Statins
The group of medications referred to as statins are widely prescribed for treating atherosclerosis. They have shown benefit in reducing cardiovascular disease and mortality in those with high cholesterol with few side effects. Secondary prevention therapy, which includes high-intensity statins and aspirin, is recommended by multi-society guidelines for all patients with history of ASCVD (atherosclerotic cardiovascular disease) to prevent recurrence of coronary artery disease, ischemic stroke, or peripheral arterial disease. However, prescription of and adherence to these guideline-concordant therapies is lacking, particularly among young patients and women.Statins work by inhibiting HMG-CoA (hydroxymethylglutaryl-coenzyme A) reductase, a hepatic rate-limiting enzyme in cholesterols biochemical production pathway. By inhibiting this rate-limiting enzyme, the body is unable to produce cholesterol endogenously, therefore reducing serum LDL-cholesterol. This reduced endogenous cholesterol production triggers the body to then pull cholesterol from other cellular sources, enhancing serum HDL-cholesterol. These data are primarily in middle-age men and the conclusions are less clear for women and people over the age of 70. Surgery
When atherosclerosis has become severe and caused irreversible ischemia, such as tissue loss in the case of peripheral artery disease, surgery may be indicated. Vascular bypass surgery can re-establish flow around the diseased segment of artery, and angioplasty with or without stenting can reopen narrowed arteries and improve blood flow. Coronary artery bypass grafting without manipulation of the ascending aorta has demonstrated reduced rates of postoperative stroke and mortality compared to traditional on-pump coronary revascularization.
A child gets separated from their parents in a large crowd and gets lost. A child sticks their head between the bars of a fence and then cannot get back out. A child crawls into a hole and gets stuck, or cannot find their way back. A child is left in their parents car, truck, or van. A child is in a crowded area with no windows (a classroom, basement, etc.) and has run-ins with other people, or is put there as a means of punishment.The term past experiences, according to one author, can extend to the moment of birth. In John A. Speyrers "Claustrophobia and the Fear of Death and Dying", the reader is brought to the conclusion that claustrophobias high frequency is due to birth trauma, about which he says is "one of the most horrendous experiences we can have during our lifetime", and it is in this helpless moment that the infant develops claustrophobia. Magnetic resonance imaging (MRI) can trigger claustrophobia. An MRI scan entails lying still for some time in a narrow tube. In a study involving claustrophobia and MRI, it was reported that 13% of patients experienced a panic attack during the procedure. The procedure has been linked not only to the triggering of preexisting claustrophobia, but also to the onset of the condition in some people. Panic attacks experienced during the procedure can stop the person from adjusting to the situation, thereby perpetuating the fear. S.J. Rachman tells of an extreme example, citing the experience of 21 miners.