Understanding the Progression of Atherosclerosis
Profile: 34 years old, weighing 260 lbs, standing at 5'9". Diagnosed conditions include Chronic Fatigue Syndrome, Fibromyalgia, and Obstructive Sleep Apnea. For the past ten years, I have struggled with persistent brain fog and extreme fatigue, and my battle with fibromyalgia has lasted approximately five years. Initially, I linked these symptoms to insufficient sleep quality, which began to deteriorate a year before I experienced my first signs. I often woke up feeling as though I had a hangover, regularly encountered night sweats, and found myself sleeping for 10 to 14 hours each night. Eventually, I underwent testing and received a diagnosis of mild obstructive sleep apnea, reflected by an Apnea-Hypopnea Index (AHI) of 6 and a Respiratory Disturbance Index (RDI) of 8. Remarkably, I was a healthy and lean 180-pound 25-year-old at that time, exhibiting symptoms such as bruxism, a scalloped tongue, and TMJ discomfort. Despite attempts to use a CPAP machine, I was unable to derive any benefit from it. As I continued to encounter health complications over the last decade and my overall condition appeared to decline, I consulted with various healthcare professionals and underwent numerous tests, all of which failed to provide any insight. In an effort to determine the cause of my sleep apnea, I opted for a CT scan of both my throat and sinuses. While the CT scan revealed no structural problems, it did indicate age-related atherosclerotic calcifications in my intracranial arteries. Notably, all my lipid profiles and cardiovascular tests have returned normal results, leading my doctor to conclude that it’s unusual for someone of my age to have significant plaque accumulation in the brain. This brings me to a pressing question: how quickly can plaque develop? I am particularly curious about this since I have contracted Covid twice in the past three years and wonder if this could have contributed to my condition or if factors such as sleep problems and inflammation are at play. My last lipid profile was obtained during the summer of 2023, and since then, I've gained around 30 pounds. This change occurred despite my efforts to maintain a healthy diet and engage in regular walking (10,000 to 20,000 steps daily), though I did have a month or two where my eating habits were less disciplined. Could there have been significant shifts in my lipid levels over the past two years that might lead to plaque development? Is that duration sufficient for plaque formation? Or is it more plausible that this has been a gradual accumulation over time?
Answers (1)
3/28/2025, 11:10:50 PM
OpenHealth AI
Understanding the progression of atherosclerosis, particularly in your case, is complex and involves multiple factors. Your questions about plaque development, sleep apnea, weight gain, and overall health are very valid, especially given your unique medical history and current symptoms.
Key Points:
- Plaque buildup in the arteries can occur gradually and is influenced by various factors, including genetics, lifestyle, chronic inflammation, and potentially infections, such as COVID-19.
- Despite having normal lipid profiles, it is possible for atherosclerosis to develop due to other risk factors, especially considering your history of sleep apnea and chronic fatigue.
- Sudden weight gain and changes in sleep quality can further complicate your cardiovascular health and may impact your overall wellbeing and energy levels.
Explanation:
Atherosclerosis is a slow process that can take years or even decades to manifest. Factors such as obesity, inflammatory conditions (like fibromyalgia and sleep apnea), and possibly the effects of COVID-19 can accelerate this process. Your weight gain of 30 pounds over the last two years might contribute to inflammation and could exacerbate existing conditions, leading to more pronounced symptoms, including brain fog and fatigue.
Although you mentioned having normal lipid levels, they can fluctuate based on diet, weight, and lifestyle, even within a short period. Chronic conditions such as sleep apnea can also influence metabolic processes and cardiovascular health, making regular monitoring of your overall health essential.
Next Steps:
-
Monitor Symptoms: Keep a symptom diary to note changes in your fatigue, brain fog, and any new symptoms, especially related to sleep. This can help you identify patterns or triggers.
-
Lifestyle Review: Reflect on your diet and physical activity. If you find it challenging to maintain healthy eating or maximizing the benefits of your daily steps, consider small, manageable adjustments. Incorporate more whole foods, lean proteins, and vegetables while reducing processed foods.
-
Regular Health Check-ups: Given your unique health profile, work with your healthcare provider to schedule regular follow-ups, focusing on cardiovascular health and possibly repeat lipid profiles to track any changes.
-
Explore Treatments for Sleep Apnea: Since CPAP hasn’t worked for you, discuss other options with your provider, such as oral appliances or positional therapy solutions. Effective management of your sleep apnea can alleviate some symptoms and potentially improve your overall health.
