Atherosclerosis of the carotid arteries ICD 10. Generalized atherosclerosis: causes, symptoms and treatment. I71 Aneurysm and aortic dissection

Atherosclerosis of peripheral arteries- disease of peripheral arteries with a chronic course. A segmental obstruction to blood flow or narrowing of the lumen of the main arteries is formed, causing a pronounced decrease or cessation of blood flow, usually in the arteries of the lower extremities. As a result, ischemia occurs with the onset of pain, and with circulatory decompensation - trophic ulcers and gangrene. At the same time, the mesenteric and celiac arteries may be involved in the process.

Code according to the international classification of diseases ICD-10:

• I70.2
• I70.8
• I70.9

Frequency increases with age (in parallel with the incidence of atherosclerosis). Predominant age- elderly. Predominant gender- male (2:1).

Causes

Risk factors. Smoking. SD. Hyperlipidemia. Arterial hypertension. Excessive physical stress.

Pathomorphology. Thrombi in the lumen of the artery. Calcified inclusions in the middle shell of an occluded vessel, atheromatous plaques of the inner shell.

Symptoms (signs)

Clinical picture. Intermittent claudication. Systolic murmur over the affected arteries. Auscultation points.. Behind the angle of the lower jaw (bifurcation of the carotid artery and the initial section of the internal carotid artery).. Place of attachment of the sternocleidomastoid muscle to the clavicle (initial segment of the common carotid artery, subclavian artery).. Under the xiphoid process (abdominal aorta, celiac trunk) .. From the navel towards the points between the inner and middle thirds of the inguinal ligament (right and left iliac arteries).. Inguinal fold (femoral artery).. Popliteal fossa (popliteal artery). Points of palpation of the arteries of the lower limb.. Femoral artery - the middle of the inguinal ligament.. Popliteal artery - popliteal fossa.. Posterior tibial artery - behind the medial malleolus.. Dorsal artery of the foot - from the middle of the intermalleolar line to the first interdigital space. Classification of obliterating atherosclerosis. Stage I - pain in the calf muscles appears when walking calmly over a distance of 1 km. IIA - the patient can walk more than 200 m before the onset of pain. IIB - the patient can walk less than 200 m at a normal pace before the onset of pain. III - pain occurs at rest and when walking at a distance of up to 25 m. IV - ulcerative-necrotic changes in the lower extremities.

Diagnostics

Laboratory research. Bleeding time. PTI. Plasma glucose. Cholesterol. Fibrinogen. Fibrinogen B.

Special studies. Non-invasive.. Segmental measurement of blood pressure (reduced distal to arterial stenosis or occlusion) at different levels of the arm or leg before and after physical activity.. Ankle-brachial index (ABI) - the ratio of blood pressure in the ankle joint to blood pressure in the brachial artery... Patients with complaints of intermittent claudication usually have a LPP below 0.8 (normally 1.0)... In patients with pain at rest, the LPP is less than 0.5. When the index is below 0.4, necrosis of the tissues of the limb is possible... The value of DILI is falsely elevated due to arterial calcification (usually with a combination of atherosclerosis and diabetes).. Rheovasography.. Doppler duplex study. Invasive methods... Intravenous angiography with digital image processing.. Arterial angiography with digital processing. Conventional arteriography is the standard method for assessing vascular diseases. The contrast agent is injected into the arterial bed either by puncture of the abdominal aorta in the lumbar region (translumbar aortography), or by puncture of the femoral artery with a special probe advanced to the required distance. Sequentially, as the contrast agent descends to the periphery, a series of x-rays are taken.

Treatment

TREATMENT

Mode. In stage I and stage IIA the mode is outpatient. In more severe stages - hospitalization for surgical treatment. Physical activity: Avoid activities that cause pain.

Diet No. 10c, which helps reduce cholesterol in the blood serum (see Atherosclerosis); for obesity - normalization of body weight.

Surgery

Indications for surgical treatment are IIB (with rapid progression), III-IV stages of the disease.

