Monday, April 4th, 2011

Before discussing the symptoms of atherosclerosis, it would be imperative to know about the disease itself. Atherosclerosis disease is basically a slow process of thickening the wall of arteries causing the less flow of blood in any part of the body as it can affect any organ of the body. but it becomes more fatal when it affects the arteries leading to the heart or brain. it is the narrowing of the arteries being occurred due to the formation of plaques in the inner part of these blood vessels. the thickness of the blood vessels increases with age.

Atherosclerosis has become a major cause of death in America since it affects the blood vessels not only leading to heart and brain but also some most important organs like kidney, intestine, etc resulting in the less supply of blood to these organs and causing more complications.

The paradox of this disease is that it affects right from adolescent stage but at the same time it’s not symptomatic. the symptoms become obvious only when the blood supply to an organ is severely reduced. this condition is called ischemia which causes discomfort and pain. Sometimes people die without the knowledge of any such symptoms as they suffer from sudden heart attack or stroke. Moreover, the symptoms also depend upon the fact that which part of your body is affected with the less supply of blood.

If blood vessels leading to the heart are affected you will have coronary artery disease. in that case you may feel pain in the heart there will be all possibility of heart attack.if blood vessels leading to brain get affected, you might suffer from cerebrovascular disease and you tend to have Ischemic attack.if arteries of your legs are affected you are prone to peripheral arterial disease. in that case you feel intermittent pain in your thighs and you won’t have smooth walk.

Some notable signs and symptoms of atherosclerosis are given below:

1. Pain in the shoulder2. Heart attack or stroke3. Brain stroke4. Blood clotting in legs5. Pain and cramps in legs6. Claudicating7. Thrombosis in coronary artery8. Erectile dysfunction

All the symptoms can be confirmed by a doctor only because some signs of atherosclerosis may match with the symptoms of some other diseases.

CHICAGO, Ill. (March 29, 2011)—A new interventional radiology treatment that blocks blood supply to men’s enlarged prostate glands shows comparable clinical results to transurethral resection of the prostate (or TURP), considered the gold standard (or most common) treatment. However, this minimally invasive treatment—prostatic artery embolization—has none of the risks associated with TURP, such as sexual dysfunction, urinary incontinence, blood loss and retrograde ejaculation, noted researchers at the Society of Interventional Radiology’s 36th Annual Scientific Meeting in Chicago.

“Benign prostatic hyperplasia or BPH is so common that it’s been said that all men will have an enlarged prostate if they live long enough. I believe that a minimally invasive interventional radiology treatment—prostatic artery embolization or PAE—will be the future treatment for benign prostatic hyperplasia or men’s noncancerous enlarged prostates,” noted João Martins Pisco, M.D., chief radiologist at Hospital Pulido Valente and director of interventional radiology at St. Louis Hospital, both in Lisbon, Portugal. “Prostatic artery embolization blocks blood supply to treat noncancerous benign prostatic hyperplasia. this study is significant because it shows comparable clinical results to transurethral resection of the prostate or TURP—without the risks of surgery, such as sexual dysfunction, urinary incontinence, blood loss and retrograde ejaculation (or entry of semen into the bladder),” added Pisco, who is a professor at the Faculty of Medical Sciences, New University of Lisbon. “While the gold standard treatment for enlarged prostates has been TURP, minimally invasive prostatic artery embolization is safe, performed under local anesthesia and has comparable clinical results—without TURP’s limitations and risks,” said Pisco. The interventional radiologist indicated that PAE patients experienced symptom improvement comparable to TURP; however, certain urodynamic results (such as flow rate of the urinary stream) did not improve as much as with TURP.

TURP can be performed only on prostates smaller than 60󈞼 cubic centimeters (cc); there is no size limitation for PAE treatment, said Pisco. “The best results are obtained on patients with prostates larger than 60 cubic centimeters and with very severe symptoms,” he added. “Pelvic arterial embolization may be the only feasible and effective treatment for benign prostatic hyperplasia in those men who cannot have TURP due to the size of their prostate (80+ cubic centimeters) or because it is inadvisable for them to undergo general anaesthesia,” said Pisco.

