I remember a patient, let’s call him Mr. David. He was a cheerful fellow in his early 60s, always insisting he felt “absolutely grand.” He’d pop in for his yearly check-up, mostly, I think, because his wife made him. We were chatting one day about his lifestyle – he did enjoy his hearty meals and perhaps a few too many cigarettes – and we decided to run a couple of extra checks. The results were a bit of a shock for him: clear signs of significant build-up in his arteries. “But Doc,” he said, looking genuinely puzzled, “I feel perfectly fine!” And that, right there, is often the tricky bit with something called an atheroma.
So, What Exactly Is an Atheroma?
You might be wondering, what is an atheroma? In simple terms, think of it as a kind of gunk. It’s a fatty substance that can quietly, slowly build up on the inside walls of your arteries. You’ll also hear doctors and nurses call it atherosclerotic plaque, or just plaque for short. Now, this isn’t like the plaque that your dentist talks about on your teeth. This particular plaque sets up shop inside your blood vessels – those vital roadways that carry blood all around your body.
This atheroma stuff is a real mix of things that are normally circulating in your blood:
- Cholesterol and other fats – these are often the main components.
- Various blood cells.
- Calcium – this is what can make the plaque hard, leading to what people sometimes call “hardening of the arteries.”
- Tiny bits of proteins and inflammatory cells – these are signs your body is reacting to the buildup.
When this plaque accumulates, it’s a process we call atherosclerosis. So, to put it simply: atheroma is the material, and atherosclerosis is the condition of that material building up. It’s not something that happens in a flash; it’s more of a slow creep. It can actually start when people are much younger than they imagine, sometimes even in their teens or twenties.
You might also hear about aortic atheroma. This just means the plaque is building up in your aorta, which is the largest artery in your body. It’s a big, important vessel, and plaque there (also known as atherosclerosis of the aorta) can increase the risk for serious things like an aortic aneurysm (a bulge in the artery wall), a heart attack, or a stroke.
And just to be clear, an atheroma is not a tumor or anything cancerous. The name might sound a bit like some tumor names, but it’s purely related to your blood vessels and heart health.
What Causes Atheroma to Form?
How does this atheroma gunk even start to build up? Well, it usually begins when the inner lining of your artery, called the endothelium, gets a bit damaged. Scientists are still learning all the ins and outs of this, but once that lining is compromised, plaque can start to form at that spot. And then, it tends to grow.
Several things can increase your risk of this happening:
- Having conditions that cause ongoing inflammation in your body, like rheumatoid arthritis.
- Diabetes.
- A diet that’s heavy in saturated fat, trans fat, and cholesterol.
- High blood pressure.
- High cholesterol levels (specifically, high LDL or “bad” cholesterol).
- High triglycerides (another type of fat in your blood).
- Getting older. Men tend to face a higher risk after 45, and women after 55 (often post-menopause).
- Smoking and using tobacco products – this is a big one.
Interestingly, these atheromas don’t just form anywhere. They seem to prefer spots where arteries branch off or split. Think of it like traffic jams on a road – they’re more likely at busy intersections than on a clear, straight stretch.
Atheroma Symptoms: The Silent Warning Signs
One of the sneakiest things about atheroma buildup – this atherosclerosis – is that you often don’t feel a single thing. Not a whisper. That is, until an artery is significantly clogged, sometimes more than 70% blocked! It’s like a hidden drain slowly getting clogged; you don’t realize there’s a problem until the water starts backing up.
If symptoms do eventually surface, what you experience really depends on which “blood highway” is getting jammed:
- Arteries supplying your heart (coronary arteries): You might feel a pressure, squeezing, or discomfort in your chest, particularly when you’re active. This is often called stable angina, and it usually eases up when you rest.
- Arteries supplying your legs (iliac or femoral arteries): This can cause pain in your legs, especially in the calves, when you walk. It typically gets better with rest. We call this claudication.
- Arteries supplying your brain (carotid arteries): Worryingly, the first real sign here can be a stroke or a transient ischemic attack (TIA), which is like a mini-stroke.
- Arteries supplying your intestines (mesenteric arteries): Some people experience stomach pain after they eat. It’s sometimes referred to as “abdominal angina” or postprandial cramps.
- Arteries supplying your kidneys (renal arteries): This can lead to secondary hypertension (high blood pressure that’s caused by another medical condition) and, over time, might reduce how well your kidneys function.
It really can be a silent troublemaker, can’t it? That’s why regular check-ups are so important.
Diagnosing and Managing Atheroma Buildup
So, if atheroma is often so quiet, how do we find out it’s there? This is where your friendly family doctor and regular check-ups come into play. We’ll have a good chat about your medical history, your family’s health history, and your lifestyle – all these things give us important clues.
To get a clearer picture, we might suggest:
- Blood tests: These help us check your cholesterol levels (the good, the bad, and the triglycerides), your blood sugar, and other markers of inflammation or kidney function.
- Blood pressure checks: A simple, quick, but incredibly vital measurement.
- Sometimes, if your risk factors are high or you have symptoms, we might consider imaging tests. An ultrasound can look at the arteries in your neck (your carotids), or a special CT scan can look for calcium in your heart arteries, which is a sign of plaque.
Now, the big question I often get: “Doc, can you just get rid of these atheromas once they’ve formed?” Unfortunately, it’s not like we can go in and scrub your arteries clean. Once that plaque is there, it’s pretty much there to stay.
But – and this is a really important “but” – we can absolutely do a lot to slow down the progression of atherosclerosis. We can work to stop those plaques from getting bigger, or from becoming unstable and causing a sudden blockage. The goal is to reduce your risk of serious problems like a heart attack or stroke.
Here’s what we usually focus on:
- Lifestyle Adjustments (These are key!):
- Medications (When needed):
Sometimes, lifestyle changes alone aren’t enough, or your risk is already quite high. In these cases, we might talk about medications:
- Statins or other drugs are very effective at lowering cholesterol.
- There are many good medications to help control high blood pressure.
- Sometimes, a daily low-dose aspirin might be recommended to help prevent blood clots, but this isn’t for everyone, so it’s a decision we make together.
We’ll always sit down and discuss all the options, weighing the benefits and any potential side effects, to come up with a plan that’s right for you.
Key Things to Remember About Atheroma
Alright, that was quite a bit of information, I know. So, let’s just boil it down to the main points. When we’re talking about atheroma and keeping your arteries healthy:
- Atheroma is the medical term for that fatty plaque that can build up inside your arteries.
- This buildup process is called atherosclerosis, and it’s serious because it can narrow your arteries and lead to major health events like heart attacks or strokes.
- It’s often a “silent” condition, meaning you might not have any symptoms until it’s quite advanced.
- Key risk factors include things like smoking, an unhealthy diet, high cholesterol, high blood pressure, and diabetes.
- While we can’t usually make existing atheroma disappear completely, we can definitely slow down its growth and reduce your risks through positive lifestyle changes and, if necessary, medications.
- Regular medical check-ups are your best ally for understanding your risk and catching any potential issues early on.
It can all sound a bit daunting, I understand. But knowing what atheroma is and what you can do about it is the very first, and most powerful, step towards taking good care of your heart and your health. And please remember, you’re not alone in figuring this out. We’re here to help guide and support you every step of the way.