Atherosclerosis Flashcards
What is atherosclerosis?
A lipoprotein-driven disease involving buildup of fats, cholesterol, and other substances at arterial walls, forming plaques.
What physiological functions does the endothelium regulate? (3)
- Vascular tone through production of vasodilators and vasoconstrictors
- Coagulation by regulating platelet activity and clotting cascade
- Inflammatory processes through cytokine and adhesion molecule expression.
List the steps in plaque development. (4)
- Endothelial damage
- Circulating LDL uptake and oxidation
- Monocyte recruitment and differentiation into macrophages
- T-cell cytokine release activating macrophages
What happens during plaque progression? (3)
- Smooth muscle cells migrate and form a fibrous cap
- Dead cells and lipids accumulate to create a necrotic/lipid core
- Vascular calcification occurs
What is vascular calcification? (3)
- Leads to vessel stiffness
- Regulated process involving differentiation of vascular smooth muscle cells
- Can be observed on CT scans and ultrasound
Where do plaques preferentially form? (2)
- Sites of low oscillatory shear stress
- At branch points in arteries
True or False: Smoking is a strong risk factor for plaque erosion.
True
What are the modifiable risk factors for cardiovascular disease? (8)
- Smoking
- Poor diet
- Excess alcohol consumption
- Physical inactivity
- High LDL and triglyceride levels
- Being overweight
- Diabetes
- High blood pressure
What is the QRISK® score?
A tool used to estimate the risk of developing cardiovascular disease over the next ten years.
What are the pathological consequences of atherosclerosis? (5)
- Carotid artery disease
- Coronary artery disease
- Angina
- Acute Myocardial Infarction
- Peripheral arterial disease
What is ischaemic stroke?
Occurs when blood supply to the brain is compromised, often due to thrombus or plaque rupture.
What imaging techniques are used to diagnose carotid artery disease? (3)
- Computerized tomography (CT) scan
- Magnetic resonance imaging (MRI)
- Duplex ultrasound
What is the treatment for elevated cholesterol levels?
Statins, which inhibit HMG-CoA reductase.
Fill in the blank: The presence of _______ in the blood indicates cardiac muscle death.
cardiac troponin
What are the symptoms of acute myocardial infarction? (5)
- Chest pain
- Shortness of breath
- Nausea
- Cold sweat
- Lightheadedness
What role do smooth muscle cells play in plaque stability?
They produce collagen that gives strength to the artery and maintain the fibrous cap.
What are the effects of hypertension on the arteries? (3)
- Increases endothelial dysfunction
- Thickens and stiffens artery walls
- Enhances LDL trapping in artery walls
What factors contribute to the formation of unstable plaques? (4)
- Endothelial dysfunction
- Smoking
- Leukocyte activation
- Modifications of sub-endothelial matrix
What is the typical treatment approach for managing cardiovascular risk? (4)
- Lifestyle changes
- Medications (statins, antihypertensives)
- Smoking cessation
- Exercise training
What is the main cause of atherosclerosis-related ischemic stroke?
Thrombus formation or plaque rupture, commonly from the internal carotid artery.
What is coronary angiography used for?
To measure blood flow
It helps in determining the extent of the infarct.
What is elevated serum troponin indicative of?
Cardiac muscle death
It is a key marker in the diagnosis of myocardial infarction.
What are the three sub-units of cardiac troponins? (3)
- Troponin C
- Troponin I (TnI)
- Troponin T (TnT)
These regulate the calcium-mediated contractile process of striated muscle.
What does Troponin C do?
Binds Ca2+
It plays a role in muscle contraction.