-
Consult about Inflammation: Consider discussing with a healthcare professional the possibility of testing for inflammatory markers, which might shed light on how inflammation could be affecting your cardiovascular health.
-
Consider Mental Health: Addressing chronic fatigue and brain fog can also involve assessing your mental and emotional well-being. Strategies such as cognitive behavioral therapy (CBT) or stress-reduction techniques may be beneficial.
Conclusion:
Your health journey is multifaceted, and understanding the causes of your symptoms requires a holistic approach. Each of these steps can help you gain clarity and control over your health. If you have further concerns or need more information, feel free to ask.
Related Questions
Seeking Assistance for Unexplained Symptoms
Hello, I’m a 15-year-old female, weighing 48.5 kg and standing at 162 cm tall, residing in Germany. At present, I’m looking for medical advice. My current medication status is none, and I have been diagnosed with Obsessive Compulsive Disorder (OCD). For the past seven months, I have been grappling with significant physical symptoms that have been largely dismissed as psychosomatic. In early 2023, I began experiencing an increased heart rate accompanied by dizziness, headaches, and episodes of near-fainting when I transition from sitting or lying down to standing. By July 2025, I noticed a gradual loss of appetite. Initially, it was mild, but it quickly escalated to a point where I no longer had any desire to eat. Once I did eat, I frequently felt nauseous, particularly with solid food, which caused painful stomach cramps and bloating. I lost around 4 kg over the initial months of these symptoms. Regrettably, my condition did not improve; it worsened, as I also experienced similar discomfort after consuming liquids. The only things I managed to take without significant pain were thicker fluids, such as drinkable yogurt and smoothies, but now even those are difficult for me. In September, I had a moderate depressive episode, for which I received psychotherapy and a prescription for Fluoxetine (20 mg). However, the medication induced severe side effects, including heightened nausea, drowsiness, muscle cramps, and weakness. My psychiatrist decided to discontinue the treatment abruptly, tapering off very quickly—after just two days at 10 mg daily, followed by 10 mg every other day for three days. One day, I became unresponsive and had to be taken to the hospital by ambulance, but no thorough examinations were conducted. While I was at school on October 11, I felt extremely fatigued, struggling to keep my eyes open. My condition deteriorated over the next couple of days, and by the 14th of October, I was unable to attend classes anymore. I began to experience severe fatigue along with muscle and joint pain, and general body aches. Despite sleeping extensively, my symptoms remained unchanged. I developed a significant intolerance to exertion, as even minimal activities like a brief 10-minute walk or sitting still for over an hour would lead to these overwhelming “crashes,” accompanied sometimes by a migraine or feelings of illness lasting 12 to 48 hours. Since mid-January 2026, I have been suffering from severe dizziness that sometimes prevents me from standing or walking normally. I have also experienced visual disturbances, like seeing dots in my left peripheral vision, and frequent facial numbness without relief. I was admitted to a psychosomatic unit, which only exacerbated my condition, putting me into a constant state of distress. I endured a prolonged migraine status for five days, which thankfully resolved gradually without any medical intervention. Many of my other days feel akin to being ill with the flu or suffering from poisoning. Whenever I discuss my symptoms with doctors or nurses, they attribute everything to either depression or a somatoform disorder, despite my persistent assertions that I do not feel depressed. I find the hospital I am at quite unfavorable. Previously, when I sought treatment for mesenteric lymphadenitis, they provided a placebo, insisting everything was psychological despite my existing diagnosis. I have undergone numerous tests, including a head MRI, endoscopy, ECG, echocardiogram, and various blood analyses. The MRI results were unremarkable, and the endoscopy showed no abnormalities. Both the ECG and echocardiogram returned normal results, and my blood work did not reveal much either, aside from a few slightly abnormal levels, which are listed below: - Vitamin B2: 333 - Vitamin B6: 76.3 - Vitamin A: 0.93 - Vitamin E: 32.0 - DAO: 5 - Histamine Degradation Ability: 34% - Ferritin: 19 - IgG: 192 - SARS-CoV-2 Antibodies: positive - Albumin: 0.75 - Neutrophils: 66% - Lymphocytes: 9.9% - Leukocytes: 4,000 - Monocytes: 3.3 - Eosinophils: 12 - Basophils: 4.4 - Absolute Neutrophils: 0.3 None of these results appear alarming. I have also performed an Active Standing test myself, leading to the following averages: - Lay down Average Heart Rate: 75 bpm - Lay down Average Blood Pressure: 90/60 mmHg - Standing Average Heart Rate: 127 bpm - Standing Average Blood Pressure: 120/80 mmHg I am desperately seeking insight regarding my symptoms and would greatly appreciate any help or guidance on what might be happening.
