Atherosclerosis of Aorta

What is atherosclerosis of the aorta?

Atherosclerosis of the aorta is a progressive buildup of plaque in the largest artery in your body, called your aorta. This condition is also known as aortic atherosclerosis. Plaque is a sticky substance made of fat, cholesterol and other components. Plaque starts forming in your arteries during childhood, and it gradually builds up more as you get older.

Plaque can form anywhere in your aorta, which is more than 1 foot long and extends from your heart to your pelvis. However, severe plaque buildup is most likely to occur in your abdominal aorta. This is the section of your aorta that runs through your belly.

People who have aortic atherosclerosis may also have plaque in other arteries throughout their body. These include the arteries that supply blood to your heart (coronary arteries) and brain (carotid arteries). That’s because atherosclerosis is a systemic disease, meaning it affects your entire body. So, plaque buildup in one artery often signals you have plaque in other arteries, too.

How does atherosclerosis of the aorta affect my body?

Atherosclerosis of the aorta leads to plaque buildup in your aorta. This is the major pipeline that sends out blood to your entire body. Many smaller arteries branch off your aorta to carry oxygen-rich blood in different directions (like up to your brain and down to your legs). Atherosclerosis in your aorta disrupts the normal flow of blood through your aorta and to the rest of your body. So, it raises your risk of ischemia (lack of oxygen-rich blood) in many different organs and tissues.

When you think of plaque buildup in your artery, you probably imagine a piece of plaque getting bigger until it blocks blood flow. While this can happen in some of your arteries, it’s less likely to happen in your aorta. That’s because your aorta has a wide diameter. So, blood can still flow through even if there’s plaque along your aorta’s walls.

The main problem with plaque buildup in your aorta is that it raises the risk of an embolus. An embolus is any object that travels through your bloodstream until it gets stuck and can’t go any further. When an embolus is stuck in one of your arteries, it immediately blocks your blood flow.

Plaque growth is gradual, like soap scum building up in the pipe below your bathroom sink. But an embolus is a sudden blockage. It’s as if you dropped the cap to your toothpaste straight down into the drain. The cap would become lodged in the pipe and block water flow.

Atherosclerosis of the aorta can trigger two different types of emboli (the plural form of “embolus”):

• Thromboembolism, which is made of blood. Blood clots can form on the plaque’s surface. One of these blood clots can then break away from the plaque and travel through your bloodstream.
• Atheroembolism, which is made of cholesterol crystals from the plaque. The plaque itself can rupture (break open). A piece of the plaque can then break away and travel through your bloodstream. Atheroembolisms are less common than thromboembolisms.

In either case, an object is traveling through your blood when it shouldn’t be. These emboli are the main complication of aortic atherosclerosis.

How an embolus affects your body depends on where it ends up getting stuck. The embolus blocks blood flow to that area, leading to ischemia (lack of oxygen-rich blood). Without enough oxygen, the organ and tissues in that area quickly become damaged.

How serious is atherosclerosis of the aorta?

Atherosclerosis of the aorta can lead to a life-threatening medical emergency. This happens when an embolus breaks away from the plaque and travels somewhere else in your body, blocking blood flow there.

Atherosclerosis of the aorta raises your risk of medical emergencies, including:

• Acute ischemic colitis: Blocked blood flow to your colon.
• Acute limb ischemia: Blocked blood flow to your limbs, usually your legs.
• Myocardial infarction (heart attack): Blocked blood flow to your heart.
• Renal infarction: Blocked blood flow to your kidneys.
• Splenic infarction: Blocked blood flow to your spleen.
• Stroke or transient ischemic attack (TIA): Blocked blood flow to your brain.

Plaque buildup in your aorta can also weaken its walls and raise your risk for an aortic aneurysm. Aneurysm ruptures and dissections can be fatal and require immediate medical attention.

Who does atherosclerosis of the aorta affect?

Atherosclerosis of the aorta can affect anyone. It’s a common condition. Your risk goes up as you get older.

What are the symptoms of atherosclerosis of the aorta?

Plaque can build up in your aorta for many years without you noticing any symptoms. In fact, you may not have any symptoms until an embolism travels through your blood to another part of your body. In that case, your symptoms depend on where the embolism is lodged and what part of your body is deprived of oxygen.

An embolism can lead to several different medical emergencies, each with specific symptoms.

Call 911 or your local emergency number if you experience any of the symptoms listed below.

Symptoms of a heart attack

• Anxiety or a feeling of “impending doom.”
• Chest pain.
• Dizziness or fainting.
• Heart palpitations.
• Nausea or vomiting.
• Pain or discomfort in your shoulder, arm, neck or jaw.
• Sweating.

Women and people designated female at birth (DFAB) may also experience:

• Fatigue.
• Shortness of breath.

Symptoms of a stroke

• Dizziness or loss of balance.
• Slurred or confused speech.
• Sudden numbness or weakness in your face, arms or legs. This may occur on one side of your body.
• Sudden, severe headache.
• Sudden trouble speaking or understanding others.
• Trouble seeing in one or both eyes.
• Trouble walking.

Symptoms of acute limb ischemia

• Cool skin.
• Gangrene.
• Mottled skin. This means you can see a blotchy pattern of red, purple or brown lines.
• Numbness or tingling.
• Pale or blue skin.
• Weak pulse or no pulse in the affected limb.

Symptoms of blocked blood flow to organs in your belly

• Blood in your poop.
• Diarrhea.
• Nausea.
• Pain or tenderness in your belly.

