atheroma (coronary arteries disease, atherosclerosis) Flashcards
how do plaques develop
LDL’s are oxidised in tunica intima to OXLDL. macrophages migrate to area and ingest OXLDL to become foam cells. foam cells form fatty streaks which build up to become plaques
what happens in a complicated plaque
ruptures or clots
what complications can occur with atheromas
stenosis, thrombosis, aneurysm, dissection, embolism
what are the 3 components of virchows triad (contribute to thrombus)
changes in blood flow, changes in coagulability and endothelial damage
what are some risk factors or thrombus
MI, surgery, cancer, AF, pill
what is an an embolism
detached mass, normally thrombus
where do arterial thrombi often lodge
coronary, cerebral, femoral
where are venous emboli likely to end up
pulmonary
what is D-dimer
a breakdown product of fibrin
what do the results of D-dimer tests show
low levels = DVT unlikely
high levels = DVT likely
what is next step after d-dimer for investigation
ultrasound for DVT, CT angio for PE
what is normal DVT treatment
anticoagulation (LMW herapin, warafin), compression stockings, apixiban
when can a V/Q scan be used
pregnancy
what can cause endothelial inhury
smoking, hyperlipidaemia, hypertension, toxins, infection
what can plaque ruptures cause
endothelial damage causes platelet adhesion, activation and aggregation. Causing a thrombus which can occlude an artery.
