Atherosclerosis is a disease of the arteries, and therefore it can affect any artery in your body. The most likely arteries affected are the arteries to your heart, the arteries going to your brain or the carotid arteries, and the arteries in your abdominal aorta going to your legs. Atherosclerosis is essentially a degenerative condition, and it involves the development of plaque in the wall of the vessel, but as it develops and progresses, it encroaches on the artery and therefore can cause narrowing of the artery and therefore limit blood flow. There are a lot of causes of atherosclerosis. There's not one thing that causes it, so it really is a disease or a condition that has many factors, and we call those risk factors, and they include diabetes, hypertension, high cholesterol, smoking, and family history. Most patients that have atherosclerosis will describe a family history, but it's not a very strong predictor and it doesn't doom you to having coronary disease or atherosclerosis.
It's important to note that you can have a lot of atherosclerosis throughout with no symptoms, and so the lack of symptoms doesn't mean you don't have this condition. It's really only until arteries get narrowed severely that it leads to some of the symptoms that you can develop. So starting with the heart, patients can develop chest pain, they can develop shortness of breath and symptoms related to the blocked arteries. If you have atherosclerosis in your leg arteries, then you may develop pain or discomfort in your calves, in your thighs or in your hips when walking. And then finally, it can affect the arteries going to the brain. So those would cause symptoms that are worrisome for stroke, and that would include things like slurred speech, transient weakness, or numbness, difficulty with their vision.
Medications are really the first line treatment, and those medications are designed to help reduce cholesterol and to stabilize the disease process. Then there are more aggressive treatments that are used, we call them revascularization, and those are to restore the blood flow, and there's a lot of different surgical options. Those surgical procedures are more aggressive, there's more risk involved, and they are reserved for patients who essentially fail medical therapy or have very severe advanced disease that requires restoration blood flow. So the advantage of UVA is we really have a multidisciplinary approach to the treatment, management, and diagnosis of atherosclerosis. We work together very collaboratively, and so since this condition affects multiple vascular beds, you therefore need the input of multiple different specialties.