Minimally invasive methods. Intravascular dilatation of the stenotic area through inflation of the balloon catheter results in crushing of atherosclerotic plaques. Stenting is the introduction of self-expanding stents into the narrowing area, often containing drugs that help dissolve the atherosclerotic plaque. Dilatation is carried out by an angiologist during angiography. The angiographic catheter is replaced with a balloon one and, under the control of an electron-optical converter, is brought to the area of ​​stenosis. Then the balloon is inflated with oxygen or an inert gas under a pressure of 4-8 atm. Arterial dilatation can be complicated by distal embolism and rupture of the vessel in the area of ​​dilatation, which occurs in 3-5% of cases. The duration of vessel patency after balloon dilatation depends on the location of the lesion. Dilatation of the iliac and femoral arteries gives good results, but the patency of small arteries is restored for a much shorter period.

Open types of surgical interventions.. Bypass operations: aorto-femoral bypass with a synthetic prosthesis, femoral-popliteal and femoral-tibial bypass with an autovenous vein... The patency of the autovenous bypass for 5 years is maintained in 65-80% of patients, the limb can be saved in 90% of cases ... The main cause of death after surgery is MI. Therefore, before surgery, patients should identify hidden coronary insufficiency and treat coronary artery disease. Endarterectomy - opening the lumen and removing the atheromatous plaque along with the inner membrane. Used only for local lesions of the aorta or common iliac arteries... Lumbar sympathectomy is indicated for patients with diseases of the arteries of the lower extremities that are not amenable to reconstruction... Good results can be achieved in patients with moderate rest pain, small superficial skin ulcers or in patients with DILI more than 0.3 ... This procedure is rarely indicated for patients with diabetes, because many of them undergo autosympathectomy. Amputation in some cases can not only save life, but also contribute to the rehabilitation of the patient. Approximately 50% of amputations occur in cases complicated by diabetes. Indications for amputation: ... Impossibility of reconstructing the affected vessels... Persistence of critical ischemia after restoration of the main blood flow... Gangrene of the foot... Sepsis.

Drug therapy. Pentoxifylline 400 mg 3 times a day. It should be used with caution in case of labile blood pressure, heart failure, sclerosis of the coronary vessels, impaired liver and kidney function, in combination with antihypertensive and antidiabetic drugs. Acetylsalicylic acid. Lipid-lowering drugs (lovastatin, lipostabil). Ganglion blockers (benzohexonium, dimecolium iodide). Andekalin. Xanthinol nicotinate 0.5-1 g 2-3 times a day after meals. Contraindicated in case of bleeding, MI, severe heart failure, peptic ulcer in the acute stage. It should be used with caution in case of labile blood pressure, pregnancy, and in combination with antihypertensive drugs. Nicotinic acid, nicoshpan. Antihypoxants (vitamin E). B vitamins, ascorbic acid. Solcoseryl.

Physiotherapy. Diadynamic currents, diathermy of the lumbar region, barotherapy. Balneotherapy: hydrogen sulfide baths (Pyatigorsk, Sochi-Matsesta).

Complications. Trophic ulcers. Vessel thrombosis. Gangrene.

Course and prognosis. The course varies from slowly progressing with minor symptoms to rapid deterioration leading to the need for surgical intervention. The prognosis is relatively favorable. Only in 10% of patients within 10 years the disease progresses to the degree of severe ischemia of the limb. The survival rate of such patients is quite high (5 years - 73%, 10 years - 38%). The most common cause of death is atherosclerotic damage to the coronary arteries of the heart .

Synonyms. Atherosclerosis of the arteries of the extremities. Obliterating atherosclerosis

Reduction. ALI—ankle-brachial index.

ICD-10. I70.2 Atherosclerosis of the arteries of the extremities. I70.8 Atherosclerosis of other arteries. I70.9 Generalized and unspecified atherosclerosis

ICD, or The International Classification of Diseases is a document, specially created for statistical recording and classification of various diseases. The World Health Organization regularly reviews and updates it, and today doctors use the tenth edition of the ICD.
Diseases in this document are divided into classes, classes into so-called diagnosis blocks, and those, in turn, into headings. Classes are formed based on the nature of the disease itself (infectious disease, nervous system disorder, circulatory disorder). The blocks specify the disorder (for example, in the class of infectious diseases there are blocks of bacterial, viral, fungal).

The headings include final diagnoses, taking into account not only the general nature of the disease, but also localization, mode of transmission, etc. All characteristics of the disease are coded using Latin letters and numbers. Letters indicate classes, numbers indicate blocks and headings.

So, for example, the diagnosis “atherosclerosis of the arteries of the extremities” has code I70.2, where the letter I denotes the class - diseases of the circulatory system, the numbers 70 - the block “atherosclerosis”, and 2 specifies the disease by location.

