CVD histo

Question 1

RF for CVD

Answer 1

Inflammation
Metabolic syndrome
Lipoprotein a - correlated with atheroscleorosis

Dyslipidemia, hyperglycemia
systemic hypercoagulability and proinflammatory state - endothelial damage

Lack of exercise
Stress
Obesity

Question 2

Pathogenesis of atherosclerosis

Answer 2

Endothelial dysfunction and injury, disrupting the flow of blood
Lipoprotein accumulation in the intima of the blood vessels
Monocyte adhesion to endothelium

Factors are released from platelets which thickens smooth muscle

An inflammatory response

Question 3

Who has fatty streaks? What do they look like on histology?

Answer 3

Everyone has fatty streaks. But ?when they accumulate, they are bad.
They look like glass shards = cholestrol clefts

Question 4

What deposits in atherosclerotic plaques?

Answer 4

Cells - SM cells, macrophages and T cells
Matrix - collagen, elastin fibres and proteoglycans
Lipids

Question 5

When do you call blocking of a vessel?

Answer 5

Stenosis particularly after 70 percept

Question 6

Presentations of occulusion

Answer 6

Claudication, chest pain

Question 7

What are some consequences of atheroma?

Answer 7

Rupture, erosion (e.g. from + haemorage into plaque

Question 8

When are some plaques prone to rupturing?

Answer 8

Some plaques are vulnerable if there is an increase in vasoconstriction or adrenaline,

Question 9

Describe a stable plaque

Answer 9

Thick fibrous cap and thin lipid core

Question 10

Describe an unstable plaque

Answer 10

Thick lipid core and thin fibrous cap

Question 11

Presentation of ischemia heart disease

Answer 11

Angina pectoris (chest pain) (Stable, unstable, prinz metal (vasospasm))
MI - ischemia long enough to cause myocyte death
Chronic IHD + HF
Sudden cardiac death

Question 12

What percentage stenosis does someone have if they have chest pain during exercise?

Answer 12

75 percent occlusion

Question 13

What percentage stenosis does someone have if they have chest pain during rest?

Answer 13

90 percent occlusion

Question 14

Define angina pectoris

Answer 14

Transient ischemia insufficient to cause myocyte necrosis

Question 15

Unstable angina

Answer 15

Transient ischemia that comes on at rest

Question 16

Which vessel is most commonly affect in mI?

Answer 16

50 percent in LAD

Question 17

Symptoms

Answer 17

Patients do come in with vomiting

Question 18

Cardiac enzymes

Answer 18

CK

Trops

Question 19

Complications of MI

Answer 19

Contractile dysfunction
Arrhythmia
Myocardial rupture
Pericarditis - Dresler’s syndrome

Question 20

What is the name for post MI pericarditis?

Answer 20

Dresler’s syndrome

Question 21

When does Dresler’s syndrome occur?

Answer 21

day 2 or 3 after MI

Question 22

Define sudden cardiac death

Answer 22

asystole or sustained ventricular dysfunction

Question 23

What is the biochemical and histopathological feature of sudden cardiac death?

Answer 23

No enzyme changes, no ECG changes but atherosclerosis seen in post mortem

Heretiory - long QT syndrome (e.g. quetiapine can increase your QT interval)