Significant Increase in Blood Pressure Over Two Months
Two months ago, on December 10th, 2025, I visited a CVS minute clinic due to a sinus infection, where my blood pressure was recorded at 120/74. However, during a recent visit to my general practitioner for my yearly health examination, my blood pressure soared to an alarming 200/114. The staff measured it multiple times, suspecting an error, even using a different device. The lowest reading captured was still quite high at 191/118. After discussing my situation, the doctor inquired whether I had a blood pressure monitor at home, which I do, and advised me to monitor my readings closely. Currently, after taking multiple readings, the most favorable result was 202/114, which is causing me some concern. - Female, age 39 - Weight: 175 lbs, Height: 5'2" - Non-smoker - Social drinker - No specific dietary restrictions - Sedentary lifestyle - No known family history of heart disease - Currently taking 20mg/day of Escitalopram and 450mg/day of Bupropion for anxiety and depression Online resources suggest that my readings indicate a "hypertensive crisis," a term that sounds rather serious. Despite my weight issues, these figures appear excessively high. I plan to message my GP for a follow-up, but I am wondering how alarmed I should be in the meantime?
Advice Needed on Possible Heart Condition (ASD)
Greetings everyone, I am a 27-year-old individual. Towards the end of 2022, a preliminary 2D echocardiogram raised concerns regarding a potential Atrial Septal Defect (ASD). Consequently, I underwent several follow-up echocardiograms and treadmill tests throughout 2023 and 2024. Fortunately, all results returned to be normal, and subsequent assessments indicated no structural issues with my heart. I also had a thorough evaluation at Apollo Hospital, which yielded normal findings as well. Later, during a consultation at Manipal Hospital, I was informed that the symptoms I am experiencing might be linked to anxiety or excessive worrying. Additionally, my lab tests revealed elevated levels of cholesterol and blood sugar, which fall into the prediabetic category. Currently, I do not experience chest pain, but I Continue to suffer from palpitations and a fast heartbeat, particularly when engaging in physical activities like climbing stairs. Despite receiving normal cardiac evaluations, these troubling symptoms persist, leading me to wonder if ASD has truly been dismissed or if I should consider further testing. I would appreciate any guidance on this matter.
Should I Request a Heart Evaluation from My Doctor?
**Personal Details**: 24 years old, no medications or substances, no existing health diagnoses, non-smoker, non-drinker, maintaining a healthy weight and height, engaging in regular physical activity. **Context**: During my time at university, I resolved to overcome my previous disinterest in academics and poor performance in school by adopting a comprehensive approach. This included selecting a challenging major, crafting a plan to finish my degree two years ahead of schedule, aiming for nothing less than As on exams, and ensuring my relationships with family and friends remained intact. However, my dedication to this plan resulted in significant stress. As I invested more time and energy into my studies, my anxiety about potential failure, looming deadlines, chaotic group projects, and unrelated personal issues escalated. Ultimately, this manifested as complications with my heart and blood pressure. What is most alarming is how I became accustomed to these health changes and dismissed the warning signs. I neglected to seek help from doctors or consider treatment options, essentially ignoring the symptoms entirely. **Health Issues Faced**: 1. **Heightened Sensitivity to Adrenaline**: Simply walking outside among people and traffic triggered noticeable spikes in my blood pressure. Roughly every thirty seconds, I experienced tingling in my abdomen, followed by a surge of pressure in my neck and a momentary slowing of my heart to manage the influx of blood pressure. Over the course of an hour, these occurrences added up, leading to possibly hundreds of episodes over days and months—quite concerning. 2. **Palpitations**: While this was not a constant occurrence, when it did manifest, it lasted for one to two weeks at a time. I would feel my heart racing, even during moments of rest at home. This would happen several times a day, persistently from morning until night. 3. **Elevated Heart Rate**: This was a continuous issue; my resting heart rate frequently soared into the 90s, even while sitting quietly. It often felt as though I was exerting effort, akin to physical activity, though I remained still. 4. **Chronic Tension and Sleep Disruption**: I dealt with ongoing feelings of tightness and inadequate sleep, at times leading to strange waking perceptions, such as seeing geometric shapes on surfaces upon waking. While not directly related to the previous issues, this level of sleep deprivation is undoubtedly harmful to one's health. These issues persisted for approximately two and a half years, but I have since regained my health. Nonetheless, I can't shake the feeling that I may have compromised my cardiovascular health due to these symptoms, which is why I am contemplating a heart evaluation with my doctor. I sought the opinion of an AI, which seemed dismissive, suggesting that given my situation and assuming no hidden health conditions, long-term damage was unlikely—perhaps even impossible. However, I would rather hear insights from healthcare professionals, so I'm reaching out for advice. Please share your thoughts!
