Internal Medicine

Symptoms of atherosclerosis

introduction

Vascular constrictions due to arteriosclerosis can also cause different symptoms, depending on the affected vascular section. It is important to mention that the first arteriosclerotic changes do not cause any symptoms at all and are not noticed. A certain amount of vascular narrowing is normal, even with a healthy lifestyle, depending on age and begins at a young age.

First symptoms

No symptoms of arteriosclerosis are perceived up to a restriction of 50% of the vascular lumen, as the bypass circuits mentioned can cover the oxygen debt. If the arteriosclerosis progresses, if the coronary arteries are affected, stress-dependent symptoms such as chest pain occur.
With further constriction it comes to rest pain and with complete closure to infarction (heart attack). In the vessels that supply the brain, symptoms of memory impairment, neuronal failures, paralysis (mostly in decline) and unconsciousness with falls (Syncope). If it is completely closed, a stroke occurs, which, if not treated in time, can result in permanent paralysis and memory impairment.

If the vessels of the extremities are affected, minor constrictions lead to drawing pains in the leg after prolonged walking.

Symptoms on the legs / feet / toes

Atherosclerosis of the blood vessels that lead to the feet is called peripheral arterial occlusive disease - PAD for short. Here, the arteriosclerotic narrowing of the blood vessels ensures that insufficient oxygen and heat no longer reach the extreme end of the blood vessels, i.e. to the toes, via the blood.

This results in a circumstance that older people in particular complain about: cold feet.

However, it must be said that not every person with "permanently" cold feet suffers from PAD. Diabetes is another major factor that creates cold and, above all, pain-resistant feet.
In the case of arteriosclerosis of the blood vessels in the leg, there are some indications of reduced blood flow, especially on the toes. In addition to the cold, these are above all very thick and mostly brittle toenails. The reduced blood flow ensures that more cells in the toenails die and, like a kind of cornea, ensure that the toenails increase in thickness.

Another very prominent symptom is toes that are very pale. Normally, if your toes are squeezed firmly between two fingers, blood will fill up again within a second and they will regain their rosy color. In patients with PAD this takes significantly longer, or the toes mostly remain pale whitish.

Do these symptoms apply to you? - Then read more about one here Circulatory disorder in the feet

Symptoms on the arms / hands / fingers

A very classic symptom when the blood vessels in the arms are affected by arteriosclerosis is the fact that fingers and hands are cold.

Do you have cold hands? - Then find out more here: Cold hands

Conversely, cold hands do not mean that everyone with cold fingers or hands automatically has an arteriosclerotic problem. There are many circumstances that can cause people to get particularly cold hands. However, the fact that arteriosclerosis of the upper extremities produces cold fingers and hands is logical in that less blood - as a transport medium for oxygen and heat - reaches the fingers. This is the best way to identify the insufficient supply of oxygen.

Those affected usually have so-called drumstick fingers and watch glass nails. To put it simply, the reduced oxygen transport through the blood vessels ensures that more body cells die at the end of the route, i.e. at the fingertips. These form more calluses there than normal, so that the fingertips appear almost bloated. Hence the name drumstick finger.

The cause behind the watch glass nails is basically the same. In this case, however, the cells of the fingernails are no longer adequately supplied with oxygen and begin to die. The result is a fingernail that is significantly thicker and larger than a normal fingernail, so-called watch glass nails.

If these symptoms apply to you, you can find out more at:

Circulatory disorder in the arm
Circulatory disorders in the finger

Symptoms in the bowel

The symptoms that affect the intestine are rather unspecific. Mainly it concerns stomach pain. Calcification of the vessels that supply the intestine with blood can only be confirmed with certainty when the corresponding blood vessels are examined more closely using CT or MRI.

The abdominal pain cannot be provoked by pressure on the abdomen and could possibly become worse during sporting activity, since the belly is already less supplied with blood during sport.

