Creation of bypass circuits
If the vessels become constricted as a result of arteriosclerosis (hardening of the arteries) and a lack of oxygen occurs, the body reacts with some countermeasures to compensate for the oxygen debt. With the reduced vascular volume in arteriosclerosis, there is an increase in blood pressure in front of the constricted vascular section. Anatomically, there are already numerous bypass circuits of the large vessels, also known as anastomosis.
As blood pressure rises in the corresponding vascular segment, the blood flow through these bypass vessels increases. However, these can only compensate for a certain part of the oxygen debt, because they are usually thinner and cannot transport as much oxygen-rich blood. With slowly progressing arteriosclerosis and the associated opening up of bypass vessels, a certain oxygen requirement can be met, but if an acute occlusion (infarction) occurs, the immediately required amount of blood usually cannot be transported. Even with chronic and slow constrictions, the capacity of the anastomosis vessels is exhausted at some point and the patient suffers clinical symptoms.
Causes of arteriosclerosis
The causes of arteriosclerosis are mainly to be found in our modern way of life. The predominantly sedentary occupation and the abundance of food combined with an almost constant stress level favour the development of arteriosclerotic plaques and thus make arteriosclerosis and its secondary diseases the number one cause of death in industrialised countries. The main cause of calcium deposits is an imbalance in blood lipid levels.
The most important value is cholesterol, which can be divided into good, protective HDL and bad LDL. The “bad” LDL is deposited from the blood on the vessel walls. There it is absorbed by cells and so-called foam cells are formed.
These attract further messenger substances, which over time leads to solid calcification of these areas in the vessel. The higher the blood lipid values are, the faster and more often these plaques develop. In addition, high blood pressure can put the vessel walls under stress and thus further accelerate the development of the calcifications.
High blood lipid values and high blood pressure are the result of our usually unhealthy and unbalanced diet. However, the chronic lack of exercise also plays its part in the fact that more and more people fall ill with high blood pressure, high blood fats and thus arteriosclerosis. The diagnosis of arteriosclerosis is usually made relatively late, as the clinical symptoms become apparent late.
An initial suspicion of arteriosclerosis can be confirmed during the patient interview. If the patient gives this information, the doctor will suspect, among other things, a vascular change in the form of vascular calcification (arteriosclerosis). In the case of arteriosclerotic changes in the leg or arm arteries, the so-called Ratschow’s position test can provide certainty.
One asks the patient to lift the affected arm or leg into the air so that the blood from the parts flows back to the middle of the body. To speed this up, the patient is asked to open and close the fist quickly or, with the leg pointing upwards, to rotate the feet. After a few minutes, the leg or arm is placed on the couch and the time required for the blood to return to the body area is measured (return of blood=red coloration of the skin).
If the time is more than 7 seconds, an artery occlusion must be concluded. However, this procedure is not used in heart failure or in severe PAD. In order to confirm the diagnosis of arteriosclerosis, ultrasound is the method of choice in cases of vasoconstriction of the aorta, the renal artery or the arteries of the legs and arms.
With the so-called Doppler examination, the blood flow and turbulence can be made visible and constrictions identified. Constrictions of the carotid artery with subsequent undersupply of the brain can also be made visible in this way. The neurological examination in the case of arteriosclerosis can indicate brain undersupply, listening to the carotid artery can reveal flow noises, the walking test can indicate the suspicion of a vascular constriction affecting the legs.
A cold and pale extremity indicates complete arterial occlusion. This is an absolute emergency and must be treated as soon as possible to save the corresponding limb. The blood test
In general, a blood test and the collection of blood lipid values also indicate arteriosclerosis or the risk of arteriosclerosis.
Here the cholesterol values and here the LDL cholesterol values are particularly important. If LDL values are high and HDL values are low, a high Arterioskleroseroserisiko exists. Well it is a LDL decrease and a HDL increase.
(HDL is a protein that quickly transports cholesterol from the blood into the cells). In addition, triglycerides should be determined in the laboratory, which are also considered risk factors for arteriosclerosis. The neurological examination for arteriosclerosis can indicate a brain deficiency.
In general, a blood test and the collection of blood lipid values also indicate arteriosclerosis or the risk of arteriosclerosis. Here, the cholesterol values and the LDL cholesterol values are particularly important. If LDL values are high and HDL values are low, a high Arterioskleroseroserisiko exists.
Well it is a LDL decrease and a HDL increase. (HDL is a protein that quickly transports cholesterol from the blood into the cells). In addition, triglycerides should be determined in the laboratory, which are also considered risk factors for arteriosclerosis.
- Complaints in the breast during exercise
- Or increasing memory loss,
- Symptoms of paralysis
- Or dizziness or syncope,
- Also, an indication of the distance that can be covered before the pain in the legs becomes tractive often indicates arteriosclerotic changes in the vessels. – Furthermore, atherosclerosis patients with increasing narrowing of the leg arteries indicate pain when lying down, which only improves when the leg is lowered. – Listening to the carotid artery can produce flow sounds,
- The walking test may indicate a suspected vasoconstriction affecting the legs.
- A cold and pale extremity indicates complete arterial occlusion. This is an absolute emergency and must be treated as quickly as possible to save the limb in question. Arteriosclerosis is a disease for many different disciplines.
It is primarily treated by an internist. If the heart is affected by the plaques, cardiologists are consulted. Vascular surgeons are usually responsible for deposits in the leg vessels or the carotid artery. Ideally, arteriosclerosis is treated on an interdisciplinary basis, i.e. with cooperation.
