Aortic sclerosis

Introduction Aortic sclerosis is mainly caused by damage to the endothelium of the aorta and decreased blood vessel elasticity. Caused by high blood pressure, mainly due to the increase in systolic blood pressure. If aortic sclerosis occurs, it suggests that the body also has arteriosclerosis. Therefore, treatment should be carried out as soon as possible. In order to prevent the occurrence of cardiovascular and cerebrovascular diseases, such as cerebral hemorrhage, cerebral infarction, and angina pectoris, heart infarction, and even sudden cardiac death.

Cause

Arteriosclerosis is a vascular disease that occurs with the age of a person. Its regularity usually occurs during adolescence, and it is aggravated and ill in the middle-aged and old age. More men than women, the disease has gradually increased in China in recent years, becoming one of the main causes of death in the elderly. The most important causes of arteriosclerosis are hypertension, hyperlipidemia, and smoking. Other obesity, diabetes, lack of exercise, nervousness, advanced age, family history, and temper are all related.

Hypertension: High-pressure blood flow causes mechanical damage to the arterial intima caused by long-term impact on the arterial wall, causing blood lipids to deposit on the arterial wall, forming fatty plaques and causing arteriosclerosis and stenosis. Blood pressure is not controlled, the incidence of myocardial infarction is about 2 to 3 times higher, and the stroke is about 4 times.

Hyperlipidemia: The amount of fat in the blood is too high to deposit on the inner wall of the blood vessel to form plaque, resulting in narrowing of arteriosclerosis. Diabetes: Diabetic people have problems with fat metabolism. Proteins that transport fat in the blood (called lipoproteins) are degenerated. During transport, fat is easily deposited on the inner walls of blood vessels to form fatty plaques.

Smoking: Nicotine, carbon monoxide, etc. in cigarettes can damage the inner wall of the artery, and the inner wall of the injured artery will trap cholesterol, causing platelet accumulation to form fatty plaque. At the same time, smoking can also cause coronary artery contraction and reduce blood flow.

Lack of exercise: exercise can increase high-density lipoprotein, reduce low-density lipoprotein, help the body excrete excess cholesterol from the biliary tract and intestines, and prevent excess cholesterol from depositing on the inner wall of blood vessels. In addition, exercise can promote blood circulation, increase blood vessel elasticity, lower blood pressure, consume excess calories, reduce body fat weight, increase muscle mass, and reduce weight. Therefore, people who lack exercise can easily get atherosclerotic arteriosclerosis.

Obesity: People who are obese or overweight have a higher cardiac load and a higher chance of abnormal blood fat. Early diagnosis, prevention and health care of arteriosclerosis increase the risk of atherosclerosis. Obesity, easy to promote high blood pressure, diabetes, hyperlipidemia, insulin resistance syndrome.

Excessive pressure: People will increase the secretion of adrenaline due to stress, which will cause blood pressure to rise, heart rate to accelerate, and damage the inner wall of arterial blood vessels.

Family history: refers to the genetic factors, so that some people have early inherited atherosclerotic disease, the cause is still unclear, and some are severe hypercholesterolemia, which accumulates in the blood, which in turn promotes arteriosclerosis. Some are early-onset hypertension, or are prone to thrombosis.

an examination

Related inspection

Vascular color Doppler coronary angiography

Most have no specific symptoms. At the time of percussion, the dural area of the posterior sternum can be found widened; the second heart sound of the aortic valve area is followed by a metallic tone with systolic murmur. The systolic blood pressure is increased, the pulse pressure is widened, and the radial artery palpation can be similar to the pulse. X-ray examination showed that the aortic node protruded to the upper left, the aorta was dilated and distorted, and sometimes the calculus in the flaky or arcuate plaque was visible.

Aortic atherosclerosis can also form an aortic aneurysm, which is most common in the abdominal aorta below the renal artery opening, followed by the aortic arch and descending aorta. Abdominal aortic aneurysm was found to have a pulsatile block in the abdomen during physical examination. It was found that the corresponding part of the abdominal wall could hear murmur, and the femoral artery pulsation could be weakened. Thoracic aortic aneurysm can cause chest pain, shortness of breath, difficulty swallowing, hemoptysis, vocal cord paralysis due to compression of the recurrent laryngeal nerve, tracheal displacement or obstruction, compression of the superior vena cava and pulmonary artery. X-ray examination showed an increase in the corresponding part of the aorta; aortic angiography showed a fusiform or cystic aneurysm. Two-dimensional ultrasound imaging, computerized tomography, and magnetic resonance tomography can show tumor-like aortic dilation. Once the aortic aneurysm ruptures, it can be fatal. Atherosclerosis can also form a dissection aneurysm, but it is less common.

Differential diagnosis

Coronary atherosclerosis

Can cause angina, myocardial infarction and myocardial fibrosis, etc., will be detailed in the next section.

Cerebral atherosclerosis

Cerebral ischemia can cause symptoms such as dizziness, headache and fainting. Cerebral arterial thrombosis or rupture of blood vessels causes cerebrovascular accidents, headache, dizziness, vomiting, sudden loss of consciousness, limbs, paralysis, hemianopia or aphasia (see "Acute Cerebrovascular Diseases" for details). When the brain is atrophy, it causes dementia, symptoms such as psychopathy, dysfunctional movements, mental and memory loss, and complete personality changes (see "Psychological disorders associated with cerebral arteriosclerosis").

Renal atherosclerosis

It is rare in clinical practice and can cause refractory hypertension. Those who are over 55 years old and suddenly have high blood pressure should consider the possibility of this disease. If there is renal artery thrombosis, it can cause pain in the kidney area, urinary closure and fever.

Mesenteric atherosclerosis

May cause symptoms such as indigestion, decreased intestinal tension, constipation and abdominal pain. When the thrombus is formed, there is severe abdominal pain, bloating and fever. When the intestinal wall is necrotic, it can cause symptoms such as blood in the stool, paralytic ileus, and shock.

Extremity atherosclerosis

The lower extremities are more common, especially the leg arteries. Due to blood supply disorders, the lower extremities are cold, numb and intermittent claudication, that is, the gastrocnemius muscles are numb, painful and even paralyzed when walking, disappear after rest, and then appear again; With persistent pain, the lower extremity arteries, especially the dorsal artery, have weakened or disappeared. Arterial lumen can produce gangrene if it is completely occluded (see "occlusive arteriosclerosis").

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