Atheroma and Complications

Question 1

What factors contribute to the formation of atheromas?

Answer 1

• Cigarette smoking
• Hypertension
• Hyperlipidemia
• Diabetes
• Age (older)
• Sex (males)
• Genetics

Question 2

Describe the pathogenesis of atheroma formation

Answer 2

• Primary endothelial injury
• Accumulation of lipids macrophages
• Migration of smooth muscle cells
• Increase in size

Question 3

What can cause primary endothelial injury that may lead to atheroma?

Answer 3

Smoking
Hypertension
Hyperlipidemia
Immune factors
Toxins
Viruses

Question 4

Describe how atheromatous plaques progress

Answer 4

• Fatty streak
• Fibrofatty plaque
• Complicated plaque (overlying thrombus)
• Loss of lumen patency and Arterial wall weakness

Question 5

When is atheromatous narrowing likely to produce critical disease?

Answer 5

• It’s the only artery supplying that organ or tissue
• Artery diameter is small (e.g coronary artery versus common iliac artery)
• Overall blood flow is reduced (i.e. cardiac failure)

Question 6

What are the complications of an atheroma?

Answer 6

• Stenosis
• Thrombosis
• Aneurysm
• Dissection
• Embolism

Question 7

Describe what happens when arteries become stenosed?

Answer 7

• narrowing of arterial lumen
• reduced elasticity
• reduced flow in systole
• tissue ischaemia

Question 8

Coronary artery stenosis produces cardiac ischaemia. What symptoms does this cause?

Answer 8

• reduced exercise tolerance
• angina/ unstable angina
• MI
• cardiac failure

Question 9

What conditions can occur if stenosis affects the carotid arteries?

Answer 9

• TIA
• Stroke
• Vascular dementia

Question 10

If the renal arteries become stenosed, what can happen as a result?

Answer 10

• hypertension

- renal failure

Question 11

If the peripheral arteries become stenosed, what does this result in?

Answer 11

• claudication

- leg/foot ischaemia

Question 12

What happens when an aneurysm forms and in which artery does this commonly happen?

Answer 12

• Abnormal and persistent dilatation of an artery due to a weakness in its wall
• Commonest site : Abdominal aorta

Question 13

What complications can occur as a result of an aneurysm?

Answer 13

• rupture
• thrombosis/ embolism
• pressure erosion of adj. structures
• infection

Question 14

What is meant by an arterial dissection?

Answer 14

• splitting within Tunica Media of vessel
• false lumen of blood forms within the media
• causes sudden collapse and death

Question 15

Most patients who suffer from an aortic dissection are of middle age. TRUE/FALSE?

Answer 15

TRUE

Question 16

What conditions are associated with an aortic dissection?

Answer 16

• atheroma
• hypertension
• trauma
• coarctation of aorta
• Marfan’s
• pregnancy