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Vascular disease
Reviewed by Dr Neal Uren, consultant cardiologist and Dr Patrick Davey, cardiologist and Dr Stephen Collins, GP
What is a vascular disease?
Vascular disease is mainly caused by atherosclerosis (hardening of the arteries) due to a thickening of the lining of the arteries (the intima).
The arteries are blood vessels that supply blood, oxygen and nutrients, to the body from the heart. Atherosclerosis is a condition leading to narrow, hardened arteries so that there is insufficient blood flow to satisfy the needs of the tissue in question.
Those parts of the body most affected by this disease suffer the consequences of an inadequate blood supply, namely poor function, tissue damage or death.
There are different symptoms depending on where in the body the vascular disease occurs. It most commonly affects the arteries of the heart, brain and legs.
The brain - cerebrovascular disease
The legs - peripheral vascular disease
What are the risk factors?
What are the symptoms of atherosclerosis in the coronary arteries?
If any of the arteries supplying the heart (coronary arteries) get completely blocked (coronary thrombosis), that part of the heart muscle deprived of a supply dies, causing a heart attack (myocardial infarction).
If you have risk factors for cardiovascular disease, beware of heavy or tight chest pain, sometimes also experienced in the throat or left arm. Pain of this nature, not settling within 20 minutes, should be assessed urgently by a doctor or paramedic.
What are the symptoms of atherosclerosis in the arteries of the brain?
Alternatively, smaller diseased arteries may rupture and bleed into the brain (cerebral haemorrhage).
Both of these events damage the brain and are collectively referred to as strokes (cerebrovascular accidents or CVAs).
A stroke normally produces a sudden onset of symptoms. Depending on the artery affected, symptoms can include paralysis, speech difficulties, difficulty swallowing, visual and sensory disturbances.
What are the symptoms of atherosclerosis in the arteries of the legs?
In the early stages of the condition, the pain usually occurs in the calves with a particular walking distance or effort, but settles again after 5 to 10 minutes' rest.
The pain is the effect of muscles not being supplied with enough blood to cater for the physical effort demanded. More advanced atherosclerosis may cause constant pain at rest, ulceration of the lower leg and even gangrene in the toes and feet.
Atherosclerosis in the arteries of the brain can lead to strokes that cause paralysis or loss of other function, such as speech.
In the legs, atherosclerosis may cause cramping pain in the muscles on exertion (intermittent claudication).
Atherosclerosis strikes many people. It can start at the age of 20 and increases with advancing age. The exact cause is unknown but several risk factors are understood to accelerate the formation of atherosclerosis:
A mild degree of atherosclerosis does not cause any symptoms. More severe cases of coronary atherosclerosis may be associated with chest pain on exertion that settles within a few minutes of rest (angina).
Diseased arteries in the brain can become blocked by clots associated with atherosclerosis (cerebral thrombosis) either in the main carotid arteries or in smaller cerebral arteries.
Atherosclerosis in the arteries of the legs can cause cramping leg pain on exertion that settles after a few minutes' rest (intermittent claudication).
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