Atheroma Creator: Cameron McCloskey Flashcards
List some risk factors for atheroma
- Smoking
- Hypertension
- Hyperlipidaemia
- Diabetes
- Age
- Sex (male)
What is the pathogenesis for atheroma?
- Endothelial injury
- Accumulation of lipids/macrophages
- Migration of muscle cells
- Increase in size
What is the fibrous cap of an atheroma formed of?
Collagen
How does an atheroma progress to an atheromatous plaque?
- Start as a fatty streak
- Become fibrofatty plaque (contain cholesterol crystals)
- Become a complicated plaque (with overlying thrombus)
What negative effects do atheromatous plaques have?
- Reduced artery diameter - easier to become blocked
- Reduced overall blood flow
If the affected artery is the only one to an organ, it is possible for the entire blood supply to be compromised
What is stenosis, in relation to blood vessels?
Abnormal narrowing reducing luminal calibre and wall elasticity
What is thrombosis?
Abnormal blood coagulation within a vessel
What is an aneurysm?
Persistent blockage (due to thrombus) which cause ballooning of vessel behind blockage due to back pressure
What is a blood vessel dissection?
Split in blood vessel wall
What is an embolism?
Any blockage (embolus) within a blood vessel
Define ischaemia
Lack of blood flow to a region of the body causing local tissue oxygen deprivation
How does arterial stenosis affect:
- Blood flow
- Blood pressure?
- Reduced
2. Increased
What may happen in carotid arteries are affected?
Stoke, TIA, vascular dementia
What may happen when peripheral arteries are affected?
Claudication, foot/leg/hand ischaemia
What may happen if renal arteries are affected?
Hypertension, renal failure
In cardiac ischaemia, low oxygen transport to heart muscle may result in what types of maladies?
- Reduced exercise tolerance
- Angina
- MI
- Cardiac failure
What is cardiac fibrosis and how is it caused?
Loss of myocardium to fibrous tissue
Caused due to ischaemia which causes death of myocardium
Why is cardiac fibrosis bad?
It leads to reduced contractility, reduced elasticity and decreased efficiency of the heart
What are some common effects of arterial thrombosis?
- MI
- Cerebral infarction
- Renal infarction
- Bowel infarction
Arterial thrombosis can lead to aneurysm formation - why?
- The thrombus causes a blockage
- Back pressure cause abnormal dilatation of the vessel
- Reduced tunica media, smooth muscle and elastic stretch also contribute to the dilatation
Where are some common aneurysm sites?
- Abdominal aorta
- Thoracic aorta
- Circle of Willis
What are the negative effects of an aneurysm?
- Rupture
- Pressure erosion on other structures i.e. oesophagus
- Infections
What is arterial dissection?
Splits within blood vessel media due to hypertension or other factors
What are two negative effects of arterial dissection?
- Blood clots within vessel walls
2. Sudden vessel collapse
What is an athero-embolism and what does it cause?
Superadded thrombus and plaque material break off and embolise
Can cause cerebral or limb infarction and also generalised vasospasm/acute renal hypoperfusion in the kidneys
clinical feaqtures of AD
chest pain that rediate to radiating to the back.
Definitive managment for AD
Type A is Aortic graft SUrgery
Type B - blood pressure control
