Atherosclerosis Flashcards
What are the aetiologies of atherosclerosis?
Smoking
Hypertension
Hyperlipidaemia
Diabetes
Ageing
Sex
Genetics
High homocysteine levels
How does hypertension increase risk of vascular disease?
High blood pressure can damage endothelium and increases turbulence
How can diabetes lead to atherosclerosis?
It increases cholesterol levels and causes Advanced Glycation End products (AGE)
This causes abnormal cross linkage in vessel walls, increasing the risk of cholesterol trapping and causing firmer blood vessels
At what age can fatty streaks begin to form in blood vessel endothelia?
Around 10 years old
What are some examples of growth factors that allow for smooth muscle migration in vascular disease?
PDGF - Platelet Derived Growth Factor
FGF - Fibroblast Growth Factor
TGFα - Tissue Growth Factor alpha
What is meant by stenosis?
Narrowing
What are the 3 stages of atheroma progression?
Fatty streak
Fibrofatty plaque
Complicated plaque (With overlying thrombus)
What are some examples of complication of arterial stenosis?
Coronary artery - Myocardial infarction
Carotid artery - Stroke, vascular dementia
Renal artery - Hypertension, renal failure
Peripheral artery - Claudication, ischaemia
What is meant by ischaemia?
Lack of blood supply, leading to hypoxia, leading to damage
What are some complications of vascular disease?
Stenosis
Aneurysm
Dissection
Thrombosis
Embolism
What is meant by an aneurysm?
A site of abnormal and persistent dilation of an artery due to weakness in its wall
What are some common types of aneurysm?
Mycotic
Atherosclerotic
Dissecting
Arteriovenous
Traumatic
Syphilitic
Where is the most common site of aneurysm?
Abdominal aorta
AAA = Abdominal Aortic Aneurysm
What are some complications of aneurysm?
Rupture (Most likely above 6cm)
Thrombosis
Embolism
Pressure erosion of adjacent structures (Most common in syphilitic aneurysm)
What is an arterial dissection?
Splitting within the tunica media by flowing blood
Blood from the lumen can pass into a new path in the blood vessel wall
This leads to a false lumen which can allow pressure to build in the wall