Atherosclerosis according to ICD-10

Atherosclerosis is a disease of the arteries, arising due to disturbances in protein and lipid metabolism in the body.

With this disease, cholesterol and lipoproteins accumulate on the walls of the arteries, forming dense plaques. Over time, connective tissue grows into these plaques, causing them to expand and harden.

At the same time, the lumen of the vessel decreases, blood flow is disrupted, and in the most severe cases, atherosclerotic plaques completely clog the artery, blocking blood access to organs and tissues.

ICD-10 distinguishes five types of atherosclerosis, and each has an additional digital index:

• I70.1 – atherosclerosis of the renal artery;
• I70.2 – arteries of the extremities;
• I70.8 – other arteries (mesenteric and peripheral);

In terms of symptoms, it is similar to atherosclerosis - it also causes the formation of blood clots and blockage of blood vessels (obliteration). The important difference is that atherosclerosis is caused by a disorder of fat metabolism, and endarteritis is an autoimmune disease. In addition, endarteritis can affect not only arteries, but also veins.
Let's take a closer look at the types of atherosclerosis of blood vessels and arteries.

ICD-10 I70.0 Aorta

The aorta is the largest blood vessel in the human body. This is why aortic atherosclerosis is especially difficult to recognize: it takes a lot of time for plaque to grow to a size that can interfere with blood flow in this vessel. This disease develops over many years, and it can only be recognized at the preclinical stage with the help of special laboratory tests.

At the clinical stage, symptoms such as:

1. cardiopalmus;
2. headache;
3. dyspnea;
4. dizziness;
5. fainting.

Attention! If left untreated, this disease can lead to myocardial infarction.

I70.1 Renal artery

This disease affects the renal artery, as a result of which the blood supply to the kidneys is disrupted, which, in turn, leads to a deterioration in their functions. This disease also develops over a long period of time, usually against the background of hypertension.

Symptoms include problems with urination, abdominal pain, and sometimes nausea and vomiting. At the preclinical stage, the development of the disease is indicated by a drop in potassium levels in the blood.

ICD-10 I70.2 Arteries of the extremities

When people talk about this disease, they usually mean damage to the arteries of the legs. Atherosclerosis of the arteries of the hands is much less common.

In both cases large blood vessels are affected, due to which blood flow in the extremities is disrupted, and tissues begin to experience oxygen starvation. Even if the blood flow is not completely blocked, the risk of developing gangrene is high.

Symptoms of the disease are numbness of the extremities, pale skin, convulsions, and in later stages – cyanosis and cyanosis.

Important: Vascular atherosclerosis should not be confused with endarteritis.

The symptoms are almost identical, but the course of the disease and treatment methods vary greatly. In addition, endarteritis almost never affects the upper extremities.

I70.8 Other species

By “others” in the ICD are meant the mesenteric arteries, which are responsible for the blood supply to the intestines and pancreas, the hepatic, gastric, splenic arteries, as well as two carotid arteries - the external and internal, which are responsible for the blood supply to the head. That is, the ICD-10 code for cerebral atherosclerosis will also be I70.8.

The defeat of the latter is the most dangerous - a violation of the blood supply to the brain leads to deterioration of memory, cognitive functions and even blindness, and with poor treatment - to a stroke. Moreover, unlike other types, The causes of atherosclerosis of the carotid arteries are still unclear. According to one hypothesis, this disease is autoimmune in nature.

I70.9 Generalized and unspecified atherosclerosis

This diagnosis is made if the disease affects several vessels at the same time, or if it is not possible to accurately determine the source of its occurrence.

If blood flow through the arteries of the legs is disrupted, accompanied by a narrowing of their lumen and partial absence of vascular patency in the femoral and popliteal areas, obliterating atherosclerosis of the vessels of the lower extremities is diagnosed, having an ICD10 code: 170.2.

Blockage of the lumen of blood vessels occurs as a response to the accumulation of a large number of lipid and cholesterol formations. These plaques, initially small, gradually increase in size and grow in the lumen of the artery. Stenosis of the arteries occurs, and then they are completely closed.

ICD 10 classifies obliterating atherosclerosis of the vessels of the lower extremities as a pathology associated with an overwhelming excess of cholesterol on the walls of the arteries. This disease is common in 20% of elderly patients with atherosclerosis.

