Dr. S.M.Sadikot.
Hon. Endocrinologist, Jaslok Hospital and Research Centre, Mumbai 400026
Macrovascular disease, or atherosclerosis as it is widely called, is a progressive disease of the large and medium sized arteries. The name is derived from the Greek "athero" meaning gruel or paste and "sclerosis" meaning hardening.
What is Atherosclerosis?
Atherosclerosis is often referred to as "hardening of the arteries."
It is a build up of cholesterol and other fat substances within the walls of the arteries.
It is a progressive disease and can develop in any artery in the body.
A gradual build up of fatty deposits (cholesterol and fat), called plaque, that occurs on the inside of the lining of the artery wall causing the opening to narrow. These deposits usually develop over many years.
Narrowing of the arteries by 70% or more decreases the blood flow through the artery and may prevent body tissues and organs from receiving an adequate blood supply. This lack of blood flow decreases the amount of oxygen being delivered to the tissues and organs resulting in symptoms such as aching or pain in the chest (angina) or cramping in the legs.
Permanent damage to body tissues and organs can occur if the blood and oxygen supply disruption is prolonged or very severe. Permanent damage results in the death of that area being supplied and is referred to as an infarction.
The inner lining of the normal artery is smooth and free of blockages or obstructions. Scientists think the disease starts when the very inner lining of the artery (the intima) is damaged.
In the early stages of the disease, lipid is deposited in the intima, the so called "fatty streaks". These streaks are flat or slightly elevated pale yellow areas, of variable size and shape.
This progresses to the stage of a fibrous plaque.
Fibrous plaques are raised firm pale areas in the intima of arteries which on cross section reveal central lipid rich debris with surrounding fibrous tissue. The streaks are only minimally raised and thus do not produce any obstructions or symptoms.
