atherosclerotic disease Flashcards
what is atherosclerosis
patho process of forming atheroma
major risk factor
age - espeially after 40
what layer of the vessel is affected
intima, and as gets worse, media
3 major areas most likely to be affected
- branch points
- curvatures
- regions of complex blood flow
6 systems affected by athero
- CAD
- AAA
- CV disease
- PVD
- mesenteric
- renovascular
what part of vessel is major regulator of activity
enodthelium
6 features of the endo thelium
- anti-inflamm
- atni -thrombotic
3 anti- proliferative - anti-oxiadative
- vasodilatory
- selectively permeable
what happens in athero
- shear stress
- LDL in
- macros eat them
- foam cells
- smooth msucle enters
3 types of athero
stable atheroma with:
- thin fibrous cap over a necrotic core
- stable fibromuscular cap
- stable fibro calcific cap
2 things that can happen when cap breaks
- non-occlusive thrombus
2. occlusive thrombus forms
what are 4 features of MI
- acute coag. necrosis
- usually in area supplied by occluded art
- LV most common
- starts in sub endocardial zone and may become mural
3 stages of MI and what is seen
- early - contraction bands
- 16-24 hours - acute inflammation
- days - early healing and macrophages with loss of myocytes
6 possible compliations of MI
- arrhymia
- free wall/septal rupture
- mittral insuff.
- papillary muscle rupture
- aneurysm
- CHF
what is sudden death in athero
most sudden death not due to athero (unless severe) but likely an arrythmia triggered by the infarct
- usually die at home, not hospital
what amount of steonis is likely to leasd to death
70-75-%
