Read the text carefully to obtain detailed understanding of it. Vascular disease includes any condition that affects the circulatory system

Vascular disease includes any condition that affects the circulatory system. As the heart beats, it pumps blood through a system of blood vessels called the circulatory system. The vessels are elastic tubes that carry blood to every part of the body. Arteries carry blood away from the heart while veins return it. Vascular disease ranges from diseases of your arteries, veins, and lymph vessels to blood disorders that affect circulation. The following are conditions that fall under the category of vascular disease.

Atherosclerosis is the build up of a waxy plaque on the inside of blood vessels that affects only the inner lining of an artery and is characterized by plaque deposits that block the flow of blood. It is often called arteriosclerosis. Atherosclerosis, a progressive process responsible for most heart disease, is a type of arteriosclerosis or hardening of the arteries.

Plaque is made of fatty substances, cholesterol, waste products from the cells, calcium, and fibrin, a stringy material that helps blood to clot. As the inner layer of the artery wall thickens, the artery's diameter is reduced, and blood flow and oxygen delivery are decreased.

Plaques can rupture or crack open, causing the sudden formation of a blood clot (thrombosis). Atherosclerosis can cause a heart attack if it completely blocks the blood flow in the heart (coronary) arteries. It can cause a stroke if it completely blocks the brain (carotid) arteries. Atherosclerosis can also occur in the arteries of the neck, kidneys, thighs, and arms, causing kidney failure or gangrene that leads to amputation.

Figure 1. Atherosclerosis picture

Symptoms differ depending upon the location of the atherosclerosis, but include chest pain, heart attack, or sudden death, dizziness, weakness, loss of speech, blindness, disease of the blood vessels in the outer parts of the body (peripheral vascular disease), and high blood pressure that is difficult to treat.

Physicians may be able to diagnose atherosclerosis during a physical exam by means of a stethoscope and gentle probing of the arteries with the hand (palpation). More definite tests are electrocardiography, echocardiography or ultrasonography of the arteries, radionuclide scans, and angiography. Coronary angiography is the most accurate diagnostic method and the only one that requires entering the body (invasive procedure).

Treatment for atherosclerosis includes lifestyle changes, lipid-lowering drugs, coronary angioplasty (a non-surgical procedure in which a catheter tipped with a balloon is threaded from a blood vessel in the thigh into the blocked artery), and coronary artery bypass surgery. Atherosclerosis requires lifelong care.

Patients who have less severe atherosclerosis may achieve adequate control through lifestyle changes and drag therapy. Many of the lifestyle changes help prevent the disease and promote good health. Most of the drugs prescribed for atherosclerosis seek to lower cholesterol. Alternative therapies that focus on diet and lifestyle can help prevent, retard, or reverse atherosclerosis. These include some herbal therapies, relaxation techniques, and dietary modifications. Atherosclerosis can be successfully treated but not cured.

A heart attack is the death of, or damage to, part of the heart muscle because the supply of blood to the heart muscle is severely reduced or stopped.

A heart attack occurs when one or more of the coronary arteries that supply blood to the heart are completely blocked, cutting off blood to the heart muscle. The blockage is usually caused by atherosclerosis, the build-up of plaque in the artery walls, and/or by a blood clot in a coronary artery.

Sometimes, a healthy or atherosclerotic coronary artery has a spasm and the blood flow to part of the heart decreases or stops. Why this happens is unclear, but it can result in a heart attack.

More than 60% of heart attack victims experience symptoms before the attack, sometimes days or weeks before. Sometimes people do not recognize the symptoms of a heart attack or are in denial that they are having one. Symptoms are:

• Uncomfortable pressure, fullness, squeezing, or pain in the centre of the chest. This lasts more than a few minutes, or may go away and return.

• Pain that spreads to the shoulders, neck, or arms.

• Chest discomfort accompanied by lightheadedness, fainting, sweating, nausea, or shortness of breath.

All of these symptoms do not occur with every heart attack. Sometimes, symptoms disappear and then reappear. A person with any of these symptoms should immediately call an emergency rescue service or be driven to the nearest hospital with a 24-hour cardiac care unit, whichever is quicker.

Experienced emergency care personnel can usually diagnose a heart attack simply by looking at the patient. To confirm this diagnosis, they talk with the patient, check heart rate and blood pressure, perform an electro­cardiogram, and take a blood sample.

Figure 2. A heart attack

Heart attacks are treated with cardiopulmonary resuscitation (CPR) when necessary to start and keep the patient breathing and his heart beating. Additional treatment can include close monitoring, electric shock, drug therapy, revascularization procedures, coronary artery bypass surgery, or repair of blood vessels using a tiny plastic tube tipped with a balloon that compresses the plaque and opens the blocked artery (angioplasty).

Many heart attacks can be prevented through a healthy lifestyle including eating right (foods that are low in fat, especially saturated fat; low in cholesterol; and high in fibre; plenty of fruits and vegetables; and limited sodium), regular exercise, maintaining a healthy weight, no smoking, moderate drinking, no illegal drugs, controlling hypertension, and managing stress.

Daily aspirin therapy may help prevent blood clots associated with atherosclerosis. It can also prevent heart attacks from both recurring and being fatal, and lower the risk of strokes.