CHD overview

Question 1

What does ischaemia mean?

Answer 1

reduced blood flow to organ/tissue

Question 2

What type of damage can occur due to ischaemia?

Answer 2

reversible or irreversible

Question 3

3 causes of CHD

Answer 3

angina pectoris, immediate/sudden cardiac death, ACS

Question 4

4 pathological factors of CHD

Answer 4

• atherosclerosis
• coronary thrombosis
• coronary artery spasm
• coronary microvascular dysfunction

Question 5

What is atherosclerosis?

Answer 5

progressive arterial disease characterised by deposition of lipids and fibrous tissue on inside of arteries

Question 6

What is the most common cause of CHD?

Answer 6

atherosclerosis

Question 7

When does atherosclerosis being and how?

Answer 7

early in life as a fatty streak

Question 8

What is the process for atherosclerosis?

Answer 8

1. LDL deposition
2. LDL oxidation
3. macrophage differentiation and uptake of LDL
4. foam cell formation
5. SMC migration
6. fibrous plaque

Question 9

3 consequences of atherosclerosis

Answer 9

• partial coronary exclusion (stable angina)
• endothelial/vascular dysfunction (spasm)
• ulceration/rupture (thrombosis)

Question 10

What is coronary thrombosis?

Answer 10

unwanted formation of a haemostatic plug/thrombus/clot within arteries

Question 11

Where does a thrombus occur?

Answer 11

on top of a ruptures plaque/atheroma

Question 12

What cascade takes place in coronary thrombosis?

Answer 12

coagulation cascade

Question 13

What are the consequences of coronary thrombosis?

Answer 13

• complete/permanent occlusion of CA
• subtotal/intermittent occlusion of CA
• thromboembolism in distal artery

Question 14

What is a coronary artery spasm?

Answer 14

transient spontaneous coronary vasoconstriction

Question 15

Coronary artery spasm is the underlying cause of whet type of angina?

Answer 15

variant angina

Question 16

There is an abnormal release of what during a coronary artery spasm?

Answer 16

vasoconstrictors

Question 17

What are the consequences of coronary artery spasm?

Answer 17

• subtotal/intermittent occlusion of CA

- complete focal occlusion of CA

Question 18

What is coronary microvascular dysfunction?

Answer 18

damage to the inner walls of small coronary blood vessels of the heart

Question 19

What can coronary microvascular dysfunction cause?

Answer 19

microvascular spasms

Question 20

What 2 types of damage does microvascular dysfunction cause?

Answer 20

structural and functional

Question 21

What are the 3 disease mechanisms of microvascular dysfunction?

Answer 21

• microvascular remodelling
• endothelial dysfunction
• functional abnormalities of SMC

Question 22

What are the consequences of microvascular disfunction?

Answer 22

• reduced coronary flow reserve

- increased risk of myocardial ischaemia