CC 6 - Atherosclerosis, Hypertension, and Million Hearts Flashcards
Definition of stenosis?
Luminal narrowing of the artery
What is another word for stenosis?
Lesion
What is a plaque?
Atherosclerotic deposition within the intima or adventitia of vessels
What does PCI stand for? What does it mean?
Percutaneous Coronary Intervention
Interventions to put in balloons and stents inside vessels
What does ACS stand for? Definition?
Acute Coronary Syndrome = any condition brought on by a sudden reduction or blockage of blood flow to the heart
What does STEMI stand for?
ST Elevation Myocardial Infarction
What does NSTEMI stand for?
Non-ST Elevation Myocardial Infarction
Is a lesion always visible on an angiogram?
NOPE, flow does not exclude the possibility of a narrowing present
What are the 3 types of ACS? What do we call type 2 and 3 together?
- STEMI
- NSTEMI
- Unstable angina
2 + 3 = Non-ST Elevation Acute Coronary Syndrome
What does PMH stand for?
Past Medical History
What does NSR stand for?
Normal Sinus Rhythm (on EKG)
At what point does atherosclerosis become symptomatic?
When plaque stenosis exceeds 70% of the vessel lumen
What fraction of all deaths in the US and Europe are due to vascular disease? What are these exactly due to?
Half of all deaths:
- 2/3rds: atherosclerosis and thrombosis of the coronary arteries
- 1/3rd: thrombosis and hemorrhage in other arteries (e.g. stroke)
What is the most common first symptom of coronary artery disease?
Unexpected myocardial infarction OR sudden death (first symptom for 50% of people)
How many people have a myocardial infarction each year?
1,450,000 (1 every 25 seconds)
How many people have a stroke each year?
800,000
What fraction of people die from CVD each year?
1 in 3
What are most acute coronary syndromes caused by?
Rupture of lesions less than 50% stenosed (2/3rds due to this)
Why has CVD incidence fallen over the years?
- Less tobacco
- Better BP control
- Better lipid control
- Other unknown factors
Where does the word atherosclerosis come from?
Greek:
- Athero = gruel or porridge
- Sclerosis = hardening
What is the definition of atherosclerosis?
Progressive pathological condition characterized by the accumulation of lipids, cells, and fibrous elements in the large arteries (but also smaller vessels)
What other diseases does atherosclerosis underlie?
- CAD
- Cerebrovascular disease
- Diseases of the aorta and peripheral arterial circulation
Why is the intima of the arterial wall so important?
If it is damaged it exposes a lot of tissue factors and pro-coagulable factors causing blood clots
Under basal conditions, in what state does the endothelium maintain the vessels?
Relatively dilated state