CHD overview Flashcards
What does ischaemia mean?
reduced blood flow to organ/tissue
What type of damage can occur due to ischaemia?
reversible or irreversible
3 causes of CHD
angina pectoris, immediate/sudden cardiac death, ACS
4 pathological factors of CHD
- atherosclerosis
- coronary thrombosis
- coronary artery spasm
- coronary microvascular dysfunction
What is atherosclerosis?
progressive arterial disease characterised by deposition of lipids and fibrous tissue on inside of arteries
What is the most common cause of CHD?
atherosclerosis
When does atherosclerosis being and how?
early in life as a fatty streak
What is the process for atherosclerosis?
- LDL deposition
- LDL oxidation
- macrophage differentiation and uptake of LDL
- foam cell formation
- SMC migration
- fibrous plaque
3 consequences of atherosclerosis
- partial coronary exclusion (stable angina)
- endothelial/vascular dysfunction (spasm)
- ulceration/rupture (thrombosis)
What is coronary thrombosis?
unwanted formation of a haemostatic plug/thrombus/clot within arteries
Where does a thrombus occur?
on top of a ruptures plaque/atheroma
What cascade takes place in coronary thrombosis?
coagulation cascade
What are the consequences of coronary thrombosis?
- complete/permanent occlusion of CA
- subtotal/intermittent occlusion of CA
- thromboembolism in distal artery
What is a coronary artery spasm?
transient spontaneous coronary vasoconstriction
Coronary artery spasm is the underlying cause of whet type of angina?
variant angina
There is an abnormal release of what during a coronary artery spasm?
vasoconstrictors
What are the consequences of coronary artery spasm?
- subtotal/intermittent occlusion of CA
- complete focal occlusion of CA
What is coronary microvascular dysfunction?
damage to the inner walls of small coronary blood vessels of the heart
What can coronary microvascular dysfunction cause?
microvascular spasms
What 2 types of damage does microvascular dysfunction cause?
structural and functional
What are the 3 disease mechanisms of microvascular dysfunction?
- microvascular remodelling
- endothelial dysfunction
- functional abnormalities of SMC
What are the consequences of microvascular disfunction?
- reduced coronary flow reserve
- increased risk of myocardial ischaemia
