Atherosclerosis & Hypertension Flashcards
What is atherosclerosis?
Disease of large and medium-sized arteries
Artery wall thickens and hardens as a result of a build up of fatty materials forming plaques or atheromas
What is atheroma texture like?
it is porridge like
What is arteriosclerosis?
Hardening and thickening of the arteries for any reason
What is atherosclerosis?
When an artery wall thickens as a result of a build up of fatty material. Blockage can be partial or complete and this predisposis to thrombus formation resulting in ischaemic damage to cells.
What is arteriosclerosis?
When an artery wall thickens as a result of a build-up of fatty material
What is atherogenesis?
The process of development of atheromatous plaques
What is arteriolosclerosis?
Thickening and hardening of arterioles
What is the leading cause of death in the developed world?
Atherosclerosis (mostly due to ischaemic heart disease and stroke)
What are the non-
modifiable risk factors for atherosclerosis?
Increasing age
Male gender
Family history
What are the modifiable risk factors for atherosclerosis?
Hyperlipidaemia (LDL vs HDL
Hypertension
Cigarette smoking
Diabetes
What are some other risk factors that can cause atherosclerosis?
Inflammation
Hyperhomocystenaemia
Lipoprotein A
Haemostatic factors
Metabolic syndrome
What percentage of CV events occur in absence of overt risk factors?
Up to 20%
What kind of effect do risk factors have?
They have an additive effect
What is the response to injury hypothesis?
A normal vessel wall with endothelium, thin intima, and more fibrous tissue on outside called intima.
Chronic endothelial injury causes endothelial dysfunction and increased permeability and so white blood cells adhere to endothelium migrating into intima as well as platelets.
Monocytes become macrophages and then lymphocytes come in.
Smooth muscle cells proliferate within plaque and a big plaque filled with inflammatory cells is formed and an indentation in lumen of vessel is created.
Is atherosclerosis always visibly problematic?
No sometimes lesions can appear silent.
What are fatty streaks?
Fat deposits under surface of cells.
Do fatty streaks always become atheromas?
No they can develop during childhood and never cause problems
What are fibrous plaques?
Rasied lesions with soft lipid core covered by a firm fibrous cap and only involve a partial circumference of the wall.
Is atherosclerosis present in veins?
No because it is a disease of arteries under pressure. Pulmonary trunk and veins are not typically affected.
Does the aorta typically have atherosclerosis?
Yes
Do upper limbs typically get atheromas?
Very rarely, cerebral arteries, coronary arteries
What is calcification useful for?
Can be seen clearly on CT scan.
What are some complications that are associated with atherosclerosis?
Calcification (easy to see on CT scan)
Ulceration and formation of atheroemboli which can occlude a branch downstream
Rupture or erosion of the surface of the atheroma causing thrombosis leading to occlusion of artery at that point or the thrombus can embolise and occlude another artery downstream.
Haemorrhage is bleeding within the plaque
Aneurysmal dilatation of the weakened artery wall
What are major consequences of atherosclerosis?
Angina pectoris when coronary arteries become slowly narrowed due to being occluded by a thrombus on a plaque after the plaque has ruptured or by haemorrhage into a plaque causing myocardial infarction and sudden death.
In the brain atherosclerotic plaques in the Circle of Willis or carotid arteries can cause transient ischaemic attacks which result in strokes
In the peripheral arteries can cause intermittent claudication, impotence, and non-healing leg ulcers.
Weakening of aortic wall can cause an abdominal aortic aneurysm. Atheroemboli or thromboemboli that block arteries downstream such as those in the legs or kidney: gangrene of toes and kidney infarction can result.
