Atheroma & its complications Flashcards
what is an atheroma?
degeneration of the walls of the arteries due to accumulation of fatty deposits & scar tissue
causes;
- restriction of circulation
- risk of thrombosis
what can an atheroma also be called?
= atherosclerosis
what effect does atheroma have on the arteries?
causing arteries to Harden
what 2 diseases does an atheroma cause?
1) coronary artery disease
2) ischaemic heart disease
what 7 things can cause an atheroma?
1) cigarette smoking
2) hypertension
3) hyper-lipidemia
= too many lipids in blood, like cholesterol
4) diabetes
5) age (older)
6) sex (males)
7) genetic
what are the 4 pathogenetic steps involved in causing ana atheroma?
1) primary endothelial injury
2) accumulation of lipids & macrophages
3) migration of smooth muscle cells
4) increase in size
what sort of things causes the primary endothelial injury?
- smoking
- hypertension
- hyperlipidemia
- toxins
- viruses
- immune factors
what are some examples of macrophages and lipids that accumulate?
- increased LDL
- reduced HDL
- V-CAM
- IL-1
- TNF
what are some examples of smooth muscle cells that migrate?
- PDGF
- FGF
- TGFalpha
as the atheromatous plaques enlarge, what is compromised?
blood flow
as the atheromatous plaques progress and become complicated, what do they become?
- fatty streaks
- fibro-fatty plaques
- complicated plaques (with overlying thrombus)
what is the progression of atheromatous plaques associated with in terms of luminal potency and arterial walls?
- further loss of luminal potency
- arterial wall weakness
what factors will likely to produce a critical disease, as a result of atheromatous narrowing of an artery?
- if the artery supplying an organ or tissue Is blocked
e. g. no collateral circulation - if the artery diameter is small
e. g. coronary artery versus common iliac artery - overall blood flow is reduced
e. g. cardiac failure
what are the 5 possible complications of atheroma?
1) stenosis
2) thrombosis
3) aneurysm
4) dissection
5) embolism
what is atrial stenosis?
= narrowing of the arterial lumen
what does arterial stenosis cause?
- reduced elasticity
- reduced flow in systole
= TISSUE ischaemia (inadequate blood supply to tissues or organs)
what does coronary stenosis produce?
CARDIAC ischemia
what does cardiac ischaemia cause?
= reduced exercise tolerance
what does cardiac ischaemia cause? (4)
- angina
- unstable angina
- MI
- cardiac failure
what does cardiac fibrosis do to cardiac myoctes?
= loss of cardiac myocytes
as a result of the loss of cardiac myocytes, what is it replaced by?
replaced by fibrous tissue
what dos the loss of cardiac myocytes in cardiac fibrosis do to contractility, elasticity & filling?
- loss of contractility
- reduced elasticity & filling
true or false.
Arterial stenosis can only affect one artery?
False.
- arterial stenosis can affect any artery
give 4 examples of the types of arteries arterial stenosis can affect?
1) coronary arteries
2) carotid arteries
3) renal arteries
4) peripheral arteries
if arterial stenosis affects the carotid arteries, what can this cause? (3)
- TIA
- stroke
- vascular dementia
if arterial stenosis affects the renal arteries, what can this cause? (2)
- hypertension
- renal failure
if arterial stenosis affects the peripheral arteries, what can this cause? (2)
- claudication
- foot/leg ischaemia
what are 4 types of infarction that can arise due thrombosis?
1) MI
2) cerebral infarction
3) renal infarction
4) intestinal infarction
how does an aneurysm form?
= due to abnormal and persistent dilation of an artery due to a weakness in its wall
what is an aneurysm?
excessive swelling of the wall of an artery
what 7 things does aneurysm formation effects?
- mycotic
- atherosclerotic
- dissecting
- congenital
- arteriovenous
- traumatic
- syphilitic
whats the most common site for aneurysm formation?
= abdominal aorta
what re 5 possible complications of aneurysms?
1) rupture
2) thrombosis
3) embolism
4) pressure erosion of adjacent structures
5) infection
what is arterial dissection?
= splitting within the media by flowing blood
who is at the greatest risk of developing an arterial dissection?
middle age +/- atheroma
what pathological change happens in arterial dissection?
= false lumen filled with blood within the media
what happens if you develop an arterial dissection?
1) sudden collapse
2) high mortality
what are 6 other associations with aortic dissection?
1) atheroma
2) hypertension
3) trauma
4) coarctation
5) marfan’s
6) pregnancy
what 2 things can break off and form an embolism?
1) superadded thrombus
2) plaque material
what are 3 usual targets for formation of an embolism?
1) cerebral infarct
2) renal infarct & renal failure
3) lower limb infarction
what is an athero-embolism?
when cholesterol is released, usually from an atherosclerotic plaque, & travels as an embolus in the bloodstream