Symptoms of an abdominal aortic aneurysm (AAA)

Atherosclerosis of the aorta is also associated with abdominal aortic aneurysms (AAAs). That means the plaque buildup may not directly cause the AAA, but the two conditions share similar risk factors and often occur together. Many people don’t have symptoms of an AAA until it’s close to rupturing. If you do have early symptoms, they may include:

• Back, leg, or belly pain that doesn’t go away.
• Pulsing sensation in your belly, like a heartbeat.

Signs of a ruptured AAA include:

• Clammy, sweaty skin.
• Dizziness or fainting.
• Fast heart rate.
• Nausea and vomiting.
• Shortness of breath.
• Sudden, severe pain in your belly, lower back or legs.

What causes atherosclerosis of the aorta?

Damage to your aorta’s inner lining (endothelium) causes atherosclerosis to begin. This damage occurs gradually, over many years.

Certain conditions damage your endothelium and raise your risk of developing atherosclerosis. These include:

• Smoking or using tobacco products.
• Hyperlipidemia (high cholesterol).
• Hypertension (high blood pressure).
• Hyperglycemia (high blood sugar).
• Autoimmune diseases and inflammation, especially large vessel vasculitis.

How is atherosclerosis of the aorta diagnosed?

Healthcare providers use imaging tests to diagnose aortic atherosclerosis and see how far it’s progressed. These tests include:

• Computed tomography (CT) scan.
• Magnetic resonance imaging (MRI).
• Transesophageal echocardiogram.

What is the treatment for atherosclerosis of the aorta?

Aortic atherosclerosis treatment focuses on:

• Lowering your risk of complications.
• Slowing down disease progression.

Medications and lifestyle changes can help with both of these goals. Your provider may recommend medications including:

• Anticoagulants or antiplatelet medications to lower your risk of blood clots.
• Antihypertensive medication to manage your blood pressure.
• Statins to manage your cholesterol.

Lifestyle changes are also important. Your provider may recommend you:

• Avoid foods high in saturated fat and cholesterol.
• Avoid foods and drinks high in sugar.
• Exercise more often.
• Lower your salt intake.
• Quit smoking or using tobacco products.

If aortic atherosclerosis has led to complications, your provider will treat those conditions. Treatments vary widely based on where and how damage occurred and may include:

• Amputation.
• Dialysis.
• Medications.
• Minimally invasive procedures.
• Surgery.

Talk with your provider about the best treatment options for you and why they’re needed.

How can I reduce my risk of developing atherosclerosis of the aorta?

You can’t always prevent aortic atherosclerosis. But you can slow down the progression and lower your risk of serious complications by taking the following steps.

• Avoid smoking and all tobacco products. These include vaping and smokeless tobacco.
• Eat a heart-healthy diet. Choose foods low in saturated fat and cholesterol.
• Keep a healthy weight. Ask your provider what your ideal range should be.
• Keep moving. Add planned exercise to your day, and find ways to get in more movement during your daily routine.
• Manage blood pressure, cholesterol and blood sugar. Talk with your provider about lifestyle changes that can help. Plus, take your medications as prescribed.
• Visit your provider every year for a checkup. Keep all your other medical appointments and follow-ups.

What can I expect if I have atherosclerosis of the aorta?

Everyone’s prognosis is different. Your outlook depends on many factors, including:

• The severity of plaque buildup. Aortic plaque larger than 4 millimeters in diameter has a higher risk of triggering an embolism. Plaque smaller than 1 millimeter in diameter is considered “mild” and carries a lower risk of complications. Talk with your provider about how the severity of plaque buildup in your aorta and what that means for you.
• Plaque buildup in other arteries. Plaque buildup in your other arteries can further increase your risk of complications like a heart attack or stroke.
• Your overall health. If you have other conditions like high blood pressure, or if you use tobacco, you face a higher risk of complications.

Talk with your provider about your outlook and how best to manage your condition.

Is atherosclerosis of the aorta curable?

There’s no cure for atherosclerosis of the aorta, and it can’t be reversed. But lifestyle changes and medications can help you manage your condition and reduce your risk of complications.

How do I take care of myself if I have atherosclerosis of the aorta?

If you have aortic atherosclerosis, you face a higher risk of other conditions like coronary artery disease. So, it’s important to do whatever you can to keep your heart and blood vessels as healthy as possible. Follow your provider’s guidance on:

• Diet.
• Exercise.
• Lifestyle changes.
• Medications.

When should I see my healthcare provider?

Visit your provider for yearly check-ups. Your provider will tell you if you need to come in more often or see any specialists, like a cardiologist.

Call your provider if you experience new or changing symptoms, or if you have questions or concerns at any time. If you have symptoms of a medical emergency, you should seek immediate medical attention.

When to seek immediate medical attention

Call 911 or your local emergency number immediately if you have symptoms of:

• Abdominal aortic aneurysm (AAA).
• Acute limb ischemia.
• Heart attack.
• Stroke.
• Thoracic aortic aneurysm.
• Transient ischemic attack (TIA).

What questions should I ask my provider?

Talk with your provider about your outlook and what you can expect going forward. Some questions to ask include:

• How severe is my condition?
• How can I slow down its progression?
• What lifestyle changes are most important for me to make?
• What medications do I need to take? What are the side effects?

If you need heart surgery or a catheter-based procedure, talk with your provider about your risk for complications. Aortic atherosclerosis raises your risk of complications during some heart and vascular procedures. Ask your provider what risks you face and what your care team can do to reduce those risks.

A note from Cleveland Clinic

If you have atherosclerosis of the aorta, you may be wondering how serious the condition is and what’ll happen down the road. Aortic atherosclerosis can lead to serious complications. But the good news is that your provider can help you manage the condition to slow down its progression. Talk with your provider about your outlook and what changes you can make in your daily life.