. Diagnosis of atherosclerosis Early diagnosis of atherosclerosis is essential , with evaluation of signs of vascular repercussion when there are still no symptoms (pre-clinical), or when these are still unimportant. Cardiology medical consultations dedicated to cardiovascular risk prevention need information on: Personal and family medical history; Any complaints; Physical examination results; Results of diagnostic tests that may be necessary. Cardiology diagnostic tests The diagnostic tests that may be necessary depend on the particularities of each person and can be, for example: Blood tests : to know details on general health and in particular the blood levels of sugar and cholesterol; Electrocardiogram (ECG) , in which the electrical activity of the heart is recorded; Echocardiogram , which uses ultrasound and allows to have an image of the heart and its dimensions, assessment of ventricular function, heart valves, among other parameters; Calcium score , which is a low-radiation, non-contrast computed tomography (CCT) scan that quantifies the presence of calcified plaques in the coronary arteries and is very useful when there are no symptoms of atherosclerosis; Exercise tests , usually on a treadmill, to assess functional capacity, identify symptoms that only arise with exercise, identify alteration in the electrocardiogram during exercise and which also provide important information for planning a physical exercise program. When it is not feasible to perform a stress test (for example due to orthopedic problems) or as an alternative to this, imaging tests can be performed using drugs to simulate stress situations. The main ones are: Myocardial perfusion scintigraphy; Perfusion magnetic resonance imaging; Pharmacological overload echocardiography. Computed tomography angiography with intravenous contrast, which in cases of suspected established atherosclerotic disease, allows the visualization of atheromas; Cardiac catheterization , an invasive test that confirms stenosis (narrowing) or obstruction of the coronary arteries, performed when there is suspicion of critical obstructive disease or positive information from other diagnostic tests. In many cases treatment is performed in the same procedure. Read also: Atherosclerosis and cardiovascular risk factors Atherosclerosis: treatment and prevention Meet the cardiology clinical team from Hospital da Luz network and book your consultation The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
