Cardiovascular Flashcards
atheroma
intimal lesion
atheromatous plaques > protrude into vessel lumen
risk factors
age - 40-60 years
sex- postmenopausal
oestrogen can be protective(?) but HRT doesn’t do this
hyperlipid
smoking
DM
modifiable risk factors
hyperlipidaemia
LDL-bad
HDL-good
statins effect
HMG-CoA reductase rate limiting enzyme in liver cholesterol synthesis
other risk factors for IHD
inflammation
metabolic syndrome
lipoprotein
haemostasis
lack of exercise
stress
obesity
pathogensis of atheroscleoris
respones to injury hypothesis
chronic inflammatory and healing response of arterial wall to endothelial injury
plaque formation - response to injury hypothesis
blood vessels more permeable
lipoprotein accumulation (LDL)
monocyte adhesion
migration into intima > foam cells
platelet adhesions
= plaque
factor release from activated platelet
smooth muscle
cholesterol cleft
Cholesterol clefts, that are depositions of cholesterol crystals in skin
fatty streak
earliest lesion
found at plaque sites in post mortem
consequences of atheroma
stenosis
critical stenosis > demand»_space;>supply
stenosis
stable angina
plaques
erode
rupture
haemorrhage
thrombose = critical ischaemia
vulnerable plaques
large number of bone cells
fibrous cap is weak = increased risk of rupture
= physical stress
stable plaque
lipid core is small
fibrous cap is thick - so less likely to rupture