Arterial Thrombosis

Question 1

Arterial thrombosis risk factors & prevention

Answer 1

• Hypertension -> lower bp
• Smoking -> stop
• High cholesterol -> lower cholesterol
• Diabetes mellitus -> treat

Question 2

What are the three main common types of arterial thrombosis

Answer 2

• Coronary
• Cerebral
• Peripheral

Question 3

How do arteries differ from veins

Answer 3

High pressure system
No valves
Faster blood flow
Thicker (muscular) vessel wall

Question 4

What condition is closely related to arterial thrombosis

Answer 4

Atherosclerosis

Question 5

Describe atherosclerosis & how its relates to arterial thrombosis

Answer 5

Atherosclerosis
1) Damage to endothelium
2) Recruitment of ‘foamy’ macrophages rich in cholesterol
3) Formation of cholesterol rich plaques
4) Reduced blood flow
5) Transient ischeamia (stable angina, intermittent claudication)

Arterial thrombosis
1) Plaque rupture
2) Endothelium exposure & vWF release
3) Platelet recruitment, granule release & aggregation
4) Acute organ Ischaemia/infarct (unstable angina & MI, stroke)

Question 6

Describe an atherosclerotic plaque

Answer 6

Cholesterol rich, foamy macrophages
Hyalinised & calcified

Question 7

Describe platelet adhesion, activation & aggregation

Answer 7

1) Plaque ruptures - more likely in the high pressure environment of arteries

2) Exposed endothelium and release of Von Willebrand factor and other proteins to which platelets have receptors (adhesion)

3. Platelets become activated - release granules that activate coagulation and recruit other platelets to developing platelet plug (e.g. ADP, thrombin, and thromboxane A2) (activation)
4. Platelet aggregation via membrane glycoproteins (GPIIbIIa and fibrinogen) (aggregation)

Question 8

Arterial thrombosis management

Answer 8

• Stroke & MI specific management
• Aspirin & other anti-platelet drugs
• Modify atherosclerosis risk factors