Atherosclerosis is a chronic generalized disease in which specific lipoproteins are deposited on the walls of blood vessels and the arteries are affected. The patient develops cholesterol plaques, the blood supply to the internal organs is disturbed.
In pathology, lipid metabolism is disturbed and the vascular epithelium is damaged. In order to detect the disease in time, it is important to know how to diagnose atherosclerosis at the initial stage. This will increase the effectiveness of therapy and prevent the development of severe complications.
Independently identify the pathology is very difficult, because at first the symptoms do not manifest themselves. Meanwhile, the disease can be recognized by conducting a comprehensive survey, including instrumental and laboratory diagnostics.
How does the development of the disease
Modern medicine considers two main causes of atherosclerosis. According to one theory, doctors believe that the primary link in the development of the disease is an increase in the concentration of low-density lipids in a patient’s blood.
Cholesterol in the excess accumulates through the walls of blood vessels, is deposited and forms atherosclerotic plaques. A reduction in the amount of good cholesterol also leads to the disorder.
In another formulation, atherosclerosis appears if the inner vascular layer is damaged. This becomes the main cause of plaque formation. Such formations may slowly and without obvious symptoms progress over several years. When they become hard, the blood flow in the arteries is disturbed.
With hypertension, this condition often causes blood clots.
How to determine the pathology
Very often, a person does not even suspect that he has an early stage of atherosclerosis, since the disease practically does not manifest itself. Identify the disease you need through a comprehensive diagnosis.
In particular, in order to make a diagnosis, the doctor identifies all risk factors, determines the specific signs of pathology, sends the patient for laboratory research and instrumental diagnostics.
There are certain phenomena that can provoke atherosclerosis. A high risk of the onset of the disease is observed with chronic stress, the abuse of fatty and high carbohydrate foods, smoking, obesity, hereditary predisposition, uncontrolled arterial hypertension, diabetes, hypothyroidism, hypodynamia, dyslipidemia.
All these factors contribute to accelerating the development of atherosclerotic lesions at any age. If certain symptoms are detected, this may be the basis for additional research in the laboratory.
You can detect certain signs of atherosclerotic lesions.
- The brain vessels are affected, which is accompanied by memory impairment, hearing loss, and noise in the head.
- If intermittent claudication occurs, the doctor can diagnose lower limb atherosclerosis.
- Angina can be a symptom of atherosclerosis of the coronary vessels. At the same time, the patient feels pain in the region of the heart during physical exertion, shortness of breath, rapid heartbeat. If you take nitroglycerin or be at rest for a long time, the pain disappears.
- With atherosclerosis of the renal arteries, renal filtration is reduced. Urinalysis can show the presence of protein, red blood cells, an increased number of cylinders. In the area where the renal artery narrows, specific noises are detected. Such a violation is often found in young people with refractory arterial hypertension.
- Dizziness and signs of damage to the head vessels are observed when the carotid arteries are affected.
- In the case of atherosclerosis of the mesenteric arteries, the digestive process is disturbed. After a heavy meal, sharp paroxysmal pain appears in the upper abdomen. Also appears bloating, belching, constipation. If the disease increases, the condition is accompanied by profuse diarrhea. During auscultation, systolic murmurs are heard in the blood vessels of the abdomen.
When systolic and pulse vascular pressure increases, the diastolic decreases, and aortic atherosclerosis is detected. This violation usually proceeds covertly and is found only in old age.
In order to reduce mortality from cardiac pathologies, today a project has been launched in Russia, which consists in conducting a blood test for screening.
This will identify cardiovascular diseases and stop atherosclerosis.
Laboratory and instrumental diagnostics
Diagnosis of atherosclerosis in the laboratory is assigned to everyone who is at risk of developing the disease, even if the symptoms are absent. This method allows you to find out what state the arterial bed is in, and whether there is a possibility of damage to the blood vessels.
In a healthy person, total cholesterol varies from 3.1 to 5.2 mmol / l, the concentration of good lipids in women is 1.42, and in men it is 1.58. Low-density lipoproteins can be 3.9 mmol / l, the level of triglycerides reaches 0.14-1.82 mmol / l. The atherogenic index rate is 3.
Additionally, the blood test shows the level of creatinine, c-reactive protein, the rate of the renal reaction. To confirm the diagnosis, instrumental examination is appointed.
- With the help of ultrasound, it is possible to detect thickening in the blood vessels. This type of diagnosis allows you to examine the heart, brain, abdominal aorta, upper limbs. The advanced triplex technique depicts the state of flow of a liquid medium in color.
- In order to examine in detail the elastic tubular formations and obtain their image, CT-angiography is performed. Such a study is safe for the body, has a minimum number of contraindications and does not provoke complications. Diagnosis is carried out by introducing a contrast agent, after which the X-ray scans and sends the data to computer processing.
- For pathologies of the heart muscles, an electron beam tomography is prescribed. This study provides additional information about the state of the heart, which could not be obtained during computed tomography. The result can be seen in 3D format.
- Angiography is used to determine the obstruction in the main blood vessels. A special substance is injected into the blood or lymph, after which an x-ray examines the vessels. Such a diagnosis is contraindicated in the presence of mental illness, idiosyncrasy and acute infection.
- An MRI of blood vessels provides a two-dimensional image. The most commonly used contrast method, but in some cases, the procedure is carried out without contrast. This type of diagnosis is prescribed if the lumens of the blood vessels are narrowed and the blood circulation is disturbed.
The study with obliterating atherosclerosis of the lower extremities
Initially, the doctor studies the symptoms of pathology. As a rule, the patient complains of moving lameness that arises from the load. At the same time, there is a sharp pain in the muscle tissues of the legs, numbness and weakness. After a long rest, these signs go away.
During palpation, the doctor may notice that the lower limbs have become colder, while the pulsation in the peripheral arteries has weakened. At the time of inspection, symptoms of muscle atrophy are detected, hairline is reduced on the legs, nail plates thicken and their growth slows down.
The skin most often turns pale, and the disease is accompanied by cyanosis of the toes. When the patient lifts and bends the foot, it becomes pale. If you return the lower limb to its original position, the sole reddens sharply.
To find out the exact diagnosis, the doctor refers to an instrumental study.
- In order to determine the ankle-brachial index, the systolic pressure in the area of the shoulder and tibia is measured, after which their ratio is determined. In a healthy person, the pressure on the ankle is higher. If an elevated level is found on the shoulder, this indicates obstructive damage to the arteries and aorta of the lower extremities.
- With the help of duplex scanning, the intensity of blood flow in blood vessels is detected. This method identifies problems that are not noticed by conventional ultrasound. The degree of sensitivity of the method is 85-90 percent.
- The most high-precision method for obtaining high-quality images with high resolution is considered to be computed tomangiography. Thanks to this research, the doctor can clearly visualize calcium overlays.
- Contrasting with gadolinium is often used in conjunction with MRI. The presence of a pacemaker is a contraindication to this type of diagnosis, and the study is not conducted if renal filtration is below 30 ml / min.
Before performing a surgical operation, a digital subtraction angiography is required, which is highly accurate.
Information on the diagnosis of atherosclerosis is provided in the video in this article.