What Is Restenosis

What Is Restenosis?

Restenosis is a condition where one or both coronary arteries become narrowed. This narrowing may occur due to atherosclerosis (hardening of the arteries) or it may develop from other causes such as heart attack, arrhythmia, valve problems and even diabetes mellitus.

The most common cause of restenosis is atherosclerotic plaques which are formed by cholesterol deposits in the artery wall. These deposits block the blood flow through the artery causing low blood pressure and sometimes even death.

Other types of plaque formation include fatty streaks, fibrous plugs, calcification, scar tissue and others. Some forms of plaque formation are reversible while others cannot be reversed.

Atherosclerosis is a disease characterized by abnormal accumulation of fat in arterial walls. Atherosclerosis is a major risk factor for cardiovascular diseases including heart attacks, strokes and vascular dementia.

Atherosclerotic plaques are usually present in the arteries leading to the brain, lungs and kidneys. They form when fatty deposits accumulate inside the artery wall.

When these deposits clump together they form hard spots called plaques. Plaque clumping occurs because of high levels of triglycerides found in fats from saturated animal products like butter, lard and tallow. Even if you don’t eat meat, high-fat and high-sugar consumptions can cause clumping of plaque.

Sometimes the body may actually produce antibodies which attack the plaques thus causing inflammation in that area. Certain factors may contribute to this process such as family history, aging (as we all age our bodies are less effective at fighting off viruses), high blood pressure, high cholesterol and smoking.

The body’s immune system responds to the inflammation by sending in white blood cells that cause more inflammation. The body then sends platelets to start the blood clotting process (clotting stops bleeding).

This begins a vicious cycle of ongoing inflammation and more clots. When a clot completely blocks the artery, it causes a heart attack or stroke.

Even a partially blocked artery can cause angina (chest pain), shortness of breath, loss of movement in one part of the body, vision problems and even erectile dysfunction in men.

Diagnosing Restenosis

One of the first diagnostic tests to detect restenosis is a cardiac catheterization. A cardiologist uses a long thin tube called a catheter to measure the blood pressure of your heart.

The cardiologist may also do other tests like an angiogram or stress test.

Another test is ultrasound which uses high frequency sound waves to create an image of your heart and coronary arteries. During this test, the technician injects a very fine fluid containing particles of air into an artery in your hand or arm.

These particles bounce back to create a picture of your coronary arteries.

Preventing Restenosis

One of the best ways to prevent restenosis is to maintain a healthy weight and cholesterol level. This can be dangerous because if you have been diagnosed with coronary artery disease, your cardiologist may put you on a low-fat diet.

Since many of the foods we enjoy eating are high in fat, this can be very difficult. If you are on a low-fat diet, talk to your doctor about adding more fat to your diet in the form of nuts, seeds and avocados.

Your cardiologist may recommend fish oils to lower your triglyceride levels. Nuts also contain heart healthy monounsaturated fats which are good for you.

Getting enough fiber, exercising daily and getting plenty of sleep are important for preventing plaque formation.

If you have had a heart attack in the past, you should have an exercise stress test every six months. If this test reveals any blockages, you may need to take medication or undergo angioplasty or even coronary artery bypass surgery.

Staying stress free is vital for heart health. Focus on what is important and learn to let go of the things that cause you stress.

Get adequate sleep as this allows your body to function at its best.

If you have been diagnosed with high blood pressure or high cholesterol, there are steps you can take to lower these levels. Your doctor may put you on medication, which if necessary can be taken for the rest of your life.

There are many natural ways to lower cholesterol such as eating a diet low in fat and sugar and getting plenty of exercise (even 10 minutes of brisk walking per day can help).

If you have had bypass or angioplasty surgery, your cardiologist may need to monitor you more frequently. You will probably have a cardiac catheterization every three to six months for the first year.

After that, the doctor may do it yearly.

The best way to monitor your coronary arteries is with coronary calcium scanning. This painless test can show any arterial plaque before it causes a heart attack or stroke.

It is not necessary to inject a dye or radiation into your body and it can be done in less than a minute.

Coronary Artery Calcium Scanning

A coronary artery calcium score is an easy, painless, and non-invasive test which can detect the amount of plaque in your coronary arteries. This test is done by a technologist at a special scanning facility or in some cases at a pharmacy that has the equipment.

The technologist will rub a special liquid containing iodine on your chest. The iodine will be absorbed by any calcium deposits in your arteries.

A special camera takes pictures of your heart which are then used to calculate the amount of plaque in your coronary arteries.

The most dangerous area of plaque is the area nearest to the heart, the coronary artery ostia. Plaque which originates here can cause a blood clot or rupture which can completely block the artery.

This is what causes most heart attacks. Plaque which forms further down the artery is less likely to cause a heart attack.

The coronary artery calcium score will tell you if there is any plaque at all and how much. Even if there is some plaque, this does not predict if or when a heart attack will happen.

It is also possible to have a high coronary artery calcium score and never have a heart attack.

Your doctor will look at your overall coronary risk factors such as age, gender, family history, smoking, high blood pressure, high cholesterol, diabetes, and obesity when deciding what your next steps are.

The American Heart Association recommends that men over the age of 45 and women over the age of 55 get a coronary calcium scan.

Recent research has shown that the test is useful for people even if they have no cardiac risk factors. It can identify those at increased risk of heart attack or stroke who don’t have any traditional risk factors.

