Atheroma Formation Flashcards
How does atherosclerosis occur?
Low density lipoproteins accumulate in endothelium and oxidise
Cause influx of macrophages and T cell recruitement
Cause local inflammation and macrophages die
Cause: smooth muscle proliferation, collagen deposition, narrowing of arteries as endothelium swell away from arterial wall
What is atherosclerosis?
Plaque build up in arteries
What is a thrombus?
Clotted blood within an artery
How is a thrombus formed from artherosclerosis?
Artherosclerosis ruptures through endothelium, cause aggregation of platelets and activation of clotting cascade= thrombus
What is an embolism?
If thrombus breaks off and starts moving in arteries or venous system
What does NSTEMI stand for?
Non-ST elevation myocardial infarction
What does STEMI stand for
ST elevated myocardial infarction
Symptoms of angina
Chest pain that is intermittent- occurs only upon exertion
Can radiate to right arm
Chest pain stops when at rest
STEMI symtoms
Chest pain
Associated sweatiness and shortness of breath
Elevated ST segment
Arm pain
STEMI treatment
Oxygen administration Antiplatlet therapy- aspirin Anticoagulation- heparin Percutaneous Coronary Intervention (PCI) if not available fibrinolysis Drug eluting stent
What is PCI
Percutaneous Coronary Intervention= PCI
Wire from the radial artery in arm to heart
Wire passed into coronary artery, balloon inflated, restores blood flow, pushes atheroma and thrombus out the way
Stent deployed to maintain lumen
More modern approach where atheroma is vacuumed up with aspiration catheter, suck material out and stent deployed
What does an increase in troponin T in blood test show?
Suggest cardiac muscle damage
MI leads to release of Troponin T and Troponin I
What is a quantitive measure to tell us difference between unstable angina and NSTEMI?
NSTEMI- troponin rise
Unstable angina- little or no Troponin rise
Does chronic stable angina still have lumen?
Yes
Symptoms of unstable angina?
Chest pain at rest, intermittent, reduced exercise tolerance
