B2.006 Acute MI Underlying Pathology Flashcards
What is atherosclerosis?
intimal based lesion composed of a fibrous cap and atheromatous core (necrotic center)
What are some inherited/constitutional risk factors for atherosclerosis?
genetic, age, gender
What are some modifiable risk factors for atherosclerosis?
hyperlipidemia, hypertension, cig smoking, diabetes
What are the 5 main steps of atherosclerosis?
- chronic endothelial “injury”
- endothelial dysfunction and emigration
- macrophage activation, smooth muscle recruitment
- macrophages and smooth muscle cells engulf lipid
- smooth muscle proliferation, collagen, and other extracellular matrix deposition, extracellular lipid
What causes hardening in plaques?
calcium deposits
What is neovascularization?
blood vessels form within plaque, making the plaque susceptible to blood leakages and inflammation
What are some major sources of endothelial “injury”?
hyperlipidemia, hypertension, smoking, toxins, hemodynamic factors, immune rxns, viruses
What are the major structural components of a blood vessel?
lumen, endothelium, intima, internal elastic membrane, media, adventitia
What makes a plaque unstable?
thin fibrous cap, neovascularization, calcium deposits
What are the 3 primary clinical results of a vulnerable plaque?
aneurysm and rupture, occlusion by thrombus, and critical stenosis
What can cause an aneurysm?
mural thrombosis, embolization, wall weakening
What can cause occlusion by thrombus?
plaque rupture, plaque erosion, plaque hemorrhage, mural thrombosis, embolization
What can cause critical stenosis?
progressive plaque growth
What is the most common cause of death in the US?
atherosclerosis
What are 3 types of CAD?
MI, angina pectoris, sudeen cardiac death