The cost of a coronary calcium scan is usually not covered by insurance as there is no consensus about who should have the test. If you haven’t had one, discuss it with your doctor to see if you should have one.

Cancer Prevention

If you have had a skin cancer, particularly a melanoma, there are some additional tests your doctor may recommend.

Skin Exam

Everyone should have a yearly skin check by a dermatologist or trained primary care physician. It is important that this professional does a thorough exam as some skin cancers occur in places that we cannot see, such as on the scalp or between the toes.

Your dermatologist will look for abnormal growths or sores. Any issues should be biopsied to see if they are cancerous.

Many skin cancers are curable if diagnosed and treated early.

Melanoma is a type of skin cancer that often starts as a small change in a moles, or an irregularly shaped spot on the skin. We all should have our moles checked periodically by a medical professional.

Not all moles will turn into cancer, but it is better to be safe than sorry.

Mole checks are particularly important for anyone who has had more than a few moles or dysplastic nevi removed by a doctor. Dysplastic nevi are large, irregular moles with irregular borders that have an unusual appearance even though they are not obviously different in color than your normal skin.

They tend to grow larger than normal moles and may itch or hurt.

If you have a large number of dysplastic nevi or any nevi that are abnormal, your doctor may recommend you see a dermatologist every 1-3 years depending upon your situation.

For children, cancer causing (carcinogenic) chemicals should be avoided. Talk to your pediatrician about the best way to care for your child’s skin.

Some situations require more frequent dermatologist visits.

If you have a history of skin cancer, you should have a full-body skin exam by a dermatologist every 3-6 months. This is especially important if you have had a serious type of skin cancer like melanoma.

Your dermatologist may do periodic full-body screenings with a tool called dermoscopy which can detect very early signs of skin cancers.

You should also have any moles, birthmarks, or skin areas that have changed color or shape checked by a medical professional.

If you have a history of skin cancer and you have a family history of certain diseases, see your doctor about getting genetic testing. You may be at increased risk of getting specific types of cancer due to your family’s genetics.

What Can I do To Lower My Risk of Cancer?

A healthy lifestyle can help prevent cancer and maintain a good quality of life.

It is never too late to start living a healthier lifestyle, but the sooner you make these changes, the more benefits you will see.

Eat a healthy diet rich in vegetables and fruits. Focus on plant foods rather than animal foods.

Be careful about how much processed food you eat.

Exercise on a regular basis. Remember that exercise doesn’t always mean going to the gym.

Any activity that causes you to move your body will provide benefits.

Don’t use tobacco in any form. Tobacco contains cancer causing chemicals.

Also, it is extremely bad for your health in many other ways. There is no safe amount to use.

Limit your alcohol intake. If you do choose to drink, do so in moderation.

One drink per day is considered safe for men, and 1-2 drinks per day is considered safe for women.

If you are overweight, lose weight. Obesity can cause hormone changes, high blood pressure, and diabetes, all of which increase risk for certain types of cancer.

Even a small amount of weight loss can have a big impact on your health.

Get ample sleep every night and take steps to manage any anxiety you may have. Both of these factors can affect your overall health and immune system.

When Should I Call My Doctor?

It is important to have a good relationship with your doctor. In fact, it is best to choose one and stay with him or her even if you have to change plans (if you are on one). There may be times when you need to see them quickly, and it is best to already have a doctor that knows your history and provides good care for you.

It’s always best to call your doctor if:

You notice any pain, swelling, or bleeding of a mole.

You have any questions about your diagnosis or care.

You aren’t sure about a medical test that was ordered.

You aren’t sure what a prescription means for you.

You want to find out what healthy steps you can take.

You are concerned that you have not gotten better.

What Else Should I Know?

If you have been diagnosed with skin cancer, there are some extra precautions you can take to protect your skin. There are also some myths about protecting yourself that you need to be aware of.

Avoiding the sun or using sunscreen on a regular basis is one of the best ways to prevent burns and lower your risk of skin cancer. When you do go out in the sun, try to schedule it for the times of day when the sun’s rays are not as strong.

This could be early in the morning or later in the evening. It also might be a good idea to stay indoors if you are an older adult. Older adults tend to have more fragile skin, which can lead to skin cancer.

The myth that tanning oil, lotion, or sunscreen give you 100% protection is untrue. Always remember to apply these items according to the directions and to also seek shade when necessary.

If you get a painful sunburn, there are some over-the-counter treatments that can help ease the pain and discomfort. These creams can be found at most drug stores and pharmacies.

Be sure to read the instructions before applying any of these creams.

To treat a sunburn, you should take a cool bath or shower and then gently pat the affected area dry. Next, apply a moisturizer.

You may also take some acetaminophen (Tylenol), but remember to do so according to the directions on the bottle.

The most important thing to keep in mind is prevention. Always remember to protect your skin from sun exposure by seeking shade, wearing protective clothing, and using sunscreen with an SPF of at least 15.

Living with skin cancer does not have to be scary or stressful if you maintain good habits and take care of your body. If you have any questions about your diagnosis, talk to your doctor.

Sources & references used in this article:

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Apoptosis in human atherosclerosis and restenosis by JM Isner, M Kearney, S Bortman, J Passeri – Circulation, 1995 – Am Heart Assoc

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