Atherosclerose

Atherosclerose, also known in English as atherosclerosis, is a chronic disease of the arteries characterized by the accumulation of lipids, calcium and inflammatory material in the inner walls. These plaques thicken and stiffen the vessel wall, narrowing the lumen and impairing blood flow. Plaque rupture can trigger thrombosis, potentially causing heart attack or stroke.

Pathophysiology involves endothelial dysfunction and inflammatory processes that promote lipid deposition, smooth muscle cell proliferation and plaque growth. Risk factors include nonmodifiable elements such as age and family history, and modifiable factors such as high LDL cholesterol, hypertension, diabetes, smoking, obesity and physical inactivity. Diet and metabolic factors also contribute.

Symptoms depend on which arteries are affected. Coronary artery involvement may produce angina or myocardial infarction, carotid or cerebral involvement may cause transient ischemic attacks or stroke, and peripheral artery disease can lead to leg pain with exertion. Many people have no symptoms until advanced disease or acute events.

Diagnosis combines clinical risk assessment, blood tests and imaging. Tools include lipid profiles and blood pressure measurement, carotid ultrasound, CT coronary calcium scoring, CT angiography and duplex ultrasound. In some cases invasive coronary or peripheral angiography is used. Additional tests may assess ischemia or cardiac function.

Prevention and treatment focus on risk factor control and symptom relief. Lifelong lifestyle changes, statins or other lipid-lowering drugs, antihypertensive therapy, and antiplatelet treatment where appropriate reduce event risk. Revascularization with angioplasty and stenting or bypass surgery may be indicated for significant obstructive disease.

Prognosis varies with overall risk profile and plaque stability. Atherosclerose remains a leading cause of cardiovascular morbidity and mortality worldwide, though early detection and comprehensive management can improve outcomes.