Atheroma, thrombosis, emboli, CAD

Question 1

What is an atheroma? complications?

Answer 1

(1. ) Hardening and narrowing of arteries due to fibrous and lipid rich plaque formation (+ macrophages + smooth muscle cells).
(2. ) Fatty streaks (earliest athersclerosis lesions) seen in 20-30y. These are reversible
(3. ) Complications: thrombosis, plaque rupture, embolism
(4. ) Main cause of IHD, but also associated with MI and peripheral vascular disease

Question 2

Define thrombosis and emboli

Answer 2

(1. ) Embolism = blocked vessel caused by a foreign body e.g. a blood clot or an air bubble
(2. ) Thrombosis = formation of a blood clot inside a blood vessel, this obstructs the flow

Question 3

Modifiable and non-modifiable RF for CAD/IHD

Answer 3

(1. ) Modifiable – smoking, HTN, diabetes, obesity, physical inactivity, poor diet, cocaine use, dyslipidaemia, metabolic syndrome
(2. ) Non-modifiable – advanced age, male sex, family history of CAD, previous CAD

Question 4

What is Virchow’s Triad?

Answer 4

Describes three factors that are important for the development of thrombosis: hypercoaguability, venous stasis, endothelial dysfunction.

(1. ) Change in vessel wall (endothelial cell injury, atheroma)
(2. ) Change in blood flow (laminar to turbulent flow)
(3. ) Change in blood constituents (e.g. too many clotting factors or platelets)

Question 5

What is an aneurysm? CAuses? Mx?

Answer 5

This is weakening of the wall.

Caused by:

• Atherosclerotic
• Arteriomegaly
• Collagen disease: Marfans, Ehlers Danlos
• Size and location

Mx
Balance the risk of it rupturing
- In abdomen - treatment is not advised, until it is big
- Risk of rupture is linked to size of aneurysm
- ‘wait and watch’ approach