I had to get an arterial blood gas done today - taking blood from an artery rather than a vein. The entire pulmonary function department with a combined 80 years of experience all took a crack at me - all of them were baffled and said I had the smallest, most deeply buried arteries they can remember.
Did not go well.
Anyway, that leaves me curious - would smaller arteries lead to more heart attacks and strokes? It seems logical - if plaque starts building up on the outside of the blood vessel, there’s not that much room for the plaque to build before it’s blocking something.
I’m in poor shape, but the technician said that the size of arteries isn’t really related to fitness but simply genetics. Is that true?
First, I don’t know the answer to the question of whether or not people with “small” (I assume you mean small in cross-section, or luminal diameter) arteries are at increased risk for atherosclerosis. Heart attacks and strokes are related (mostly) to atherosclerosis, as you know. Actually, most blockages occur in lesions which start just under the endothelial lining and then those lesions get built up with lipid and other deposits. It’s really more of an inside-out than outside-in process.
On average, folks with smaller hearts have smaller vessels. On average, smaller people have smaller hearts. There are groups (I can think of South Indians) who seem genetically pre-disposed to smaller vessels. South Indians who move here to the US also seem to develop coronary artery disease more than they do in India, and I do hear (anecdotally) that their small vessels, along with a tendency to develop diffuse disease, make them tough bypass candidates.
On the other hand, I wouldn’t say a small person with a small heart and small coronaries is more prone than a larger person with larger vessels to get disease. In the end, as far as I know, risk factors such as smoking and bad genes and diabetes are bigger risks than vessel size.
I might add that the size of your particular distal arteries (probably either brachial or radial) that they were attempting to stick is not necessarily a correlate with your other vessels. Everyone has a lot of natural variation. And maybe you just have tough skin or something…
That’s the issue - I’m a big guy with the arteries of a small person I guess. It was enough for all 3 of the technicians to comment how unusual it was.
They tried both brachial and radial - ended up digging for the radial because neither presented a good pulse and the radial is less invasive. In fact my pulse kept dissapearing - they’d feel around for it for a few minutes, find it, grab the needle … and then it was gone.
Maybe I have unusually small arteries just in the arms, who knows. I’ll talk to my doctor about it in a few weeks to see if I need some sort of blood vessel workup done. There was another issue too - my blood now apparently clots like crazy, with my sample turning into a gooey string in a heparanized needle in just a few minutes - they took the blood right up to the lab and it was almost untestable because of how fast it clotted. Sounds like a scary combo there.
While I can’t comment on your particular situation accurately, it’s not uncommon for a difficult stick–arterial or venous–to have clotting issues by the time it gets to the lab, and we would not typically infer from that a physiologic perturbation of the patient. It’s more of a mechanical issue.