Table of contents:
- Blocked blood vessels usually show no symptoms
- What tests can be done to check for fat deposits?
- Carotid Intimal Media Thickness (CIMT)
- Coronary Artery Calcium(CAC)
Atherosclerosis is a collection of diseases caused by narrowing of the body's blood vessels due to blockages in the walls of blood vessels. The blockage causes the blood supply to a certain organ to be blocked so that the cells in that organ can die. For example, if the one that is blocked is the heart blood vessels (coronary arteries), then a person can have a heart attack. On the other hand, if the blockage is in the blood vessels leading to the brain, such as the carotid arteries, then a stroke cannot be avoided. Both of these diseases, both heart attack and stroke, still occupy the leading causes of death in the world.
Blocked blood vessels usually show no symptoms
Blockages in the walls of blood vessels consist of cellular waste, blood cells (such as platelets and leukocytes), immune cells, calcium and most of them are fat. Fat stuck in damaged blood vessels can form fatty plaques or crusts. The thicker the fat crust, the narrower our blood vessels.
The presence of plaque or crusts in our body does not initially cause symptoms. Until the thickness limit of ± 50% of the width of the blood vessels, this layer of the crust only causes symptoms. The symptoms that arise depend on the dead organs. Differences in symptoms were also shown between women and men. In women, symptoms are often atypical, so they are usually more fatal. Mortality for women is still higher than men.
Finally, various studies studied how to recognize groups of atherosclerosis diseases earlier. In coronary heart disease, for example, early assessment can be used Framingham Risk Score (FRS) which is commonly used in the United States or Systematic Coronary Risk Evaluation (SCORE) in Europe. In Indonesia alone, these two scores were adapted to recognize atherosclerosis in risk groups but without symptoms.
However, the limitations of the assessment component cause this scoring to be unable to prevent it completely. Disabilities and deaths due to coronary heart disease and stroke are still high. According to the Basic Health Research (RISKESDAS) of the Indonesian Ministry of Health, the number of stroke cases has increased, from only 8.3% in 2007 to 12.1% in 2013.Therefore, various types of follow-up tests were developed to detect fat crusts. that is in our body. This examination is usually performed on healthy people with risk factors or people who are at moderate risk for disease due to atherosclerosis.
What tests can be done to check for fat deposits?
Carotid Intimal Media Thickness (CIMT)
Enhancement intimal media thickness (BMI) occurs in the early phases of the atherosclerosis process. Several studies say, measuring the increase in carotid artery IMT using ultrasonography has become the standard for assessing atherosclerosis. This is also recommended by American Heart Association as a cardiovascular risk assessment. Research has shown that the higher the carotid BMI value, the higher the incidence of strokes and heart attacks. This can happen to everyone, with or without previous heart disease.
Why are measurements taken in the carotid arteries? The carotid artery is chosen for BMI measurement because the carotid arteries are not deep, with no bony structures or air shadows obstructing them, and away from moving structures, such as the heart. Ultrasound measurement of carotid artery IMT B-mode is a non-invasive, sensitive test that can be used to identify and measure the severity of atherosclerosis, as well as the risk of cardiovascular disease.
The American Society of Echocardiography can see atherosclerotic plaques that cause heart attack> 1.5 cm or ≥ 50% of the thickness of the artery wall. Another study stated that CIMT> 1.15 cm was associated with a 94% chance of having a heart attack or stroke.
Coronary Artery Calcium (CAC)
Calcification of the blood vessels is caused by a blockage consisting of calcium deposits. This buildup of calcium causes blood vessels to constrict. From various case reports, 70% of cases of heart attacks have calcification in their blood vessels. CAC detection only detects hard plaques, but from calcification findings, it is usually found that there is also soft plaque or plaque mixed between the two.
The CAC value alone can be used to predict cardiovascular events and change the level of risk. A positive CAC value indicates an atherosclerosis process. An increase in the CAC score is known to increase the risk of heart attack and stroke, especially if the CAC score is> 300. A study shows that people with a CAC score> 300 will have a heart attack within 4 years. The study also concluded that the CAC score when carried out in a low-risk population according to Framingham Risk Score (FRS), however, would be useful for predicting cardiovascular events.
