Topic Progress:

Atherosclerosis

Atherosclerosis is a local thickening (plaque) of the inner most layer of elastic and muscular arteries (intima), such as the aorta, coronary, cerebral, internal carotid, iliac, femoral and mesenteric arteries. Blood vessels with a diameter of less than 3µm are not affected (Tortora & Derrickson, 2014).

This condition presents as fatty deposits called atheroma, laid down in the arteries. The flow of blood through the artery can become impaired by the build-up of atheroma.

The artery can also become completely blocked by this build up, or from a blood clot forming on the rough surface of the deposits. Smokers are more likely to develop atherosclerosis (Powell, 2010; ASH, 2016).

There are also other risk factors for the development of atherosclerosis, which include:

  • Cigarette smoking
  • Hyperlipidaemia
  • Hypertension
  • Obesity
  • Physical inactivity
  • Age 65+
  • History of coronary artery disease
  • Family history
  • Diabetes mellitus
  • Oxidative stress (e.g. Angiotensin II – free radical)

There are a number of clinical conditions caused by atherosclerosis:

Brain Renal
Cerebrovascular disease Renal artery disease
Transient ischaemic attacks Renal failure
Cerebral thrombosis (stroke) Hypertension
Heart Gut
Coronary artery disease Mesenteric artery disease
Stable angina Intestinal angina
Unstable angina
Myocardial infraction
Thorax & abdomen Lower limbs
Aortic artery disease Peripheral vascular disease
Aortic dissection Intermittent claudication
Aortic aneurysm Critical limb ischaemia
Acute limb ischaemia

(Ockenden, 2001).

These atherosclerosis-derived conditions are caused by the effects of reduced or occluded blood flow to an area of tissue, and this results in pain, dysfunction and, at the worst end of the spectrum, tissue death (Ockenden, 2001).

Arterial ulceration (explained further in Module 4) results from a lack of adequate blood supply to adequately perfuse tissues. Atherosclerosis is the reason for reduced blood supply and, therefore, the commonest cause for arterial ulceration (Moffatt, 2001; Wound Source, 2019).