Atherosclerosis Flashcards
Atherosclerosis
the gradual process by which plaque builds up on the body’s arterial walls
What is the fundamental precursor of atherosclerosis
endothelial injury
True or false: atherosclerosis is a chronic and progressive disease with a long asymptomatic period
true
What injurious agents in the bloodstream are endothelial cells exposed to during endothelial injury
oxidizing free agents, shearing force of high bp, high circulating glucose levels, elevated levels of LDL
Atherogenesis
the development of atherosclerotic plaque
What stimulates atherogenesis
inflammatory process from endothelial injury combined with high circulating LDL
3 steps of atherosclerosis
formation of foam cells, formation of fatty steaks and plaques, plaque rupture
How are foam cells formed
injured epithelium attract WBC which engulf and ingest LDL becoming foam cells
When is reverse transport unable to occur
if high LDL and low LDL creates plaque formation
How are fatty steaks and plaques formed
foam cells have fibrotic changes that protrude into vessel lumen
What does the formation of fatty steaks and plaques cause
causes narrowing and eventually calcified arteries, reducing wall elasticity and hardening arteries
How are plaques ruptured
a complex inflammatory process where inflammatory mediators allow clot formation and vessel spasm
What does constant remodeling increase the risk for
plaque rupture
What does plaque rupture do
attracts platelets and leads to release plaque or blood clots into the bloodstream, causing blockage
What occurs before MIs
plaque rupture
Clinical presentation of atherosclerosis
often no symptoms until organ dysfunction
What should history be targeted at
determining risk factors and detecting atherosclerosis of coronary arteries, peripheral arteries of extremities
Symptoms to look for of organ dysfunction
chest pain, leg pain, edema, SOB, palpitations
Physical exam
BP, weight, heart sounds, presence of bruit, dependent edema, cyanosis, ophthalmic exam
Labs
increase in lipid profile, c-reactive protein, homocysteine level
When is endothelial function determined
during cardiac cath
Why are CT scans easy diagnostic tools
no provider referral required
What is the gold standard diagnostic test
cardiac angiography (but there are risks)
Diagnostic tools
endothelial function, CT scan, cardiac angiography, intravascular ultrasonography
Lifestyle changes
diet, activity, no smoking, reduce alcohol
Statins
medications that diminish cholesterol synthesis in the liver
Atorvastin
Lipitor
Rosuvastatin
Crestor
Simvastin
Zocor
Surgical treatment options
CABG, PCI