But it has been noted that in people of pre-retirement age, the number of diagnosed cases of atherosclerosis of the lower extremities is close to 4%, and after 10 years - twice as often.

Male patients are at risk, especially those who continue to smoke.

Causes

In order for excess cholesterol in the blood to cause such a serious disease as atherosclerosis of the vessels of the lower extremities, included in the international classification ICD 10, there must be a combination of several factors influencing the structure of the arteries:

Stages and symptoms of the disease

The severity of symptoms and their nature depend on the degree of development and progression of atherosclerosis of the lower extremities (ICD code 10), the involvement of the arteries of the legs in the process and the blocking of their lumen.

There are 4 stages, differing in clinical manifestations:

• The first stage - the diagnosis is established only by the results of laboratory blood tests that detect excess cholesterol levels. There are no symptoms of the disease that are noticeable to the patient.
• The second stage is characterized by the presence of the first noticeable signs of the disease, including numbness, pain in the lower extremities, the appearance of muscle cramps and chilliness (which is explained by a deterioration in the blood supply to these parts of the body).
• At the third stage, clinical symptoms clearly appear: thinning of the skin on the legs, ease of skin damage and the appearance of wounds; lameness and severe pain in the lower extremities appear.
• The fourth stage is a serious condition. The patient's lameness becomes permanent, persistent pain persists, and the leg muscles atrophy. The development of trophic ulcers and gangrene is likely, which can have fatal consequences including loss of a limb.

If the described signs are identified, if alarming phenomena appear, it is necessary to consult a doctor as soon as possible for examination, diagnosis and treatment. Left unattended, atherosclerosis of the vessels of the lower extremities (ICD code 10) leads to disability.

Diagnostics

Diagnostics consists of:

• Taking anamnesis;
• Assessment of clinical symptoms;
• Instrumental and hardware examination;
• Laboratory examination.

Laboratory tests include blood and urine tests.

Instrumental studies include Dopplerography to determine the characteristics of blood supply in the lower extremities, rheovasography, arteriography, angioscanning and thermography.

Attention is also paid to differentiating atherosclerosis disease (CAD) from thromboangitis and endarteritis.

Treatment

After confirming the diagnosis in a medical institution, the doctor selects the most suitable treatment regimen for the patient, which takes into account the characteristics of the course of the disease, the condition of the body and the stage of the disease.

Treatment can be conservative, with health measures, endovascular or surgical.

Treatment is designed to solve priority problems:

1. Reduce and facilitate the passage of pain in the patient;
2. Promote endurance during everyday walking;
3. Stop the development of plaques in blood vessels and prevent the formation of ulcers.

With conservative treatment, medications are prescribed to restore blood supply to the legs; vitamin complexes; ointments containing antibiotics; local agents that stimulate regeneration; physiotherapy; drugs to improve blood microcirculation.

Endovascular treatment involves acting directly on damaged vessels. This is dilatation stenting, angioplasty (its essence is in dilation of blood vessels using local anesthesia).

Surgical treatment comes to the rescue if nothing else has helped. Then doctors resort to thromboendarterectomy or bypass surgery (organizing a bypass for blood flow).

With advanced gangrene, in irreversible cases, amputation of the limb is performed.

Any treatment brings the best results with an integrated approach, including drug therapy, household health measures, and natural remedies of traditional medicine.

Traditional medicine

Prevention

Like any type of atherosclerosis, obliterating atherosclerosis of the lower extremities (ICD 10) is easiest to prevent if you regularly monitor your health and know the risk factors.

The diet should be adjusted so as not to contain excess cholesterol-causing foods. There are scientifically proven dietary recommendations, but they are remembered only when the disease has already appeared.

You can delay its appearance or eliminate it completely if you make the rule of life a sufficient amount of physical activity, walking in the fresh air, excluding alcoholic beverages and tobacco, reducing the proportion of sweet and flour products in the diet, and an almost complete absence of canned food, fatty, fried, and spicy foods.

It is necessary to avoid hypothermia of the lower extremities, stagnation of blood in them due to uncomfortable shoes and high heels. Sitting in one place for a long time without changing posture also provokes problems with blood circulation.
People with diabetes will help their skin on their legs, especially their feet, if they rub it with a small amount of insulin.

