Atheroma Flashcards
Risk factors of atheroma
Cigarette smoking Hypertension Hyperlipidemia Diabetes Age (older) Sex (males) Genetics
The process of Pathogenesis of atheroma
- Primary endothelial injury
- Accumulation of lipids and macrophages
- Migration of smooth muscle cells
- The fibrous cap and layer of endothelial will eventually burst as the mass grows
Causes of primary endothelial injury
Smoking Hypertension Hyperlipidemia Immune factors Toxins Viruses
The progression of atheroslerosis
- fatty streak
- fibrofatty plaque
- complicated plaque (overlying thrombus)
- the progression is associated with a further loss of luminal patency and weakening the arterial wall
Where is the most common part of the blood vessels for plaque to develop?
Where the arteries branch off
Complications of atheroma
Stenosis Thrombosis Aneurysm Dissection Embolism
What is arterial stenosis?
a narrowing of the arterial lumen, reducing vessel elasticity, reducing flow in systole and resulting in tissue ischaemia
What are the clinical effects of cardiac ischemia?
- reduced exercise tolerance
- angina
- unstable angina
- mycardial infarction (ischaemic necrosis)
- cardiac failure
What is an anuerysm?
Abnormal and persistent dilatation of an artery due to a weakness in its wall
What are the different types of anuerysm?
Mycotic atherosclerotic dissecting congenital arteriovenous traumatic syphillitic.
Where is the most common site of a anuerysm?
The abdominal aorta
Complications of anuerysms
Rupture(6cm) Thrombosis Embolism Pressure erosion of the adjacent structures Infection
What is arterial dissection?
Splitting within the media of the artery by flowing blood, the false lumen will be filled with blood within the media, the artery will suddenly collapse - there is a high mortality associated with dissection
Aortic dissection’s associated factors
Atheroma Hypertension Trauma Coarctation Marfan's Pregnancy
Where is the place the atheromatous narrowing of an artery is most likely to produce critical disease?
if it’s the only artery supplying an organ or tissue
if the artery has a small diameter
there is already reduced blood flow - e.g. cardiac failure
What are the consequences of cardiac fibrosis caused by atheroma?
loss of cardiac monocytes
replacement by fibrous tissue
loss of contractility
reduced elasticity and filling
What are the effects of arterial stenosis in different arteries?
coronary arteries
carotid arteries - stroke, vascular dementia
renal arteries - hypertension and renal failure
peripheral arteries - claudication and foot/leg ischaemia
What is a thrombosis?
local coagulation or clotting of the blood in a part of the circulatory system
What are some of the common clinical effects of a thrombosis?
Myocardial infarction
celebral infarction
renal infarction
intestinal infarction
What is an embolism?
Both superadded thrombus and plaque material may break off when they do this is embolising. An embolus is a clot which is in circulation and has the potential to cause a blockage to the arteries.
What are the usual targets of an embolism?
Celebral infarct
Renal infarct and renal failure
lower limb infarction
