Artherosclerosis

Question 1

What is atherosclerosis characterised by?

Answer 1

Patchy intimal plaques (atheromas) that encroach on the lumen of medium-sized and large arteries; the plaques contain lipids, inflammatory cells, smooth muscle cells, and connective tissue.

Question 2

What are some risk factors of atherosclerosis?

Answer 2

dyslipidemia 
diabetes 
smoking
family history
sedentary lifestyle
obesity
hypertension

Question 3

When do symptoms develop in atherosclerosis?

Answer 3

When growth or rupture of the plaque reduces or obstructs blood flow; symptoms vary by artery affected

Question 4

What would your management plan consist of?

Answer 4

Lifestyle, and dietary modification,
physical activity,
medication from GP’s (anti-platelet)

Question 5

What are the 3 major components of a atherosclerotic plaque?

Answer 5

• Lipids
• Inflammatory and smooth muscle cells
• A connective tissue matrix that may contain thrombi in various stages of organization and Ca deposits

Question 6

Describe modifiable and non-modifiable risk factors of atherosclerosis.

Answer 6

Nonmodifiable

• Age
• Gender
• Family history of premature atherosclerosis*

Modifiable

• Smoking
• Diabetes mellitus
• Hypertension

Question 7

When do transient ischemic symptoms (eg, stable exertional angina, transient ischemic attacks, intermittent claudication) develop?

Answer 7

when stable plaques grow and reduce the arterial lumen by > 70%.

Question 8

How does vasoconstriction contribute to atherosclerosis?

Answer 8

It can change a lesion that does not limit blood flow into a severe or complete stenosis.

Question 9

Describe when symptoms of unstable angina or infarction, ischemic stroke, or rest pain in the limbs may develop

Answer 9

When unstable plaques rupture and acutely occlude a major artery, with superimposition of a thrombosis or embolism

Question 10

What could help in prevention and treatment of atherosclerosis?

Answer 10

• Stopping smoking
• Exercising
• Eating a diet low in saturated fat and refined carbohydrates and high in fiber
• Consuming omega-3 fatty acids and moderate amounts of alcohol
• Medication

Question 11

The plaques of atherosclerosis cause which three main kinds of cardiovascular disease?

Answer 11

• Coronary artery disease:
Stable plaques in the heart’s arteries cause angina (chest pain on exertion). Sudden plaque rupture and clotting causes heart muscle to die. This is a heart attack, or myocardial infarction.

• Cerebrovascular disease:
Ruptured plaques in the brain’s arteries causes strokes with the potential for permanent brain damage. Temporary blockages in an artery can also cause transient ischemic attacks (TIAs), which are warning signs of stroke; however, there is no brain injury.

• Peripheral artery disease:
Narrowing in the arteries of the legs caused by plaque causes poor circulation. This causes pain on walking and poor wound healing. Severe disease may lead to amputations.