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.
What does Troponin I (TnI) do?
Binds to actin and inhibits actin-myosin interactions
It is crucial for regulating muscle contraction.
What is the role of Troponin T (TnT)?
Binds to tropomyosin; attaching the troponin complex to the thin filament
This is essential for muscle contraction.
What is the significance of ECG?
Detects and records the strength and timing of the electrical activity in the heart
It is a vital diagnostic tool in cardiology.
What does MACE stand for?
Major adverse cardiovascular event
What is the primary treatment for STEMI?
Angioplasty to unblock coronary arteries
It often follows coronary angiography.
What are the common treatments for NSTEMI?
- Blood thinning drugs (e.g., aspirin, clopidogrel)
- Further treatment if necessary
What is the procedure for angioplasty?
- Insert a catheter into artery via groin or wrist
- Use local anaesthesia
It is a minimally invasive procedure to treat blocked arteries.
What is Smooth Muscle Cell Hyperplasia in Stent Restenosis (ISR)?
It refers to the proliferation of smooth muscle cells leading to stent blockage
This complication can occur after stent placement.
What are drug-eluting stents designed to do?
Prevent in-stent restenosis and stent thrombosis
They release medication to inhibit cell proliferation.
What is CABG?
Coronary artery bypass grafting
It is performed in patients with advanced atherosclerosis or multi-vessel disease.
What is the consequence of aortic aneurysms?
Weakening and bulging of the aortic wall
AAA rupture is extremely serious and often fatal.
What are the clinical signs of Peripheral Artery Disease? (3)
- Claudication
- Critical limb ischaemia
- Slow-healing wounds or ulcers
These symptoms indicate reduced blood flow to the extremities.
What are some treatments for Peripheral Artery Disease? (5)
- Surgical revascularisation
- Balloon angioplasty
- Stenting
- Bypass
- Amputation
Combination therapies may be utilized based on severity.
What is the role of statins?
Cholesterol lowering medication
They inhibit HMG-CoA reductase, decreasing cardiovascular disease risk.
What are beta-blockers used for?
Decreasing heart rate and cardiac output
They lower blood pressure and reduce heart workload.
What do ACE inhibitors do?
Lower blood pressure by inhibiting angiotensin converting enzymes
They are essential in managing cardiovascular diseases.
What are some drug treatments for diabetes?
- Insulin
- Metformin
- Sulfonylureas
- Giltazones
These medications help manage blood glucose levels.