Obliterating atherosclerosis of the lower extremities is a vascular pathology that occurs as a result of lipid metabolism disorders. The disease more often affects older people. It requires timely treatment, as the consequences of the disease are dangerous to health.

Description of the pathology, its code according to ICD-10

Obliterating atherosclerosis of the legs is a vascular disease in which the vascular lumen is blocked and blood circulation in the extremities is impaired. Arterial blockage occurs due to a large accumulation of lipids in them.

Cholesterol plaques form on the walls, which gradually increase in size. As a result, the vascular lumen narrows more and more, and then completely closes off. This entails a disruption in blood flow, which is observed not only in the legs, but throughout the body.

Obliterating atherosclerosis of the vessels of the lower extremities has a code according to the International Classification of Diseases (ICD-10) I70.

Why does pathology develop?

Atherosclerotic disease occurs due to damage to the walls of blood vessels and high levels of cholesterol in the blood. The progression of the anomaly occurs under regular and prolonged exposure to negative factors on the human body.

The disease can be provoked by:

• Smoking and alcohol abuse.
• Poor nutrition, when a lot of food with a lot of animal fat is consumed.
• High blood pressure.
• Excess body weight.
• Excessive physical activity.
• Heredity.
• Diabetes.
• Sedentary lifestyle.
• Regular stress.
• Prolonged hypothermia of the legs.

Arterial disease most often affects older people, but recently the disease has become increasingly diagnosed in the younger generation.

Mechanism of arterial damage

Under the influence of unfavorable factors, damage appears on the walls of the arteries. In their place, lipids begin to accumulate, which form a yellowish stain. Connective tissue begins to form near them, resulting in a plaque growing. Other elements can settle on top of it: salts, fibrin clots, platelets.

The affected area becomes increasingly covered with plaque. Particles can break off from it, move through the bloodstream throughout the body and can clog blood vessels.

Due to impaired blood circulation in the arteries, tissues suffer from a lack of oxygen and nutrients. This entails the development of ischemia and cell necrosis.

Symptoms

Arterial disease develops over several years. It may not cause any unpleasant symptoms for a long time, so a person often has no idea that he is sick.

Symptoms usually appear in the later stages of the pathology. The main symptom is pain during movement. It manifests itself even with short walking and is accompanied by severe fatigue of the legs.

In addition to pain, patients are concerned about the following manifestations:

1. numbness of the feet;
2. excessive sensitivity to low temperatures;
3. feeling of constant burning of the skin;
4. the occurrence of lameness;
5. increased body temperature;
6. the appearance of painful cracks in the heels;
7. pallor or bluishness of the skin;
8. hair loss on the extremities;
9. deterioration of nail condition;
10. skin thickening;
11. formation of ulcers;
12. night cramps.

When atherosclerosis affects the femoral arteries in men, sexual dysfunction may occur, including impotence.

Diagnostics

To make a diagnosis, the doctor performs a thorough examination of the lower extremities. First of all, an external inspection is carried out. The doctor studies the patient’s complaints, his medical history, checks blood pressure, and evaluates blood pulsation in the arteries of the legs.

In addition to a visual examination and medical history, additional diagnostics are prescribed. This includes duplex scanning. It helps to identify abnormalities in the arteries, their shape, and the speed of blood movement.

Arteriography is also performed. It is a study using x-rays. When performing diagnostics, a contrast agent is used, which is injected into the arteries of the limbs. If the patient has intolerance to the contrast component, arteriography is not prescribed. This examination method is necessary to detect an aneurysm, blockage of vascular lumens, and determine the speed of blood flow.

Another effective way to detect atherosclerosis is magnetic resonance angiography. With its help, it is possible to examine the condition of the vessels in more detail and detect even small pathological changes in them.

Treatment regimen

Treatment of obliterating atherosclerosis is carried out using different methods. The choice of specific treatment tactics depends on the degree of damage to the arteries of the extremities. Therapy is carried out only in a comprehensive way.

Adjusting nutrition and lifestyle

Atherosclerotic plaques form when there is a large amount of harmful fats in the blood. They mostly enter the body with food. That is why patients need to follow a diet.

The diet should not contain foods high in animal fat, such as fatty meats, fast food, dairy products with a high fat content, smoked foods, processed meats, sausages, and fried foods.

Patients with atherosclerosis of the arteries need to switch to a healthy lifestyle. And this applies not only to nutrition. Doctors advise moving more, performing therapeutic exercises, but avoid overstraining the limbs. You will also have to give up bad habits.

