Atheroma Flashcards
What is atheroma?
The formation of plaques in the intima of artery walls
What does atheroma in coronary arteries lead to?
Ischemia
What is arteriosclerosis?
The thickening and hardening of artery walls reducing the the vessel’s diameter
What is arteriosclerosis caused by?
Old age
What does arteriosclerosis lead to?
Ischemia (various types)
What are the 3 stages of development of an atheroma?
Fatty streak -> Early atheromatous plaque -> Fully developed atheromatous plaque
What is the clinical significance of a fatty streak?
No clinical significance (just a small mass of lipid-laden macrophages)
What age group are fatty streaks found in?
Children
What age group are early atheromatous plaques found in?
Young adults onwards
What is the structure of a fully developed atheromatous plaque?
A central lipid core with a fibrous tissue cap covered by arterial endothelium
What provides the cap of atheroma with structural strength?
Collagens
What resides in the fibrous cap of atheroma?
Inflammatory cells (macrophages, lymphocytes, mast cells, etc)
Where are the cellular lipids from atheroma cores derived from?
Macrophages
What occurs in the late stage of plaque development that is used as as a marker for atherosclerosis in angiograms or CTs?
Dystrophic calcification
Where do atheromatous plaques usually form?
At arterial branching points (bifurcations)
What clinically complicates atheromas? (3)
Plaque rupturing
Thrombosis
Calcification into plaque
What is the largest risk factor for atheroma?
Hypercholesterolaemia (excess of cholesterol in the blood stream)
What are 4 biochemical signs of major hyperlipidaemia (high lipid levels in bloodstream)?
LDL (low density lipoproteins)
HDL (high density lipoproteins)
Total cholesterol
Triglycerides
What are 2 physical signs of major hyperlipidaemia?
Corneal arcus
Xanthelasmata
What are 2 medical risk factors for atheroma?
Hypertension
Diabetes mellitus
What are 3 social risk factors for atheroma?
Smoking
Male
Elderly
What are the 2 steps in the process of atheromatous plaque development?
- Endothelial lining of artery injured
2. Chronic inflammation and healing response of vascular wall
What type of lipoprotein is responsible for atherosclerosis?
LDL
What are 3 of the clinical consequences of the rupture of plaque leading to total occlusion?
MI
Stroke
Lower limb gangrene
What aortic problem can arise from atheromatous ruptures?
Abdominal aortic anuerysm
What are 5 lifestyle related therapeutic options to prevent consequences of atheroma?
Stop smoking Control BP Weght-loss Exercise Diet
What 2 types of drug can be used to prevent consequences of atheroma?
Cholesterol lowering drugs
Asprin
