What Is an Atheroma?

An artery is a flexible blood vessel that carries oxygen-rich blood away from the heart to other tissues and organs of the body. It has a smooth inner lining (called the endothelium), allowing an unobstructed flow of blood.

However, atheromas, or plaque buildups, can obstruct that flow of blood.

Atherosclerosis is the condition caused by atheromas. It’s marked by arteries narrowed with and hardened by plaque. The term originates from the Greek words athero, meaning paste, and sclerosis, meaning hardness.

Atheromas and the atherosclerosis they produce can lead to things like cardiovascular disease. Cardiovascular disease is linked to 1 of every 3 deaths in the United States.

Atheromas can occur in any artery, but they are most dangerous in the medium-to-large arteries of the heart, arms, legs, brain, pelvis, and kidneys. They don’t just suddenly arise after an unhealthy meal. They accumulate over many years, often starting in childhood.

According to the National Heart, Lung, and Blood Institute, the exact cause of atheromas and the atherosclerosis they produce isn’t fully known. But researchers suspect that atheromas occur after repeated injury to the endothelium, which causes inflammation. This injury is produced by both genetic and lifestyle factors. In response to the injury, the body sends white blood cells to the affected area. These cells morph into what are known as foam cells. These cells attract fat and cholesterol and thereby help encourage the growth of atheromas.

Things that cause injury to artery walls include:

• high blood pressure (hypertension)
• diabetes
• obesity
• high cholesterol
• smoking
• inflammatory diseases such as lupus and rheumatoid arthritis
• age
• sex (men and postmenopausal women are at higher risk)

Atheromas can grow steadily over the course of many years. Most people don’t even know they have them until they become so large they’re restricting blood flow, or until a piece of one breaks off and obstructs an artery. Symptoms vary depending on which arteries are affected and how much the atheroma is blocking blood flow.

Cardiovascular

When an artery supplying blood to the heart is affected by atheromas, you may experience symptoms of a heart attack or heart disease. These symptoms can include any of the following:

• chest pain
• weakness
• fatigue
• sweating
• jaw, abdominal, and/or arm pain

Cerebral/carotid

When arteries in the neck that supply blood to the brain are restricted or blocked, you may experience a stroke or a transient ischemic attack (TIA). A TIA is a kind of “mini” stroke with more fleeting neurological effects. Symptoms of both include:

• loss of vision in one eye
• slurred speech or trouble talking
• weakness or paralysis on one side of the body
• sudden, severe headache
• dizziness or loss of balance

Peripheral arteries

These arteries transport blood to the arms and legs, but the legs seem most prone to dangerous atheromas. Symptoms of problems include:

• cramping, usually in the calf
• burning or aching in the feet and toes, usually at rest
• toe and foot sores that do not heal
• feet that are cold to the touch
• red skin, or skin that changes color

Your doctor can diagnose an atheroma and the atherosclerosis it causes in a variety of ways. With a Doppler ultrasound, high-frequency sound waves bounce off your heart and arteries. This shows how blood is flowing and whether there are blockages.

An echocardiogram, which is akin to an ultrasound of your heart, can also give an image of how blood flows. A CT scan can show narrowing of arteries.

Angiography gives a picture of your veins by using dyes and X-rays. And something called the ankle-brachial index can compare the blood pressure in your ankle with that in your arm. This helps doctors diagnose peripheral artery disease.

Treating uncontrolled risk factors is the first step to halting the damage from atheromas. That may mean taking:

• medications (usually statins) to reduce cholesterol
• anti-hypertensives (such as ACE inhibitors) to lower blood pressure
• glucose-control medications to treat diabetes

If artery blockages are severe, your doctor may recommend surgery to clear them. Methods include angioplasty, which involves widening a narrowed artery with a balloon threaded onto a catheter. (A stent may be used to keep the artery open once the balloon passes through.)

Artery bypass grafting may also be an option. This is when a healthy vein is grafted to an artery above or below the blockage to redirect the flow of blood.

Carotid endarterectomy removes plaque from the carotid arteries in the neck that supply blood to the brain.

While you can’t control all the risk factors that promote atheromas, you can control some.

• Quit smoking. According to the Merck Manual, people who quit smoking cut their risk of cardiovascular disease in half when compared to those who don’t quit. What’s more, former smokers have a better chance of surviving a heart attack than current smokers.
• Change your diet. Limit fat to no more than 25 to 35 percent of your daily calories. Consume fewer saturated and trans fats — the kind that can raise cholesterol levels. Try to eat at least five servings of fruits and vegetables daily and increase your intake of fiber-rich foods. One study looked at the health benefits of a Mediterranean diet that included 30 grams of mixed nuts daily. Atherosclerosis plaque formation was reduced or halted in the group following the diet versus those in the low-fat diet group who saw plaque formation continue to progress.
• Ask your doctor about the role of supplements. According to the Mayo Clinic, niacin (a B vitamin) can increase HDL (the “good cholesterol”) in the bloodstream by 30 percent. Also, a study published in the Journal of Nutrition suggests that aged garlic extract not only reduces arterial plaque but also lowers blood pressure.

Virtually everyone will develop some degree of atheromas as they age. For a lot of people, they pose no risks. But when the atheromas become so large they inhibit blood flow, serious problems can occur. This is more likely to happen if you are overweight, have diabetes, smoke, or have high blood pressure.

If you have any of health problems that put you at increased risk for atheromas or are experiencing symptoms of these plaque formations, make an appointment to see your doctor.