Atheroma Pathology Flashcards
Name the synonyms of atheroma
ATHEROSCLEROSIS
HARDENING OF THE ARTERIES
CORONARY ARTERY DISEASE
ISCHAEMIC HEART DISEASE
Aetiology of Atheroma
Cigarette smoking Hypertension Hyperlipidemia Diabetes Age (older) Sex (males) Genetics
Describe the pathogenesis of atheroma
primary endothelial injury
accumulation of lipids and macrophages
migration of SM cells
increase in size
smoking, hypertension, hyperlipidemia, immune factors etc
Increased LDL, reduced
V-CAM, IL-1 and TNF
PDGF, FGF, TGFalpha
What do atheromatous plaques look like?
Fatty streak
Fibrofatty plaque
Complicated plaque
(with overlying thrombus)
when is an artery likely to produce critical disease?
It is the only artery supplying an organ or tissue (i.e. There is no collateral circulation)
The artery diameter is small (e.g coronary artery versus common iliac artery)
Overall blood flow is reduced (i.e. cardiac failure)
Name some complications of atheroma
STENOSIS THROMBOSIS ANEURYSM DISSECTION EMBOLISM
d:aneurysm
weakening and bulging of an artery wall
d: arterial stenosis
NARROWING OF THE ARTERIAL LUMEN
REDUCED ELASTICITY
REDUCED FLOW IN SYSTOLE
TISSUE ISCHAEMIA
give some clinical effects of cardiac ischaemia
REDUCED EXERCISE TOLERANCE CARDIAC FAILURE ANGINA UNSTABLE ANGINA MYOCARDIAL INFARCTION
describe pathology of cardiac fibrosis
LOSS OF CARDIAC MYOCYTES
REPLACEMENT BY FIBROUS TISSUE
LOSS OF CONTRACTILITY
REDUCED ELASTICITY & FILLING
clinical effects of thrombosis
MYOCARDIAL INFARCTION
CEREBRAL INFARCTION
RENAL INFARCTION
INTESTINAL INFARCTION
where is the commonest site for aneurysm formation?
abdominal aorta
describe aneurysm formation?
Abnormal and persistent dilatation of an artery due to a weakness in its wall
types;
Mycotic, atherosclerotic, dissecting, congenital, arteriovenous, traumatic, syphillitic.
complications of aneurysm
RUPTURE (6cm) THROMBOSIS EMBOLISM PRESSURE EROSION OF ADJACENT STRUCTURES INFECTION
What is arterial dissection and what does it do?
SPLITTING WITHIN THE MEDIA BY FLOWING BLOOD
MIDDLE AGE +/- ATHEROMA
FALSE LUMEN FILLED WITH BLOOD WITHIN THE MEDIA
SUDDEN COLLAPSE and HIGH MORTALITY
