Atheroma and risk factors Flashcards
where is atheroma common internationally
developed world
risk factors for atheroma
cigarette smoking hypertension hyperlipidaemia diabetes age sex genetics
4 stages of atheroma formation
primary endothelial injury
accumulation of lipids and macrophages
migration of smooth muscle
complication
what can primary endothelial injury be caused by
smoking, hypertension, hyperlipidaemia, toxins, viruses, immune factors
accumulation of lipids may be due to
higher LDL and lower HDL
V-CAM, IL-1 and TNF
what might a plaque start off as
fatty streak
when is atherosclerosis more likely to be complicated
only artery supplying an organ or tissue
small arterial diameter
blood flow reduced eg heart failure
what are the complications of atheroma
stenosis - caused by ishaemia or fibrosis thrombosis aneurism dissection embolism
what is stenosis
narrowing of arterial lumen
reduced elasticity
reduced systolic blood flow
aortic thrombosis may embolise to cause…
cerebral, renal or intestinal infarction as well as lower limb
what is dissection
splitting within media by flowing blood, creating a false lumen that may rupture through and through
what conditions are aortic dissection common
atheroma, pregnancy, hypertension, trauma, coarctation, marfans
what is aneurism and where is it common
common in abdominal aorta
abnormal and persistent dilation of an artery due to wall weakness
types of aneurism
mycotic, atherosclerostic, dissecting, congenital, arteriovenous, traumatic, syphilitic
incidence rates for CVD are increasing/decreasing
decreasing, but higher in men
mortality rates for CVD are increasing/decreasing, and wealthy/deprived backgrounds are more likely to die
decreasing
deprived
modifiable cardiovascular risk factors
smoking hyperlipidaemia hypertension diabetes mellitus obesity thrombogenic factors exercise alcohol consumption
non-modifiable cardiovascular risk factors
personal Hx CVD
FHx CVD
Age
Gender
what risk category benefit best form CVD prevention
high risk, as most deaths occur in moderate risk
ways to prevent CVD
lose weight limit alcohol intake increase physical activity reduce salt intake stop smoking limit fat/cholesterol intake in food
true/false - CAD is worse in men and they are more likely to die
false - it is worse in women
HFpEF is more common in men/women
women
who is more likely to suffer stroke from AF
women
why are there worse outcomes for CAD in women
delayed presentation
less awareness
more comorbidity
Assessment/treatment/biological bias
in women, when do they become more high risk to CAD?
post menopause, increasing with older age
men with atherosclerosis have a stepwise decrease in BP when they pass a plaque. is this true for women?
no, female plaques progressively decrease blood flow across the entire vessel, not just in specific places
Symptoms of MI in women
SOB, weakness, fatigue, aches, discomfort in arms, jaw, back
heartburn, nausea and vomiting
What are risk factors for atherosclerosis in women that are neither modifiable or non modifiable
preterm delivery hypertensive pregnancy disorders autoimmune disease depression early menopause gestational disease
how can women reduce mortality from CAD
prevention of CAD, maintain weight and cholesterol, exercise, blood glucose monitoring and DASH diet