Cardiovascular Pathology Flashcards
What is atherosclerosis?
An accumulation of cholesterol in the walls of blood vessels which leads to hardening and thickening (arteriosclerosis)
Who is commonly affected by atherosclerosis and why?
Males
Females AFTER menopause
Oestrogen promotes vasodilation.
What causes atherosclerosis?
Hyperlipidaemia !!!!
Modifiable factors: i.e. diet
Non-modifiable factors:
age = females after menopause
sex = males higher risk
Genetic predisposition = LDL mutations
What occurs in atherosclerosis?
Immune system attacks the cholesterol deposited in the vessel was and causes damage to the endothelial cells.
This damage is repaired/healed by fatty scar tissue which hardens to forma a plaque called an atheroma.
Atheroma can rupture and cause haemorrhage.
What are the effects of atherosclerosis?
Ischaemic heart disease:
Angina - narrowing which causes lack of blood supply to cardiac muscle.
Infarction:
Myocardial infarction = infarction which leads to coagulation necrosis of cardiac muscle.
Thrombosis and embolism:
The atheroma produces thrombogenic factors which cause a blood clot to form on the surface. This clot can break off and cause an embolism.
What does atherosclerosis commonly cause?
Aortic aneurysm.
What is an aneurysm?
Weakening of the vessel walls which create a bulge.
Bulge can rupture and cause haemorrhage.
What are the 3 ways an aneurysm can form?
Developmental
Degenerative i.e. atherosclerosis
Trauma
What are the two forms of endothelial cells? What occurs in these states?
Basal state - health
Activated state - pathology
Increased permeability
Therefore;
Increased production of pro-inflammtory factors
Increased production of adhesion molecules
Increased expression of pro coagulants.
Give examples of acute coronary disease.
Angina
Myocardial infraction
What causes acute coronary diseases?
Atherosclerosis
What are the symptoms of angina? Why do these occur?
Crushing pain in the chest that can radiate down arm up neck, tightness.
Narrowing of the coronary vessels (by atherosclerosis) causes a reduction in blood supply to cardiac muscle - therefore reduction in oxygen and nutrients.
Cardiac muscle cannot meet metabolic demands.
What occurs in Myocardial infarction?
Complete obstruction of the coronary vessels (by atherosclerosis) which causes COAGULATION NECROSIS of the cardiac muscle. Dead muscle tissue is replaced by GRANULATION TISSUE which does not provide the same function as cardiac muscle = permanent damage to the heart.
What are the microscopic features of cardiac muscle cells which have undergone coagulation necrosis?
Outline of cells remain
Dark cytoplasm
Remains of nuclei
Loss of striations
Give examples of chronic coronary disease.
Congestive heart failure
