3: Atheroma Flashcards
What atheroma also known as?
Atherosclerosis
Hardening of the arteries
(Coronary artery disease
Ischaemic heart disease)
Atheroma is most common in developed / developing countries.
developed
Outline the pathogenesis of an atheroma.
Primary endothelial injury
Accumulation of lipids and macrophages (swelling starts)
Migration of smooth muscle cells (further swelling, narrowing the lumen, causing stenosis)
Increase in size
greatest risk at this point is that endothelial forms a ‘cap’ over the atheromatous plaque, which can then rupture, trigger coag. cascade and thrombosis.
What is a fibrous cap usually made of?
Collagen
Electrical instability caused by hypoxia (caused by atheroma) in a coronary artery can give rise to ___.
arrhythmia
What is the name given to the start of an atheromatous plaque?
Fatty streak
What is the name given to the atheromatous plaque after it has thickened?
Fibrofatty plaque
Which layer of a blood vessel gives it tensile strength to pump blood?
Tunica media
In which situations would atheromatous narrowing of an artery produce critical disease?
- Only artery supplying an organ / tissue
- Artery has small diameter
- Overall blood flow is reduced
What are some complications of atheroma?
Stenosis (narrowing of lumenal calibre)
Thrombosis (abnormal mass within the circulation)
Aneurysm (constant dilatation of blood vessel due to weak walls)
Dissection (splitting of a vessel)
Embolism (mass within circulation which circulates, blocks and causes disease)
Stenosis where causes cardiac ischaemia?
Coronary arteries
What are some effects of cardiac ischaemia caused by coronary stenosis?
Reduced exercise tolerance
Angina (stable/unstable)
MI
Heart failure
Why does cardiac fibrosis eventually lead to heart failure?
Reduced elasticity and filling due to death of cardiac myocytes
Arterial stenosis can affect ___ artery.
any
What commonly occurs following thrombosis blocking an artery?
Infarction
