Can someone explain the difference between Atheroma and Stenosis in an artery? Is it possible to have a different degree of atheroma vs stenosis? For example, moderate atheroma with severe stenosis? If that is possible - what are the other causes for the narrowing to be more than the plaque formation? Inflammation maybe?
Any knowledge share appreciated in advance!
An atheroma is a fatty substance that builds up in your arteries over time. An atheroma is more commonly known as atherosclerotic plaque, or simply plaque. Atheromas form along the inside lining of your arteries and interrupt blood flow through your body. Stenosis means blockage.
So I guess severity depends on whether or not the plaque is causing a blockage. Theoretically it would be possible to have lots of atheroma but not enough in any one place to cause stenosis?
Certainly inflammation or perhaps micro vascular disease can have a similar effect.
Basically anything which requires the heart to work harder to pump blood is problematic.
Atheroma is total plaque volume, from all strata of plaque, it does not say where it is located, but it is in the artery.
Stenosis represents how far the plaque impinges into the artery, Stenosis literally means narrowing, so a 50% stenosis, means that half the artery is blocked by plaque extending into the center.
As an absolute rough rule, 50% stenosis they will keep an eye on , 70% and above you may start to experience effects, and have an angiogram, this is all very approximate, and you could have problems at 40% although it's unlikely. You could have 90% stenosis and pass a stress test.
You could have a low plaque volume , by this you mean a low cac score, however it is all concentrated in one location and causes severe stenosis, such cases exist in the medical literature.
Yes there are many cases of people with high cac scores, with minimal stenosis, cardiologists tend to call this patent defecting and say in slang :" the calcium is all in the wall" and there are many cases of people with high numbers who have genetics for low risk of rupture, every case is different nothing is pre-determined,
Many thanks for the clarification. So, how do you interpret minor atheroma with moderate stenosis? Does it mean that narrowing is 50%, while plaque is less? Just a bit confused? I assumed previously that the degree of atheroma and stenosis had to be the same. Not sure if that holds in practice.
Not medical advice, opinions and suggestions only;
What type of test did you have a CCTA or an angiogram?
Unless they have specified the % of the stenosis, it is impossible to tell, but you could write a letter and ask.
The degree of atheroma does not have to equal the degree of stenosis.
In some ways there are advantages to having high atheroma and low stenosis.
In other ways there are advantages to having low atheroma and the stenosis all in one spot, means you would be an excellent candidate for a stent, assuming its in a position they can reach.
All of this is speculative though, your probably not even in need of a stent with moderate stenosis but only an angiogram can rule that out, and if you have no symptoms then it's unlikely they will order one for you.
CCTA - the one with the dye.
Not medical advice , opinions and suggestions only.
Then I would suggest getting in contact and asking the % stenosis , so you know where you stand.
i already have it is about 50%. Then again, minor is 25%~49% all a bit arbitrary if you ask me.
But thanks for your help - appreciate the prompt multiple replies and answers.
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