Atherosclerosis Flashcards
What is atherosclerosis? What vessels are affected?
disease of the elastic arteries and large and medium sized muscular arteries
What is the progression/pathogenesis of atherosclerosis? What hormone factors are involved?
atherosclerosis is an INFLAMMATORY disease. endothelial cell dysfunction cause macrophage and LDL accumulation. Foam cells develop and you see fatty streaks on the arteries. Smooth muscles micrate in and proliferate. Extracellular matrix is deposited, fibrous plaques are formed, and there are complex atheromas.
PDGF and FGF help bring in smooth muscle cells.
What are the common locations for atherosclerosis?
abdominal aorta > coronary arteries > popliteal artery > carotid
What are some manifestations of an aortic aneurysm and what might they signify?
often painless. however, painful symptoms of aortic aneurysm may imply imminent rupture, leaking, or dissection.
Who is at risk for a thoracic aortic aneurysm? What is associated with a thoracic aortic aneurysm?
it depends on the age.
Young patients with Marfan’s. Older patients with cystic medial degeneration (accumulation of cysts of “ground substance” in the media)
historically associated with tertiary syphilis from obliteration of the vasa vasorum
What is an aortic dissection?
intraluminal tear that forms a false lumen.
What conditions are associated with aortic dissection?
hypertension, BICUSPID aortic valve, Marfans?
How does aortic dissection present?
sudden onset sharp/tearing pain that may radiate to the back, +/- markedly unequal BP in the arms. mediastinal widening on CXR.
What drugs can trigger prinzmetal angina?
triptans
What is coronary steal syndrome?
Assume coronary arteries have atherstenosis. To compensate, they are always maximally dilated. When we administer a drug that causes vasodilation (eg. nitrates), other vasculature in the body dilates, but the coronary arteries can’t. this brings blood toward well oxygneated parts of the body and away from the heart tissue, and may cause pain and ischemia. basis for pharmacologic stress tests.
What is a myxoma? Where is it likely to occur and how might it present?
A myxoma is a tumor in adults that usually presents as sycope due to obstruction of the mitral valve. it is likely to occur in the left atrium.
It is a gelatinous, pedunculated proliferation of mesenchyme. Lots of ground substance histologically.
most common cardiac tumor in adults.
What is a rhabdomyoma?
the most common cardiac tumor in kids. benign hammartoma. strongly associated with tuberus sclerosis (remember, this is a genetic disease associated with hamartomas in CNS and skin, angiofibromas, renal angiomyolipoma, seizures, among other things)
What is Kussmaul sign?
incr. in JVP on inspiration instead of the normal decrease. in this case, increase in JVP is evident because of impaired filling of the RV as more blood is returned to the heart. seen in constrictive pericarditis, restrictive cardiomyopathies, and right atrial or ventricular tumors