Concerns About Ear Irrigation at the Pediatrician's Office for My Son
Summary: Can using a spray-type irrigation for ear wax removal harm a five-year-old? My child had a extreme reaction and experienced significant pain during and shortly after the procedure. I have a five-year-old son who suffers from severe allergies to both foods and environmental factors, alongside eczema which is mostly controlled. He takes Famotidine to manage reflux and a daily children's multivitamin, but does not regularly take any other medications. He has no history of surgeries. Although he has consulted with an ENT in the past, I don’t believe this is particularly relevant to the current situation, yet I will provide details later. During a recent well-visit at the pediatrician's office for five-year-olds, my son struggled with the hearing test, which marked the first time he did not perform well. In this examination, he wore headphones that emitted various beeps and was supposed to indicate which ear he heard the sounds from. The staff expressed concerns regarding his performance on the left side. As our assigned provider, the Physician's Assistant (PA) examined his ear and noted the presence of wax, suspecting it might be impeding his hearing. When she attempted to use a plastic curette, my son resisted and stated that it hurt. The PA remarked that the wax was harder than she anticipated, leading her to opt for an irrigation method to remove it. The nurses proceeded to administer some red-tinted drops, which he tolerated other than their cold temperature. A few minutes later, he laid down, and they used a spray bottle to irrigate his ear. At this point, he screamed as though we had never experienced before—he fought against the staff and cried intensely, even holding his breath to the extent that they needed to remind him to breathe. His reaction was reminiscent of when he has sustained a severe injury, such as from a significant fall. His cries of pain made it clear that he was genuinely suffering. After only a few moments, they decided to halt the procedure, presumably realizing that his discomfort was not an act of dramatization, and I was on the verge of stopping them myself due to my rising concern. When he eventually settled down, I inquired about the nature of his pain: whether it was a hot or burning sensation, a sting from the cold water, or a feeling of pressure in his ear. He communicated that it felt like it was going to burst inside, which suggests pressure-related pain. The irrigation attempt did not fully clear the wax they noticed. Now they are recommending that we use Debrox drops daily combined with a warm washcloth pressed against his ear after a steamy bath each night. We are to return in two weeks to check if the wax has been successfully removed and to retest his hearing. Though he appears to be okay now, he is visibly upset due to the discomfort from the procedure, especially since he had begged them to stop. He has also mentioned a sensation of water still being trapped in his ear and has been tilting his head intermittently as if it bothers him. This all transpired today right after the irrigation session. Could the forceful spraying of water have caused any damage to his eardrum, especially considering the intensity of his screams? I have previously experienced a perforated eardrum and am anxious about the potential harm this procedure may have inflicted on him. We avoid using Q-tips and inserting anything into his ears. What preventive measures should we adopt routinely to avoid wax buildup? This marks the second instance of noticeable wax at his pediatric visits, despite him bathing daily. I am puzzled as to why only one side is accumulating wax. Last year, the first attempt at wax removal was successful using a curette. ENT Background: At age three, my son was having trouble sleeping. An ENT suggested a tonsillectomy and adenoidectomy, although there were no other alarming symptoms to justify the surgery besides his restlessness at night. We sought a second opinion, where the new ENT indicated that while his tonsils appeared fine, his adenoids were mildly enlarged and might be beneficial to remove. However, due to COVID-19 and RSV, the surgery was postponed twice, leading us to reconsider the necessity of the operation. Given that he is now sleeping better, we have yet to pursue surgery thus far. I appreciate you taking the time to read through this lengthy account!