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    Your Arterial Lifeline

    Are you at risk for hidden complications of atherosclerosis?

    Diseases Caused by Atherosclerosis: Beyond the Heart continued...

    Angina can be stable, meaning symptoms progress slowly or not at all, and don't permanently damage heart muscle.

    If a plaque gets disrupted, unstable anginacan result. In unstable angina, chest discomfort changes, becomes more severe, or occurs at rest. "Usually, this means there is inflammation in the plaque," which is now highly dangerous, says Silverman.

    Unstable angina can quickly transform into a blood clot, blocking a coronary artery. This causes a heart attack, or myocardial infarction. Heart muscle, starved for blood, dies.

    Heart attacks also frequently occur with no prior symptoms of angina. "The initial symptom of a heart attack in 50% of men is sudden death," warns Silverman.

    Heart attacks or severe blockages can also cause heart failure. "The heart doesn't really fail, but can't pump blood well enough to keep up with demand," says Mosca. The result can be shortness of breath with activity, or leg swelling. Heart failure is a serious problem, and atherosclerosis is one of the most common causes.

    Your Brain

    Our brains demand an enormous amount of energy, delivered by blood through a handful of arteries in our necks and heads. A stroke happens when a vital artery delivering blood to the brain becomes blocked. If the artery is not reopened quickly, the brain tissue it supplies dies. Permanent brain damage can result in lasting weakness or difficulty with speech.

    In a transient ischemic attack (TIA), stroke symptoms occur, but then resolve. Most likely, TIAs are caused by blockages that somehow improve spontaneously. TIAs are near-misses, warning that a real stroke could occur at any time.

    Half of all strokes are caused by atherosclerosis. Similar to a heart attack, a stroke is a "brain attack." An unstable atherosclerotic plaque ruptures, a blood clot forms, and the artery is blocked. Less commonly, a plaque elsewhere breaks off and travels up an artery into the brain.

    Your Legs and Feet

    Progressive narrowing of the arteries of the legs leads to peripheral arterial disease. Symptoms are in the muscle groups of the leg (buttock, thigh, or calf) and most often occur with exercise, disappearing with rest. They can occur on one side or both.

    "Although some people are incapacitated by the chronic pain caused by peripheral arterial disease, this is rare," says Silverman. "Many people have no symptoms at all, even with significant disease," he adds.

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