Atherosclerosis

Overview

Atherosclerosis of the aorta is a chronic disease in which fatty deposits, cholesterol, calcium, and other substances accumulate inside the wall of the aorta. Over time, these deposits, called plaques, cause the aorta to become stiffened. Because the aorta carries oxygen-rich blood from the heart to the rest of the body, this condition can greatly impact cardivascular health, as the normal elasticity of the aorta is important for a normal blood pressure.

The process develops gradually over many years and is closely linked to common risk factors such as high blood pressure, high cholesterol, smoking, diabetes, obesity, and aging.

Symptoms

Atherosclerosis of the aorta usually develops silently. Most people have no symptoms until the disease becomes advanced or complications occur. When symptoms appear, they are mostly caused by atherosclerosis of different vessels for example:

  • Coronary Arteries: Chestpain or discomfort (angina)

  • Carotid Arteries: Numbness or weakness in limbs, even permanent strokes

  • Groin Arteries: Pain, numbness and coldness in the lower extremities.

Diagnosis

Doctors often diagnose aortic atherosclerosis through a combination of clinical evaluation and imaging tests, including:

  • Blood tests: to check cholesterol levels, blood sugar, and inflammation markers

  • Ultrasound (Doppler): to assess blood flow and detect plaque formation

  • CT angiography or MR angiography: to obtain detailed images of the aorta and plaque buildup

  • Transesophageal echocardiography (TEE): to closely examine the thoracic aorta

Complications

If untreated, atherosclerosis of the aorta can lead to severe and potentially life-threatening problems, including:

  • Acute Aortic Syndromes

  • Embolism (plaque or clot fragments blocking blood flow to vital organs such as the brain, kidneys, or legs, depending on the branches involved)

  • Stroke or transient ischemic attack

  • Chronic kidney disease or intestinal ischemia when branch arteries become involved

Treatment

Management aims to slow disease progression, relieve symptoms, and prevent complications. Treatment generally includes a combination of lifestyle changes, medication, and, in some cases, surgery.

Lifestyle changes:

  • Quitting smoking

  • Following a heart-healthy diet low in saturated fats and high in fruits, vegetables, and whole grains

  • Regular physical activity

  • Maintaining a healthy weight

Medications:

  • Statins to lower cholesterol and stabilize plaques

  • Antihypertensive drugs to control blood pressure

  • Antiplatelet therapy (such as aspirin) to reduce the risk of clot formation

  • Diabetes management as necessary

Procedures or surgery:

In cases where the disease causes acute aortic events or other complications, surgical or endovascular repair may be required to reinforce or replace the affected section of the aorta.