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Heart Disease - Related Disorders

Arterial obstruction and occlusion by fatty deposits (atheroma) are not confined to the coronary arteries. This is a general disease of the arteries. It occurs in the aorta and its larger branches, especially those of the brain and the lower limbs. By the age of 60, most people can be presumed to have atheromatous lesions spread over their arterial tree. Such lesions may be profound in those who have bee indulging in an unhealthy life-style marked by factors such as excessive smoking, lack of physical activity, obesity, hypertension and uncontrolled diabetes.

Why do you want to discuss the aforementioned disorders in a book on heart attacks?
These related disorders are mentioned here for three reasons. First, a patient of ischaemic heart disease may, in addition, exhibit symptoms related to the brain. It is not uncommon for a patient to have repeated transient ischaemic attacks of the brain and then have a heart attack or hemiplegia. Secondly vascular surgery is making rapid progress and it is becoming increasingly feasible to replace diseased arteries, where accessible, with artificial ones. Thirdly, we must examine how much we stand to make additional gains by taking precautions against coronary artery disease.

Do these lesions also create as many problems as the coronary artery lesions?
The lesions in the aorta may remain completely symptomless unless they produce obstructions at critical points like the bifurcation of the aorta. The lesions in the legs are much less likely to create problems than the coronary artery lesions. The lesions in the arteries of the brain also may remain symptomless until and unless clotting of blood on a lesion or a spasm of the artery produces stoppage of the blood flow. These lesions can also lead to problems if the blood pressure suddenly falls to very low levels, say, due to a heart attack or after taking an excessively large dose of antihypertensive drugs. In such situations, the blood flow through the already partially obstructed arteries may come to a standstill and cause thrombosis ( clot) and produce infarction of the brain. After the heart, the brain is the next most frequently affected organ.

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