Atheroma & its complications

Question 1

what is an atheroma?

Answer 1

degeneration of the walls of the arteries due to accumulation of fatty deposits & scar tissue

causes;

• restriction of circulation
• risk of thrombosis

Question 2

what can an atheroma also be called?

Answer 2

= atherosclerosis

Question 3

what effect does atheroma have on the arteries?

Answer 3

causing arteries to Harden

Question 4

what 2 diseases does an atheroma cause?

Answer 4

1) coronary artery disease

2) ischaemic heart disease

Question 5

what 7 things can cause an atheroma?

Answer 5

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

Question 6

what are the 4 pathogenetic steps involved in causing ana atheroma?

Answer 6

1) primary endothelial injury
2) accumulation of lipids & macrophages
3) migration of smooth muscle cells
4) increase in size

Question 7

what sort of things causes the primary endothelial injury?

Answer 7

• smoking
• hypertension
• hyperlipidemia
• toxins
• viruses
• immune factors

Question 8

what are some examples of macrophages and lipids that accumulate?

Answer 8

• increased LDL
• reduced HDL
• V-CAM
• IL-1
• TNF

Question 9

what are some examples of smooth muscle cells that migrate?

Answer 9

• PDGF
• FGF
• TGFalpha

Question 10

as the atheromatous plaques enlarge, what is compromised?

Answer 10

blood flow

Question 11

as the atheromatous plaques progress and become complicated, what do they become?

Answer 11

• fatty streaks
• fibro-fatty plaques
• complicated plaques (with overlying thrombus)

Question 12

what is the progression of atheromatous plaques associated with in terms of luminal potency and arterial walls?

Answer 12

• further loss of luminal potency

- arterial wall weakness

Question 13

what factors will likely to produce a critical disease, as a result of atheromatous narrowing of an artery?

Answer 13

• 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

Question 14

what are the 5 possible complications of atheroma?

Answer 14

1) stenosis
2) thrombosis
3) aneurysm
4) dissection
5) embolism

Question 15

what is atrial stenosis?

Answer 15

= narrowing of the arterial lumen

Question 16

what does arterial stenosis cause?

Answer 16

• reduced elasticity
• reduced flow in systole
  = TISSUE ischaemia (inadequate blood supply to tissues or organs)

Question 17

what does coronary stenosis produce?

Answer 17

CARDIAC ischemia

Question 18

what does cardiac ischaemia cause?

Answer 18

= reduced exercise tolerance

Question 19

what does cardiac ischaemia cause? (4)

Answer 19

• angina
• unstable angina
• MI
• cardiac failure

Question 20

what does cardiac fibrosis do to cardiac myoctes?

Answer 20

= loss of cardiac myocytes

Question 21

as a result of the loss of cardiac myocytes, what is it replaced by?

Answer 21

replaced by fibrous tissue

Question 22

what dos the loss of cardiac myocytes in cardiac fibrosis do to contractility, elasticity & filling?

Answer 22

• loss of contractility

- reduced elasticity & filling

Question 23

true or false.

Arterial stenosis can only affect one artery?

Answer 23

False.

- arterial stenosis can affect any artery

Question 24

give 4 examples of the types of arteries arterial stenosis can affect?

Answer 24

1) coronary arteries
2) carotid arteries
3) renal arteries
4) peripheral arteries

Question 25

if arterial stenosis affects the carotid arteries, what can this cause? (3)

Answer 25

• TIA
• stroke
• vascular dementia

Question 26

if arterial stenosis affects the renal arteries, what can this cause? (2)

Answer 26

• hypertension

- renal failure

Question 27

if arterial stenosis affects the peripheral arteries, what can this cause? (2)

Answer 27

• claudication

- foot/leg ischaemia

Question 28

what are 4 types of infarction that can arise due thrombosis?

Answer 28

1) MI
2) cerebral infarction
3) renal infarction
4) intestinal infarction

Question 29

how does an aneurysm form?

Answer 29

= due to abnormal and persistent dilation of an artery due to a weakness in its wall

Question 30

what is an aneurysm?

Answer 30

excessive swelling of the wall of an artery

Question 31

what 7 things does aneurysm formation effects?

Answer 31

• mycotic
• atherosclerotic
• dissecting
• congenital
• arteriovenous
• traumatic
• syphilitic

Question 32

whats the most common site for aneurysm formation?

Answer 32

= abdominal aorta

Question 33

what re 5 possible complications of aneurysms?

Answer 33

1) rupture
2) thrombosis
3) embolism
4) pressure erosion of adjacent structures
5) infection

Question 34

what is arterial dissection?

Answer 34

= splitting within the media by flowing blood

Question 35

who is at the greatest risk of developing an arterial dissection?

Answer 35

middle age +/- atheroma

Question 36

what pathological change happens in arterial dissection?

Answer 36

= false lumen filled with blood within the media

Question 37

what happens if you develop an arterial dissection?

Answer 37

1) sudden collapse

2) high mortality

Question 38

what are 6 other associations with aortic dissection?

Answer 38

1) atheroma
2) hypertension
3) trauma
4) coarctation
5) marfan’s
6) pregnancy

Question 39

what 2 things can break off and form an embolism?

Answer 39

1) superadded thrombus

2) plaque material

Question 40

what are 3 usual targets for formation of an embolism?

Answer 40

1) cerebral infarct
2) renal infarct & renal failure
3) lower limb infarction

Question 41

what is an athero-embolism?

Answer 41

when cholesterol is released, usually from an atherosclerotic plaque, & travels as an embolus in the bloodstream