Understanding Aortic Atherosclerosis: How a 70-Year-Old Man Managed His Heart Health
A 70-year-old man, referred to as Mr. Zhang for privacy, visited the hospital complaining of persistent chest tightness and palpitations over the past ten days. Despite having a history of cerebral infarction and no history of smoking or alcohol consumption, he had not experienced any other significant symptoms such as shortness of breath, chest pain, or difficulty breathing. After undergoing coronary angiography and a chest X-ray, he was diagnosed with atherosclerotic heart disease and aortic atherosclerosis. His treatment plan included the use of clopidogrel bisulfate tablets, atorvastatin calcium tablets, and metoprolol succinate extended-release tablets. After a month of treatment, his symptoms resolved and the progression of the disease was halted.
Key Information
- Gender: Male
- Age: 70 years
- Condition: Aortic Atherosclerosis
- Hospital: First Affiliated Hospital of Xi'an Jiaotong University
- Visit Date: March 2022
- Treatment: Medication therapy with clopidogrel, atorvastatin, and metoprolol
- Follow-up: Monthly check-ups
- Outcome: Symptoms resolved; disease progression halted
Initial Consultation and Diagnosis
Mr. Zhang came to the hospital with a history of cerebral infarction but no other chronic conditions. He has never smoked or consumed alcohol. Over the past ten days, he had been experiencing persistent chest tightness and palpitations without other major symptoms. To determine the cause, he underwent a coronary angiography which revealed significant narrowing of the coronary arteries, indicating atherosclerotic heart disease. A chest X-ray also showed signs of aortic calcification, a hallmark of advanced atherosclerosis where plaque buildup hardens the arterial walls. This led to the diagnosis of aortic atherosclerosis.
Medical Treatment Plan
Following the diagnosis, Mr. Zhang was admitted to the hospital with a diagnosis of aortic sclerosis and coronary atherosclerotic heart disease. Given that atherosclerosis is often linked to platelet aggregation and elevated cholesterol levels, a treatment plan was developed to include clopidogrel bisulfate to prevent platelet clumping and atorvastatin calcium to lower lipid levels. Additionally, due to the narrowing of the coronary and aortic arteries, which can reduce blood flow to the heart and increase the risk of oxygen deprivation, metoprolol succinate was prescribed to lower heart rate and reduce myocardial oxygen demand. This medication also helps dilate blood vessels, improving blood flow to the heart and alleviating symptoms like chest tightness and palpitations. Regular monthly follow-ups were recommended to monitor his condition.
Progress and Outcomes
After one month of consistent medication, Mr. Zhang reported that his symptoms of chest tightness and palpitations had disappeared. While the current treatment does not reverse arterial narrowing or aortic calcification, it successfully prevented further progression of the disease. Follow-up coronary angiography confirmed that the degree of coronary artery narrowing had not worsened, and chest X-rays showed no additional calcification in the aorta. These findings indicated that the treatment had effectively stabilized his condition.
Lifestyle and Ongoing Care
It is encouraging that Mr. Zhang's symptoms have subsided after treatment. However, maintaining his health requires ongoing lifestyle management. He was advised to avoid high-fat, high-cholesterol, and difficult-to-digest foods such as fried chicken and fast food to prevent spikes in blood lipid levels. Incorporating light physical activity like tai chi or walking into his daily routine can help burn excess fat and support cardiovascular health. Consistent medication use is essential to maintain therapeutic benefits and improve his quality of life. If he experiences symptoms such as dizziness or chest pain in the future, prompt medical attention is recommended to reassess his treatment plan.
Medical Insights and Final Thoughts
Atherosclerosis develops when substances like lipids and platelets accumulate on the inner walls of blood vessels, forming plaques that can eventually calcify and narrow the arteries. In Mr. Zhang's case, this narrowing of the coronary and aortic vessels led to reduced blood flow to the heart, causing his symptoms. Fortunately, since the blockage was not severe and he did not experience more critical symptoms, medication therapy was sufficient to relieve his discomfort. If treatment had been delayed and the arteries had become severely obstructed, surgical intervention might have been necessary. His case highlights the importance of early diagnosis and proactive management of atherosclerosis to prevent life-threatening complications.