Should I be concerned about atherosclerosis throughout my body?

Question

I recently had a heart attack. The diagnosis was that I had 2 blockages (atherosclerosis) in my heart arteries and 2 stents were put in. If this is happening in my heart arteries, what about all the rest of the arteries in my body? Aren't they also forming blockages? What about them? Should I be worried? What will that cause if they become blocked as well? I am currently on Plavix and Crestor for blood thinning and cholesterol.

Answer 1

Certain arteries are much more at risk than others for arterosclerosis. The carotid arteries, vertebral (and other cranial arteries), aorta, renal, illiac, and femoral arteries are all included. Some people seem more predisposed for peripheral vascular disease than do others - for reasons that are not clear. And for some reason the arteries in your arm and shoulders are not usually affected.

As part of a full evaluation, I would expect your cardiologist to at least screen you for:

*claudication symptoms (tightness and/or pain in your leg muscles with activity, improved with rest)

*renal disease (elevated creatinine, difficult to control b/p)

*carotid disease (auscultation of your neck arteries, questioning about any of mini strokes or TIAs, and/or referral for a carotid ultrasound.)

I doubt this would happen in the hospital, in the context of you just having had a heart attack...first things, first.

Being a smoker has a very high correlation to PVD and if you are - and if the heart attack wasn't convincing enough - this should add to it. Also beating your cholesterol levels down to where your LDL's are to 70 or below and HDL's as high as possible, have actually demonstrated some regression of plaques angiographically (per the HATS and ARBITER2 studies See this link as an example: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?itool=abstractplus&db=pubmed&cmd=Retrieve&dopt=abstractplus&list_uids=15537681). You may want to consider adding long-acting niacin to your current therapy - discuss it with you physician.

In short, it is a concern, but unless you are having clear cut symptoms associated with PVD, then this is something that can be evaluated over time. Many of the things you are doing for your coronary artery disease will be helpful on the peripheral vascular disease front as well.

Good luck.

Oh, I see Razwell came by to add his two cents. If you don't know him, he's a troll that patrols this forum claiming that cholesterol control has no benefit in reducing heart disease and probably PVD. I think his proof is insubstantial but its a free country. Oh and it goes without saying, my income has nothing to do with writing prescriptions - its like getting people to stop smoking and answering questions on this forum - You do it because it helps.