Atherosclerosis of the intestinal blood vessels almost never occurs in isolation and is only rarely the organ that causes the most unpleasant symptoms. As a rule, blood vessels in the arms, legs or the carotid arteries are affected much earlier and their effects cause much more unpleasant symptoms.

Do these symptoms apply to you? - Then find out more about one here Circulatory disorder in the intestine

Symptoms of the aorta

Symptoms of the aorta, the so-called main artery, do not usually affect it directly, but rather organs that receive their blood supply from the main artery.
For example, the kidneys are supplied with much less blood, which causes damage to the kidneys and an increase in blood pressure.

However, atherosclerosis of the aorta can only be visualized with the help of ultrasound, CT or MRI. Since the calcifications in arteriosclerosis tend to accumulate at bifurcations or branches of the blood vessels, the main artery is a predestined blood vessel.

Do you suspect you have a blocked carotid artery? - Then the following articles can help you:

Clogged carotid artery - what to do?
Diseases of the aorta

Symptoms in the brain

Atherosclerosis does not actually affect the brain, but rather the blood vessels that supply it. Mainly the two carotid arteries. They are the main supply lines for the brain.

As with other organs, a reduced blood flow ensures that cells die at the end of the supply path because they are no longer adequately supplied with oxygen. Since certain regions in the brain are linked to different abilities, the symptoms always depend on which part of the brain is currently suffering from an insufficient supply.

Conversely, this also has the advantage that the examiner knows in which region to look for the reduced blood flow if he can correctly interpret the symptoms.
For example, motor difficulties can arise. Actions can be slightly delayed, etc.

Furthermore, if the blood flow to the brain is further restricted, there may be brief fainting. For example, by getting up too jerkily or something similar.
However, arteriosclerosis usually only becomes really clear when a thrombus or embolus is deposited in the constriction, which leads to a complete closure and then to a stroke. Those affected usually begin to talk slurred; sometimes it can also lead to temporary paralysis of the arms, legs, hands or feet.

Are you afraid of a stroke? - Then read all about them here Signs of a stroke

Coronary artery disease (CHD) symptoms

The coronary heart disease CHD is probably the most prominent place for the occurrence of arteriosclerosis, also the place that can be best treated with today's technology.
Classically, patients with CHD stand out because they feel a tightness of the chest during physical exertion. It's like having a heavy stone on your chest that makes it difficult for you to breathe.

Depending on the severity of the arteriosclerosis, this condition can last longer or shorter and can occur with heavier or lighter physical stress. The symptoms become fulminant when the constriction is blocked by blood clots or a calcium deposit flakes off and the blood flow to the heart muscle is completely interrupted. Then there is talk of a heart attack, which is associated with nausea and chest tightness. In men, there is usually also a pain radiating into the left arm.

Symptoms of peripheral arterial occlusive disease (PAD)

PAD - the peripheral arterial occlusive disease - affects the arms or - much more often - the legs. The blood flow is reduced by the arteriosclerotic deposits, so that the temperature balance in the hands and feet is not functioning properly. The sick people therefore often complain of cold hands and cold feet.

Another striking feature is the limited walking distance that patients can walk without having to stop. The muscles of the legs suffer from the insufficient blood supply and start to hurt, so that people have to stop to allow their muscles to relax. This is the reason why the PAOD got its name “intermittent claudication”.

Division into stages

A classification according to Fontaine indicates the severity of the constriction. In stage 1 of arteriosclerosis, the patient has no symptoms. Stage 2a of arteriosclerosis causes pulling pain when walking more than 200 meters, in stage 2b of arteriosclerosis it is less than 200 meters. If the patient is already in pain at rest, it is stage 3. If the arteries are completely blocked and the corresponding areas die off, it is called stage 4. Peripheral arterial occlusive disease is also known as intermittent claudication because the patient stops after a few meters have to stay and want to cover up their complaints by looking at the shop window. The forced to stand still after a certain distance is also known as intermittent claudication.