Aortic atherosclerosis (aortosclerosis): what it is and why it is dangerous

Aortic atherosclerosis (aortosclerosis) is thickening of the wall of the body's largest vessel due to the deposition of cholesterol plaques. Let us explain what this wording means.

What aortic atherosclerosis and aortosclerosis are

Atherosclerosis is a chronic disease of elastic and musculo-elastic arteries. Cholesterol and lipoproteins are deposited under the inner lining, plaques form; then connective tissue grows within them (sclerosis), calcium appears, the wall becomes deformed, and the lumen narrows up to complete blockage. The aorta is an elastic-type artery, so it takes part in this process.

A plaque is a dense structure of cholesterol, fats, blood cells, and calcium: it hardens, and the vessel loses its ability to dilate. Mechanically, it is like scale in a pipe: the lumen is narrowed, the wall is rough, and the heart-pump works in a system that has lost its elasticity.

Why aortic atherosclerosis occurs

Deposits often begin to form in childhood and increase with age. The exact cause is unknown; the process is linked to damage to the artery wall caused by habits, diseases, and heredity. First, lipid spots appear in the wall, then leukocytes migrate to oxidized lipoproteins. Plaques more often form at arterial branch points, where even blood flow is disturbed.

• age: risk increases after 45 years in men and after 55 years in women;
• smoking and tobacco in any form;
• high cholesterol, high blood pressure, diabetes, kidney disease;
• excess body weight and physical inactivity;
• family history of cardiovascular disease and high cholesterol.

Reference points: total cholesterol above 5 mmol/L and LDL above 3 mmol/L. The list also includes metabolic syndrome, inflammatory diseases such as rheumatoid arthritis and psoriasis, and postmenopause. European prevention guidelines suggest assessing leading risk factors using the SCORE scale.

What manifestations occur and why it stays silent for a long time

In the early stages there are usually no symptoms: the wall changes over years, and complaints appear when the body needs more oxygen — during physical or emotional stress.

Common signs: chest pain, pain in the arms and legs during exertion, shortness of breath, constant fatigue, weakness, confusion. The picture depends on the affected arteries: coronary — angina, palpitations, shortness of breath; carotid — a bruit that the doctor hears with a stethoscope, and transient ischemic attack; leg arteries — pain and cramps when walking. In men, erectile dysfunction is sometimes an early risk signal.

How atherosclerosis is detected

The doctor takes a history of diseases and family history, asks about habits and risk factors, performs an examination, listens to the heart and blood flow in the arteries, and orders blood tests and heart investigations. Next, it is clarified which arteries are affected and how limited the blood flow is.

Possible complications

Without lifestyle changes and medical care, atherosclerosis progresses over time. Plaque rupture triggers thrombus formation: it can close the artery or travel further with the bloodstream. Outcomes depend on the territory — heart attack, stroke, peripheral artery disease, vascular dementia, loss of a limb. Established changes cannot be fully reversed today.

Which doctor to see

With a conclusion of "aortic atherosclerosis" or "aortosclerosis", people usually start with a visit to a doctor (cardiologist). A reason to come without a long delay is chest pain that comes and goes, shortness of breath, or pain in the arms or legs during walking.

The mere mention of aortosclerosis in a conclusion is not a reason to call an ambulance. Call 103 or 112 for signs of a heart attack (squeezing pain or a feeling of a heavy weight in the chest), for signs of a stroke (drooping corner of the mouth on one side, inability to raise both arms, impaired speech), for severe difficulty breathing and sudden confusion, when a person cannot think or speak clearly.

This material is for reference: it explains terms from a conclusion but does not replace consultation with a doctor who sees the patient and their test results.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer