Atherosclerosis Flashcards
What is arteriosclerosis?
The generic name for the thickening of the arterial wall which then loses elasticity
What is atherosclerosis?
A focal disease of the arteries which involves the development of fatty plaques within the walls of the large and medium sized arteries.
What can cause endothelial damage?
Shear stress, toxic damage, high lipid levels and viral/bacterial infection
What are the different types of lipoprotein?
- Chylomicrons
- VLDL (very low-density lipoprotein)
- IDL (intermediate-density lipoprotein)
- LDL (low-density lipoprotein) – “BAD” cholesterol
- HDL (high-density lipoprotein) - “GOOD” cholesterol
How do statins work?
They inhibit HMG CoA which reduces intracellular synthesis of cholesterol and increases LDL receptors which leads to reduced plasma cholesterol levels
What drugs are present in the ‘polypill?
Statin and aspirin etc.
What are the complications of atherosclerosis?
Coronary heart disease
Outline the process of atheromatous plaque formation
1) Accumulation of modified lipid
2) Endothelial cell activation
3) Inflammatory cell migration and activation
4) Smooth muscle cell recruitment
5) Proliferation and matrix synthesis
6) Fibrous cap formation
7) Plaque erosion/rupture
8) Platelet aggregation
9) Thrombosis
What is a stable plaque?
This causes a reduced blood flow but there is stable, exertional (with exercise) angina, and therefore is relatively manageable. The plaque is still covered by the endothelium and hasn’t ruptured. Usually there isn’t a formed fibrous plaque.
What is an unstable plaque?
When the fragile fibrous cap ruptures, and this causes the exposure of collagen to the flowing blood and this leads to the release of tissue factor and platelet aggregation. Thrombi will tend to form as there is platelet accumulation.
