Atheroma: Symptoms, Causes, and Treatment Options

Atheroma is a buildup of cholesterol, fats, inflammatory cells and other materials within the inner lining of an artery. It may develop silently for years, but it can narrow arteries or contribute to blood clots that cause serious cardiovascular events.

What Is Atheroma?

Atheroma is a fatty deposit, often called plaque, that forms in the wall of an artery. It contains cholesterol, fats, calcium, immune cells and fibrous tissue. Over time, this material can make an artery less flexible and reduce the space available for blood to flow.

Atheroma is the characteristic change seen in atherosclerosis, a long-term condition affecting arteries throughout the body. Plaques may develop in the coronary arteries that supply the heart, the carotid arteries in the neck, arteries supplying the brain, kidney arteries, or arteries in the legs. The possible effects depend on which blood vessel is affected and how much blood flow is reduced.

Not every plaque causes the same level of risk. Some plaques grow gradually and mainly narrow an artery. Others can become inflamed or unstable and may rupture. When this happens, a blood clot can form suddenly over the plaque and block blood flow, potentially causing a heart attack, stroke or another acute circulation problem.

Symptoms and Possible Effects

Atheroma usually causes no noticeable symptoms in its early stages. This is why risk-factor screening, including blood pressure and cholesterol checks, is important even for people who feel well. Symptoms tend to appear when an artery is significantly narrowed or when a clot develops suddenly.

When coronary arteries are affected, reduced blood flow may cause angina, which can feel like pressure, tightness, heaviness or discomfort in the chest during activity or emotional stress. Some people, particularly women, older adults and people with diabetes, may instead notice shortness of breath, unusual fatigue, nausea or discomfort in the jaw, back, shoulder or arm.

Atheroma in the leg arteries may cause peripheral artery disease. Typical symptoms include cramping, aching or fatigue in a calf, thigh or buttock while walking that improves with rest. Carotid or brain artery disease may remain silent, but a sudden blockage can cause weakness or numbness on one side, speech difficulty, facial drooping, visual changes, loss of balance or a severe sudden headache.

• Heart: chest discomfort, breathlessness or reduced exercise tolerance
• Brain: sudden weakness, speech or vision changes, confusion or imbalance
• Legs: pain on walking, cold feet, slow-healing sores or color changes
• Kidneys: worsening blood pressure control or reduced kidney function in selected cases

How Atheroma Develops: Causes and Risk Factors

Atheroma develops through a gradual process involving injury or dysfunction of the artery lining, cholesterol deposition and inflammation. Low-density lipoprotein (LDL) cholesterol can enter the artery wall, where it may trigger an immune response. As the body attempts to respond, plaque can grow and become more complex.

Several factors increase the likelihood of plaque formation. Some can be changed through treatment or daily habits, while others, such as age and family history, cannot. Having one risk factor does not mean a person will develop a serious complication, but multiple factors together can substantially increase overall cardiovascular risk.

• High LDL cholesterol or low levels of protective high-density lipoprotein (HDL) cholesterol
• High blood pressure
• Diabetes or insulin resistance
• Smoking, vaping nicotine products or regular exposure to tobacco smoke
• Physical inactivity, an eating pattern high in saturated fats or trans fats, and excess body weight
• Chronic kidney disease, inflammatory conditions, older age and a family history of early cardiovascular disease

Stress, poor sleep and heavy alcohol use may also contribute indirectly by affecting blood pressure, metabolism or health behaviors. A clinician can help assess individual risk by considering medical history, examination findings and laboratory results rather than relying on a single factor alone.

How Doctors Diagnose Atheroma

Diagnosis begins with a discussion of symptoms, medical history, family history and lifestyle factors. A clinician will usually measure blood pressure, check circulation in the arms and legs, listen for abnormal blood-flow sounds in certain arteries and assess for signs of heart, brain or peripheral artery disease.

Blood tests commonly include a lipid profile, which measures cholesterol and triglycerides, and may include blood glucose or hemoglobin A1c to assess for diabetes. Kidney function and other tests may be useful when planning treatment or evaluating related conditions. These tests estimate risk but do not, by themselves, show the exact location or size of plaque.

Imaging or functional tests may be recommended when symptoms, examination findings or overall risk suggest arterial disease. Depending on the situation, these may include an electrocardiogram, exercise or medication-based stress testing, echocardiography, carotid ultrasound, ankle-brachial index testing, CT angiography, MR angiography or invasive coronary angiography. The choice depends on the artery being assessed and whether urgent treatment may be needed.

Some people ask about coronary artery calcium scoring. This CT-based test can help refine cardiovascular risk in selected people without known coronary artery disease, but it is not necessary or appropriate for everyone. A clinician can explain whether it is likely to meaningfully guide prevention decisions.

Treatment Options for Atheroma

Atheroma treatment aims to slow or stop plaque progression, stabilize existing plaque and reduce the chance of heart attack, stroke and circulation problems. The treatment plan is individualized according to the arteries involved, symptoms, cholesterol levels, other medical conditions and overall cardiovascular risk.