BPH is not cancer; it is a condition that affects a man’s prostate, a gland found between the bladder and the urethra. as a man ages, the prostate gland slowly grows bigger (or enlarges) and may press on the urethra and cause the flow of urine to be slower and less forceful. BPH is characterized by urinary frequency, urgency, passing urine more often (particularly at night), weakened stream and incomplete bladder emptying. “Such symptoms can have significant negative impact in quality of life, leading many men to seek treatment,” said Pisco. “We need innovative technologies, such as prostatic artery embolization, to continue to improve outcomes and minimize patient discomfort and morbidity when managing enlarged prostates,” he added.

An estimated 19 million men in this country have symptomatic BPH, (14 million undiagnosed; 2 million diagnosed but untreated). Statistics show that a small amount of prostate enlargement is present in many men over age 40, as many as 50 percent experience symptoms of an enlarged prostate by age 60 and more than 90 percent of men over the age of 85 will report symptoms.

João Martins Pisco, M.D., is the chief radiologist at Hospital Pulido Valente and director of interventional radiology at St. Louis Hospital, both in Lisbon, Portugal.

(Photo Credit: Society of Interventional Radiology, sirweb.org)

“The men who were treated with prostatic artery embolization showed significant clinical improvement,” said Pisco. In this study, 84 men (ranging in ages from 52 to 85) with symptomatic BPH underwent prostatic artery embolization after failing other medical treatments for at least six months, said Pisco. The men were followed for more than nine months (on average), and PAE was found to be technically successful in 98.5 percent of the patients—with 77 men showing “excellent” improvement, six men “slight improvement” (but needing no medications) and one experiencing no improvement (due to receiving an incomplete embolization), he added. two hours after PAE, most men were passing urine less frequently. It was impossible to embolize both prostate arteries in the men showing “slight improvement” due to advanced atherosclerosis, said Pisco. according to Pisco, he used angiography (by pelvic magnetic resonance and computed tomography) to evaluate the possibility of embolizing prostatic blood vessels.

Prostatic artery embolization is performed by an interventional radiologist, a physician who is trained to perform this and other types of embolization and minimally invasive procedures. an interventional radiologist makes a tiny nick in the skin in the groin and inserts a microcatheter into the femoral artery. Using real-time imaging, the physician guides the catheter through the artery and then releases tiny particles, the size of grains of sand, into the prostatic arteries that supply blood to the tumor. these tiny particles block blood flow to the tumor, causing it to shrink. following PAE treatment, most men experience no pain to light pain and leave the hospital four to eight hours after intervention. “There is no sexual dysfunction following prostatic artery embolization, and a quarter of our patients report that sexual function improved after the procedure,” added Pisco.

BPH can be treated by TURP, a procedure in which a scope is inserted through the penis and the prostate is removed piece by piece, or surgery through an abdomen incision (prostatectomy). During surgery, a man generally undergoes general anaesthesia and needs to spend several days in a hospital. Major complications are frequent, such as blood loss, severe pain, sexual dysfunction, impotence, retrograde ejaculation, urinary incontinence, pain, infections and urethral stricture, said Pisco.

Other treatments for enlarged prostrates—besides prostatic artery embolization, TURP and prostatectomy—include watchful waiting, drugs (to relax muscles near prostate to ease symptoms or help shrink the prostate) and other minimally invasive therapies (such as transurethral needle ablation and laser surgery), which have major disadvantages, such as providing less effective improvement in symptoms, poorer durability of symptomatic benefit, and greater risk of continued catheterization and reoperation. “Additional research is needed to explain why some patients improve better than others,” said Pisco.

what are the symptoms of blood clots?

When a thrombus occupies more than 75% of surface area of the lumen of an artery, blood flow to the tissue supplied is reduced enough to cause symptoms because of decreased oxygen (hypoxia) and accumulation of metabolic products like lactic acid. More than 90% obstruction can result in anoxia, the complete deprivation of oxygen, and infarction, a mode of cell death.
Cerebral thrombosis (blood clot in the main cerebral artery of the brain) may cause stroke.
Coronary thrombosis (blood clot in the coronary artery) may cause heart attack.
Deep vein thrombosis may cause pulmonary embolism.
Symptoms will differ according to the location of the blood clot in the various organs of the body.

What are the symptoms of blood clots?

