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  • Atherosclerosis is not only a tongue twister;

  • it’s the leading cause of heart attacks worldwide.

  • Understanding how this disease can lead to an attack starts with knowing how your immune

  • system works for and against you.

  • The good news is that thanks to medical advancements, people are living longer and surviving in

  • the face of this disease.

  • - So there's really good news on the horizon for atherosclerosis.

  • We are increasingly understanding the disease.

  • My name is DeLisa Fairweather.

  • I'm a PhD researcher in Jacksonville, Florida, working at Mayo Clinic.

  • I've been studying heart disease for around 25 years.

  • Atherosclerosis is a very long name that's difficult to pronounce.

  • So it really refers toathero-,” which talks about the vessels in our heart, and

  • sclerosis,” which means fibrosis of those vessels.

  • And it is one of the most common heart diseases around the world.

  • And what happens is inflammation goes into the vessel wall and accumulates there, and

  • we call that a plaque.

  • Plaque and atherosclerosis is caused by inflammation, and the inflammation is really trying to regulate

  • a problem.

  • And the problem is that we have too much cholesterol.

  • Cholesterol is a type of fat made by our liver, and that we get in part from our food.

  • There are two main types of cholesterol: “good cholesterol,” HDL,

  • andbad cholesterol,” LDL.

  • The good cholesterol helps keep the bad cholesterol in check, but, if there’s an imbalance,

  • the bad cholesterol can build up on the walls of your arteries, increasing your risk of

  • a heart attack.

  • One way to think of the arteries around your heart is like pipes.

  • And when those pipes get filled with bad cholesterol, it can create a kind of clog.

  • The body’s immune cells then come along and try to clear up the fat, absorbing it

  • into themselves.

  • - The immune system is really important in this process because it is going in and is

  • trying to repair the damage.

  • On the one hand, it's trying to repair the damage; on the other hand it contributes to

  • the damage.

  • And you can kind of think of it as if you had a bomb, and you wanted to try to protect

  • it, but you couldn't remove the bomb, what would you do?

  • Well, you would want to try to create a protective covering so that it could not cause damage.

  • And that's what the immune cell, the macrophage, tries to do and it takes the fat inside its

  • body.

  • It accumulates all of that fat.

  • So it ends up looking like what we call a “foam cell,” all full of the fat molecules.

  • This foaming process creates a backlog of these fatty immune cells which clog the vessel

  • wall, with more and more cells clogging that pipe and creating a problem with blood flow.

  • This often presents as high blood pressure, which means the blood is trying to get through

  • this small area of the vessel.

  • This can lead to a rupture.

  • - And when the rupture happens, then everything is released.

  • It ends up in a clot, and you can have a heart attack, or that clot can break free and become

  • loose and travel through your vessels, and cause a stroke if it goes to your brain.

  • All of this so far isatherosclerosis,” but this form of heart disease is most commonly

  • linked to heart attacks.

  • So what is a heart attack exactly?

  • - So what is happening when you have a heart attack is that the conditions have all come

  • to this perfect storm

  • and what happens with a heart attack is the vessel wall has inflammation that ends up

  • in what we call a plaque.

  • And that plaque buildup then can burst open and clog the artery and

  • that then causes a heart attack.

  • It completely stops up the vessel.

  • And when that happens, the blood flow's cut off to that area of your heart and when the blood

  • flow's cut off, then the cells in that area will start to die.

  • So the technical term is a myocardial infarct.

  • We most commonly call it a heart attack.

  • Symptoms of a heart attack include pain down the left side of your arm, shortness of breath,

  • and nausea - and these are all associated with that cutoff of blood flow to the heart.

  • Then what's happening inside the heart is that when that blood flow's cut off, it is

  • needed to provide energy and life to those cells in your heart and those cells start

  • to die very rapidly and cause heart damage.

  • Risk factors for atherosclerosis and heart attacks include things that you can control

  • like smoking, diet, and high cholesterol - and some you can’t control, like age.

  • - An important risk factor is if you're male, especially younger, middle-aged male, you

  • have a higher risk factor; as you age, for women, the risk factor of having atherosclerosis

  • comes after menopause and actually when you're much older, maybe around age 70, and that's

  • because estrogen really protects you from having a heart attack when you're younger.

  • Fortunately, there have been exciting new developments in the area of understanding

  • this disease and preventing it.

  • - Really the statistics are wonderful that we are preventing people from dying.

  • So even though you might have the clot, we're able to go in and remove the clot very rapidly

  • when someone has a heart attack and put in what's called a stent.

  • And this just holds this area open.

  • And that technology is improving every year, so that people can live after having these

  • heart attacks, a really great life and a full life.

  • And we're making great inroads, so that this disease is not killing nearly as many people

  • as it used to.

Atherosclerosis is not only a tongue twister;

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心臟病發作的原因是什麼? (What Causes a Heart Attack?)

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    林宜悉 發佈於 2021 年 01 月 14 日
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