Lifestyle measures are a foundation of care. These generally include stopping tobacco use, following a heart-healthy eating pattern rich in vegetables, fruit, legumes, whole grains and unsaturated fats, being physically active within a clinician-approved plan, maintaining a suitable weight and managing sleep and stress. These changes can improve blood pressure, cholesterol and blood sugar, even when medication is also needed.

Medicines may be prescribed to lower LDL cholesterol, control blood pressure, manage diabetes or reduce clotting risk in particular circumstances. Statins are commonly used because they lower LDL cholesterol and help stabilize plaque. Antiplatelet medicines are not appropriate for every person with risk factors; they should be used only when a clinician recommends them, as they can increase bleeding risk.

If an artery is severely narrowed and causing significant symptoms, or if there is an acute blockage, a procedure may be considered. Options can include angioplasty with stent placement, carotid endarterectomy, vascular surgery or bypass surgery. These procedures address important blockages, but long-term risk reduction through medicines and lifestyle care remains essential.

Prevention and Everyday Self-Care

Because atheroma can begin long before symptoms develop, prevention is valuable at every stage of life. Regular health checks can identify high blood pressure, elevated cholesterol and diabetes early. Adults should discuss the timing of lipid and diabetes screening with a qualified clinician, especially if they have a family history of early heart disease or stroke.

A practical eating pattern emphasizes minimally processed foods and limits foods high in saturated fat, added sugars and salt. Replacing processed meats, fried foods and refined carbohydrates with fish, nuts, beans, vegetables and high-fiber grains can support heart health. Dietary changes should be realistic, culturally appropriate and sustainable rather than overly restrictive.

Regular movement supports circulation, blood pressure and metabolic health. Many adults benefit from a combination of aerobic activity and strength training, but anyone with chest symptoms, significant shortness of breath, known cardiovascular disease or a long period of inactivity should seek medical advice before beginning vigorous exercise. Stopping smoking is one of the most effective steps a person can take to lower cardiovascular risk.

People who have been prescribed medicines for cholesterol, blood pressure or diabetes should take them as directed and attend follow-up appointments. Stopping medication because a person feels well can allow risk factors to rise again. A clinician can monitor response, side effects and whether treatment needs adjustment.

When to Seek Medical Care

Emergency medical care is needed for possible heart attack or stroke symptoms. These include chest pressure or pain that is severe, persistent or associated with breathlessness, sweating, nausea or fainting; sudden weakness or numbness on one side of the body; facial drooping; difficulty speaking or understanding speech; sudden vision loss; or a sudden severe headache. Emergency services should be contacted immediately rather than waiting to see if symptoms improve.

Urgent assessment is also appropriate for sudden severe pain, paleness, coldness, numbness or weakness in an arm or leg, as these can indicate an acute circulation problem. New or worsening shortness of breath, fainting, chest discomfort during exertion, or leg pain that limits walking should be discussed promptly with a doctor.

People without symptoms should arrange a routine medical review if they have high cholesterol, high blood pressure, diabetes, kidney disease, a smoking history or close relatives with early cardiovascular disease. Acibadem International’s multidisciplinary specialists and JCI-accredited hospitals diagnose and treat cardiovascular and vascular conditions for international patients.

Frequently asked questions

Is atheroma the same as atherosclerosis?

Atheroma is the plaque that builds up within an artery wall. Atherosclerosis is the broader disease process in which these plaques develop, harden or narrow arteries over time. The terms are often used closely together in clinical discussions.

Can atheroma be reversed?

Treatment can slow plaque growth and make plaques less likely to rupture. Intensive cholesterol lowering and healthy lifestyle changes may reduce plaque burden in some people, but the main goal is usually long-term stabilization and prevention of complications. A clinician can recommend an approach based on individual cardiovascular risk.

Does atheroma always cause chest pain?

No. Atheroma often causes no symptoms, particularly in its early stages. Chest pain may occur when plaque narrows coronary arteries enough to reduce blood flow to the heart, but symptoms vary between individuals.

What foods help reduce the risk of atheroma?

A heart-healthy pattern includes vegetables, fruits, beans, whole grains, nuts, fish and unsaturated fats such as olive oil. Limiting processed meats, foods high in saturated fat, highly refined carbohydrates and excess salt can help improve cholesterol and blood pressure. Individual dietary needs may differ, particularly for people with diabetes or kidney disease.

Can thin or active people develop atheroma?

Yes. Body weight and physical activity are important, but they are not the only factors. Genetics, cholesterol levels, blood pressure, diabetes, smoking and age can all contribute to atheroma development.

Are statins used to treat atheroma?

Statins are commonly used to lower LDL cholesterol and reduce the risk of heart attack and stroke in people who may benefit from them. They also help stabilize plaques, making them less likely to rupture. The decision to use a statin depends on a person's overall risk profile and medical history.

References

• American Heart Association
• American College of Cardiology
• National Heart, Lung, and Blood Institute
• Centers for Disease Control and Prevention
• European Society of Cardiology

This article is for general information only and is not a substitute for professional medical advice. Please consult a qualified doctor about your individual situation.