The most well known form of arteriosclerosis is atherosclerosis, but the disease actually occurs in three forms: atherosclerosis, Monckeberg medial calcific sclerosis, and small artery arteriosclerosis. Arteriosclerosis is characterized by a hardening of the arteries due to thickening and a loss of elasticity in the arterial walls.
Arteriosclerosis symptoms occur when it involves the arteries supplying the heart, brain, kidneys, and lower extremities. When affecting the heart, the disorder results in a heart attack (myocardial infarction) by preventing oxygen from flowing to the heart tissue. Heart attack symptoms are chest and arm pain or numbness. Blocking the blood flow to the brain results in stroke, or cerebral infarction, and the symptoms are dizziness, numbness, and headaches. If arteriosclerosis affects the lower extremities it may be felt as pain when walking during the development of peripheral vascular disease, or gangrene of the legs. Other end results or symptoms of atherosclerosis are seen at death, including aortic aneurysms or dissections, aortic dilations, and thrombosis or embolism.
Atherosclerosis treatments include diet and lifestyle changes such as reducing cholesterol intake, exercise, and to stop smoking cessation. Prescription medications to reduce blood levels of cholesterol or to prevent clotting, as well as surgery to bypass or remove the affected arteries, are also options.
An overview of the various types of arteriosclerosis:
Atherosclerosis is the most common form of arteriosclerosis. The disorder is named for the cholesterol-filled (atherosclerotic) plaques that build up in the larger arteries over time. The arteries usually affected are the coronary arteries and aorta. Age is the dominant influence for the development of atherosclerosis, and there is a five times greater risk of a heart attack, which is the result of the coronary arteries being closed off by a plaque, between the ages of 40 and 60. Men are more prone to developing the disease than women until menopause.
There is a familial predisposition, or hereditary nature, to the disease. Other risk factors include diet, lifestyle, and personal habits such as a high intake of cholesterol (hypercholesterolemia) and saturated fats (hyperlipidemia), cigarette smoking, and being diagnosed with another disease including chronically high blood pressure (hypertension), diabetes mellitus, homocystinuria, and hyperhomocystinemia which can be caused by low folate and vitamin B intake.
The plaques begin naturally as a fatty streak in the arteries of children and adolescents. New channels for blood flow are cut through the edges of the plaque in a process called neovascularization. The atherosclerotic plaques generally continue to enlarge through reorganization and further accumulation of lipids when they are available, resulting in a hardened and clogged artery.
Occlusive plaques are known as lesions and they may rupture, ulcerate, or erode the inner arterial surface; hemorrhage; thrombose; or cause an aneurysmal dilation by weakening the arterial wall. When occurring in the coronary arteries, those supplying the heart, it can result in heart attacks, chest pain (angina pectoris), sudden cardiac death perhaps from plaque rupture or vasospasm, and chronic ischemic heart disease with chronic heart failure.
Other Forms of Arteriosclerosis
Another form of arteriosclerosis that occurs due to deposits in the arteries is Monckeberg medial calcific sclerosis. This is a disorder characterized by calcium deposits in the muscular arteries of persons over 50 years of age.
The third form of arteriolosclerosis consists of two variants that occur in the small arteries and arterioles, hyaline arteriosclerosis and hyperplastic arteriosclerosis. These disorders may induce downstream ischemic injury, which is a reduction in the oxygen that gets to the tissue and results in cell death, and are most often associated with hypertension and diabetes.
Hyperplastic arteriolosclerosis is an "onion-skinning" of the artery seen in severe hypertension, with the inner diameter, lumen, being obliterated. In malignant hypertension, the arteriole may undergo necrosis. Hyaline arteriolosclerosis is caused by leakage of blood plasma components across the endothelium, and is seen in the elderly and in nephrosclerosis.
Kumar, Cotran, Robbins. Robbin's Basic Pathology, 7th edition (medical school text)