Atherosclerosis, Angina, Myocardial Infarction

Question 1

What is atherosclerosis?

Answer 1

1. Characterized by stiffening of the arterial wall and formation of lipid plaques
2. Affect medium and large blood vessels, coronary arteries
3. Inflammation allows build up of plaques

Question 2

What are the steps of progressive atherosclerosis?

Answer 2

1. Endothelium irritated or damaged
2. Lipids start to gather and build up
3. Monocytes migrate and become macrophages
4. Macrophages “fill up” and become foam cels
5. These burst and release cytokines and chemical signals that call more to the area
6. Smooth muscle cells migrate in an secrete fibrous cap and calcium

Question 3

Relate angina to atherosceotic pathophysiology.

Answer 3

1. external/stable (demand): predictably triggered by exertion, emotion, cold
2. Unstable (supply): occurs during exertion or rest, episodes may be longer
3. variant/prinzmetal (supply): unpredictable, caused by vasospasm

Question 4

What are clots called in lungs?

Answer 4

Pulmonary embolism

Question 5

What are clots called in legs?

Answer 5

Deep vein thrombosis (DVT)

Question 6

Describe the pathophysiology of a Myocardial infarction.

Answer 6

1. Myocytes near blood clot: decreased O2 sends signal to increase blood flow (and therefore heart rate)
2. Run out of O2/ energy: slow down an stop contracting altogether
3. Heart tries to compensate by continuing to beat faster
4. Dead myocytes start to break down releasing troponins (these proteins are found only in heart muscle cells)
5. Area of infarct (tissue death) increases with time

Question 6

Describe the pathophysiology of a Myocardial infarction.

Answer 6

1. Myocytes near blood clot: decreased O2 sends signal to increase blood flow (and therefore heart rate)
2. Run out of O2/ energy: slow down an stop contracting altogether
3. Heart tries to compensate by continuing to beat faster
4. Dead myocytes start to break down releasing troponins (these proteins are found only in heart muscle cells)
5. Area of infarct (tissue death) increases with time

Question 7

What are fibrous cap consists of?

Answer 7

1. smooth muscle
2. macrophages
3. lymphocytes
4. collagens

Question 8

What does the necrotic center consist of?

Answer 8

• smooth muscle cells
• macrophages
• lymphocytes

*foam cell

• cholesterol crystals
• cell debris
• calcium

Question 9

external/stable angina is a problem of _______.

Answer 9

demand

Question 10

unstable angina is a problem of _______.

Answer 10

supply

Question 11

variant/prinzmetal is an angina problem ________.

Answer 11

supply

Question 12

nitrates are what type of class?

Answer 12

direct vasodilators

Question 13

What are the adverse effects of nitrate treatment?

Answer 13

decrease in blood pressure, headache, dizzy, and flushing