Taking medications and performing physical therapy

For atherosclerotic disease, medications must be taken for a long time - at least two months. Drug therapy involves the use of the following drugs:

1. Vasoactive agents. Medicines help make the lumen of the arteries wider, which prevents the development of ischemia.
2. Antiplatelet agents. Help prevent blood clots and normalize blood flow. During therapy with such drugs, it is necessary to regularly undergo laboratory blood testing for clotting.
3. Drugs intended to improve the rheological properties of blood.
4. Analgesics to eliminate pain in the legs when walking.

As a complement to medications, doctors prescribe physiotherapeutic procedures. Methods such as UHF, electrophoresis, balneotherapy, and mud baths are effective for atherosclerosis of leg vessels.

Surgical methods

Surgery for atherosclerosis is prescribed in severe stages, when it is impossible to cope with it with medications. Open and minimally invasive treatment methods are used. The latter are safer, but are effective only for minor vascular lesions.

The following types of operations are used for atherosclerosis and endarteritis of the leg arteries:

• Endarterectomy. It involves removing a damaged section of an artery.
• Shunting. During this operation, instead of the affected part of the vessel, a prosthesis made of synthetic material or tissues of other arteries is inserted.
• Balloon angioplasty. A special catheter with a balloon is installed into the arterial lumen. Thanks to it, the vascular walls expand, which helps normalize blood circulation.
• Stenting. A stent containing substances that promote the resorption of atherosclerotic plaques is inserted into the lumen of the vessel.

If gangrene or a large number of ulcers develops, the leg is completely removed. This consequence occurs only at the last stage of atherosclerotic disease, so treatment of vascular pathology should begin as early as possible.

Prevention

Atherosclerosis of the arteries is a dangerous disease, so care should be taken to prevent it. Preventive measures will help minimize the risk of developing vascular anomalies. Doctors advise the following:

1. Eat properly.
2. Exercise.
3. To refuse from bad habits.
4. Control your body weight.
5. Avoid overcooling your feet.

Also, for the prevention and timely detection of atherosclerosis, it is necessary to undergo an annual vascular examination. This is the most important and effective measure to protect yourself from many health problems.

Insufficient blood supply to the brain with slowing blood flow, a tendency to stagnation, slow reactions of expansion and contraction to external and internal irritations leads to the fact that a patient with cerebral atherosclerosis begins to experience headaches - dull, worsening with fatigue and becoming almost constant over time. . There is often noise and ringing in the head, dizziness with staggering during a sudden change in body position and when walking, redness of the face with sweating or paleness, and sometimes “flying spots” before the eyes. During a long conversation (report, speech), “stumbling” on syllables may occur.
As a rule, sleep is disturbed - it becomes intermittent, with sudden awakenings, palpitations and fears, often with unpleasant dreams, and falling asleep during the day while working is noted.
One of the first symptoms of cerebral atherosclerosis is a decrease in mental activity, weakening of attention, and inability to quickly grasp what is essential. A typical symptom is impaired memory for recent events while intact for long-past events. It is important to note that mechanical memorization is more impaired than logical semantic memory. Along with weakening of mental activity, emotional instability in the form of tearfulness, suspiciousness, anxiety, irritability, pickiness, and grumpiness is typical. Mental “stuckness” is characteristic – slow recovery from the slightest failures, a tendency to depressive reactions.
When examining patients with cerebral atherosclerosis, a number of objective disorders are also revealed. First of all, coordination of movements is impaired. The gait becomes unstable, staggering appears in a standing position, and subtle manipulations with the hands become unclear. The pace of movements slows down, and trembling of the head, chin, or one or both hands may appear. Nystagmus is sometimes noted. The pupils may change their shape, become uneven, and their reaction to light is sluggish. Facial asymmetry is common - one corner of the mouth is lower than the other, the tongue deviates to the side when protruding. Even with normal blood pressure, the pulsation of the vessels in the neck becomes visible, the temporal arteries become tortuous, and the pulsation in the arteries may weaken. When pressing on the arteries, their pain is noted. When examining the fundus, narrowing of the arteries and tortuosity of the veins are detected.
The blood cholesterol level is elevated (more than 250 mg per 100 ml). X-rays of the skull often reveal calcification of the internal carotid and basilar arteries supplying the brain.