Atherosclerosis Flashcards
What is Arteriosclerosis?
“Hardening of the arteries”
A group of disorders that have in common thickening and loss of elasticity of arterial walls.
What are the three distinctive morphological variants of arteriosclerosis?
Atherosclerosis,
Monckeberg’s medial sclerosis,
Arteriolosclerosis.
What is atherosclerosis?
A progressive disease affecting the intima of elastic and muscular arteries.
Characterised by focal atheromas (fibrofatty plaques) consisting of a lipid core covered by a fibrous cap.
Atherosclerosis overwhelmingly accounts for more death and serious morbidity in the Western world than any other disorder.
What is Monckeberg’s medial (calcific) sclerosis (MCS)?
A ring-like calcification of the vascular media of small to medium sized vessels without associated intimal thickening.
Characterised by calcification of the media of muscular arteries.
What is Arteriolosclerosis?
Characterised by the proliferative or hyaline thickening of the walls of small arteries and arterioles.
Results in the hardening and loss of elasticity of arterioles or small arteries.
Most often associated with hypertension and diabetes mellitus.
What is difference between atherosclerosis and arteriosclerosis?
Arteriosclerosis is the stiffening or hardening of the artery walls.
Atherosclerosis is the narrowing of the artery because of plaque build-up.
Atherosclerosis is a specific type of arteriosclerosis.
What are some Major predisposing factors for atherosclerosis?
Diet and hyperlipidaemias;
- (hypercholesterolaemia, hypertriglyceridemia).
Hypertension;
- both systolic and diastolic hypertension.
Cigarette smoking;
- esp. responsible for increasing heart disease in women.
Diabetes mellitus;
- 2x risk of myocardial infarct,
- 8x-150x risk of gangrene of the extremities.
What are some Minor predisposing factors for atherosclerosis?
Obesity.
Physical inactivity.
Male gender.
Increasing age.
Family history.
Stress.
Why is atherosclerosis more dangerous in smaller arteries? (like coronary arteries)
In small arteries, atheromas are occlusive, compromising blood flow to distal tissues and causing ischaemic injury.
How many stages are there in the development of an atheromatous plaque?
Four.
What is stage 1 in the development of an atheromatous plaque?
Lipid is present in macrophages in the intima.
What is stage 2 in the development of an atheromatous plaque?
Lipid is present in both macrophages and smooth muscle cells.
What is stage 3 in the development of an atheromatous plaque?
Fibrous plaque is present.
What is stage 4 in the development of an atheromatous plaque?
Complex plaque (fibrous cap overlying a lipid core).
How does endothelial injury start atherosclerosis?
Lesions of atherosclerosis are initiated as a response to some form of injury to arterial endothelium.
The injury is normally caused by consistent trauma to the endothelial lining, hence why hypertension is a risk factor.
Macrophages gain access into the wall of the vessel.
- Monocytes migrate into the intima and then accumulate low-density lipoprotein (LDL) to produce foam cells.
Endothelial damage is a major risk factor in atherogenesis.