Venous clots do not allow blood to return to the heart and symptoms occur because of this damming effect. Most often occurring in the legs or the arms, symptoms include:

•swelling,

•warmth,

•redness, and

•pain.
Arterial clots do not allow blood get to the affected area.

•Pain is the initial symptom of this ischemia, or oxygen deprivation due to loss of blood supply.

•Other symptoms depend upon the location of the clot, and often the effect will be a loss of function. Heart attack and stroke are self-explanatory.

•In an arm or leg, in addition to pain, the limb may appear white, and weakness, loss of sensation, or paralysis may occur.

•If the blood supply is lost to an area of the bowel, in addition to intense pain, there may be bloody diarrhea.

A bad headache. Difficulty focusing. Confusion or fumbling to find words. It’s tempting to explain away troubling symptoms and chalk them up to fatigue, eye trouble, one too many cups of coffee. But these symptoms – particularly if they’re severe – may signal a stroke.Stroke is the third leading cause of death, behind cancer and heart disease. A disease that affects the blood supply to the brain, stroke occurs when a blood vessel or artery is blocked by a blood clot or bursts. when this happens, the area of the brain that is supplied with oxygen and nutrients by this blood vessel is damaged. as a result, the body part or function controlled by this part of the brain doesn’t operate the right way.another frightening statistic: according to the National Stroke Association, people who have a stroke are four times as likely to have another stroke during their lifetime. Recurrent strokes carry an even higher risk of death and disability because the brain has previously been injured by the original stroke.A stroke can change a person’s life forever. it can leave the victim with moderate to severe physical, mental or psychological disabilities. Depending on the area of the brain affected, a stroke victim may lose their memory, speech, balance, certain fine motor skills, control over certain muscles or movement of entire limbs – even paralysis of one side of the body. A person’s personality or behavior can be forever changed by a stroke. they may have difficulty reading, processing information or even eating.About 87 percent of all strokes are ischemic strokes, where a blockage of a blood vessel that supplies blood to the brain occurs. the clot can form in the brain area, or in a blood vessel elsewhere in the body – the heart, chest area or neck – where it can break loose and travel to the brain. the remaining 13 percent are called hemorrhagic strokes – strokes caused by a weakened blood vessel that breaks and bleeds into the surrounding brain tissue. A brain aneurysm refers to the bulging of the weakened blood vessel, which continues to weaken and, if not treated, breaks and bleeds into the brain.if you suspect that someone is having a stroke, act quickly. A stroke is an emergency – and mere seconds can make an enormous difference in the outcome for a stroke survivor. call 9-1-1 and try to recall the time that symptoms first appeared. if a stroke victim receives immediate medical assistance, a clot-busting drug can be administered by medical personnel within three hours of first symptoms which may reduce the likelihood of long-term disability resulting from a stroke. the quicker that medical care is received, the greater a stroke victim’s chances are of not only surviving a stroke, but minimizing its effects.Learn to recognize stroke signs, and be prepared – to save a friend or loved one’s life, or your own.Warning Signs of a Stroke• Sudden numbness or weakness of the face, arm or leg, especially on one side of the body.• Sudden confusion, trouble speaking or understanding.• Sudden trouble seeing in part of one’s visual field.• Sudden trouble walking, dizziness, loss of balance or coordination.• Sudden, severe headache with no known cause.Not all of these warning signs may be present, and one or more may go away. Don’t ignore these signs or dismiss them, even if they do not persist. call 9-1-1 or seek medical assistance immediately.this information is not intended to replace the advice of your doctor, but rather to increase awareness and help equip patients with information and facilitate conversations with your physician that will benefit your health.Editor’s note:  this information was writte and provided by Dr. Allen Tyler.  Dr. Tyler is a member of the medical staff at Pottstown Memorial Medical Center, Department of Internal Medicine – Neurology.  he is a graduate of the University of Pennsylvania, and received his medical degree from Jefferson Medical College.  he also completed a postgraduate Fellowship in Neurophysiology & Epilepsy at Thomas Jefferson University Hospital.  he is a member of the American Academy of Neurology; the American Clinical Neurophysiology Society; the American College of Physicians; American Society of Internal Medicine and the American Epilepsy Society. 

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