Arterial disease – when the arteries become blocked

Arterial disease - when the arteries become blocked

Everyone knows the dire consequences of arteriosclerosis on the heart and brain: heart attacks and strokes are life-threatening, common diseases that everyone fears as they get older. However, hardening of the arteries also leads to severe diseases in the abdominal and leg arteries. Then, one speaks of an arterial occlusive disease (AVK) or – more correctly, in connection with the extremities – of the peripheral arterial occlusive disease (PAD).

What is arteriosclerosis?

Atherosclerosis is a hardening and narrowing of the arteries, the blood vessels that transport blood away from the heart, that occurs over years or decades. The narrowing of the arteries leads to reduced blood flow and less oxygen supply to the organs and parts of the body.

Unfortunately, we still do not know precisely why arteriosclerosis develops, but certain risk factors lead to arteriosclerosis more quickly.


How does arteriosclerosis develop?

Atherosclerosis does not develop overnight but gradually and unnoticed. It can be 20 to 40 years before the first symptoms appear, but they are already severe. The blocked blood vessels mean that the affected organ is poorly supplied with oxygen under stress – pain is the result. At heart, these symptoms are called angina pectoris; in the gastrointestinal tract, severe abdominal pain occurs after a meal, the so-called angina abdominalis.

In extreme cases, an artery occlusion occurs and, thus, a heart attack, intestinal infarction or stroke because the arterial occlusive disease caused by arteriosclerosis affects not only the heart and brain but all arteries in the body and particularly often the arteries that lie below the diaphragm: the abdominal, pelvic and leg arteries.

How common is arterial disease?

Around 4.5 million people in Germany are affected by AVK. Every tenth person between the ages of 55 and 65 now suffers from arterial occlusive disease, and after the age of 65, even every fifth person is affected.

Around 80,000 people are constantly under medical treatment for AVK, and around 35,000 people have to be amputated every year because the tissue that is no longer supplied with blood would otherwise lead to life-threatening blood poisoning.


How does an AVK manifest itself?

AOD only causes symptoms in the advanced stage. Doctors divide AVK into four phases:

  • In the first stage, imaging methods can detect a narrowing of the arteries. However, the patient does not notice it because the blood flow is still sufficient even when the affected arteries are under strain, for example, when walking for a long time.
  • In the second stage, prolonged exertion causes pain, which forces the affected person to stand still in the case of constricted leg arteries. This stage is also called intermittent claudication. Now, you should take action to stop the progression of AVK.
  • In the third stage, the pain also occurs at rest, often at night when the legs are raised, and gravity cannot support blood flow in the arteries.
  • In the fourth stage, blood flow is so reduced that the affected tissue dies. The most distant parts of the body, i.e. the toes, are usually affected.

The fact that circulatory disorders affect not only the muscles but all body tissues in the affected area can also be seen, for example, in the changes in the skin, such as healing disorders and hair reduction. 

Narrowing of the arteries in the gastrointestinal tract

On the other hand, the body can compensate for a massive narrowing of the arteries in the gastrointestinal tract for a long time because, fortunately, there are connections between the individual arteries, so that if one artery is severely narrowed, the blood can still reach the intestine, which is sensitive to oxygen deficiency, via others. However, the consequences of a massive lack of oxygen can be life-threatening.

Since the blood flow in the intestines is particularly demanding after eating because of the absorption of the food components, painful colic occurs in the case of abdominal angina if the intestines cannot perform this task. It becomes life-threatening for those affected when a narrowed abdominal artery is completely blocked, the other arteries cannot take over the transport of oxygen, and the intestine dies.

It must be removed as quickly as possible. Otherwise, the dead tissue will cause dangerous inflammation of the peritoneum (peritonitis), affecting the entire abdomen. The necessary major abdominal surgery is then an emergency operation and carries a high risk for the person concerned.



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