Dr. Maciej Malinski is on the medical staff at Sherman Hospital. He has been kind enough to answer some frequently asked questions related to maintaining a healthy heart. Look for additional articles in our popular Ask the Cardiologist series over the coming weeks.
Q: I was recently diagnosed as having severe atheroma in my aorta and descending coronary artery-what can be done about this? I’ve had 2 TIAs and feel like I’m a walking time bomb. Help! -Colleen
A: What you refer to is atheromatous plaque. Atheroma in the arterial vessel is an accumulation in the artery wall that is made up of various cells and cell debris containing lipids (cholesterol, and another fats), calcium and fibrous tissue. The process forming this pathological structure starts in young children, and all children older than 10 have them. It is an unhealthy condition, but it is present in all older humans.
As we age we develop more atheromatous plaques, and in some people the arteries (in the heart, brain, legs) become severely narrowed, and they become diseased. That is what we call cardiovascular disease (CVD). Depending on which organs are affected it can be called coronary artery disease (heart), TIA/stroke (neck or brain), or peripheral arterial disease (pelvis and legs).
That’s a lot of information to take in, so let’s back up a bit. TIA stands for transient ischemic attack. You can think of it as a mini-stroke in which all the symptoms are the same as a stroke, but they last for less than 24 hours. If the symptoms persist for longer than 24 hours, the TIA officially becomes a stroke.
Sometimes people also have large atheromatous plaques in the largest artery in the body, the aorta. When pieces of this plaque go to peripheral arteries they can ‘plug’ them causing small strokes/TIAs in the brain or kidney damage.
As you now know, we all have these plaques, so to a certain extent we are all loaded with “time bombs,” so to speak. But it turns out that not everybody develops the symptoms, and not at the same age. So far we can’t explain it, but most likely this depends on both our lifestyle and our genes.
The most effective approaches to reduce atheroma progression are:
- reduction in saturated fat ( meat, cheese, milk ) intake
- if indicated, treatment with cholesterol-lowering medications, especially ones known as statins
- aerobic exercise
- normalizing blood glucose levels
- weight loss
- if indicated, aspirin
As you see, help is available. The best option for you, Colleen, is to see your cardiovascular specialist if you’ve already had symptoms, which it sounds like you have. Thanks so much for your question!
Do you have a question for Dr. Malinski? To submit your question, either post it in the comments section below or email email@example.com with the subject line “Question for Dr. Malinski.” For more information on heart health, click here to visit Sherman’s Heart and Vascular Center.
This post is published by Sherman Health to provide general health information. It is not intended to provide personal medical advice, which should be obtained directly from your physician.