CVD histo Flashcards
RF for CVD
Inflammation
Metabolic syndrome
Lipoprotein a - correlated with atheroscleorosis
Dyslipidemia, hyperglycemia
systemic hypercoagulability and proinflammatory state - endothelial damage
Lack of exercise
Stress
Obesity
Pathogenesis of atherosclerosis
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
Who has fatty streaks? What do they look like on histology?
Everyone has fatty streaks. But ?when they accumulate, they are bad.
They look like glass shards = cholestrol clefts
What deposits in atherosclerotic plaques?
Cells - SM cells, macrophages and T cells
Matrix - collagen, elastin fibres and proteoglycans
Lipids
When do you call blocking of a vessel?
Stenosis particularly after 70 percept
Presentations of occulusion
Claudication, chest pain
What are some consequences of atheroma?
Rupture, erosion (e.g. from + haemorage into plaque
When are some plaques prone to rupturing?
Some plaques are vulnerable if there is an increase in vasoconstriction or adrenaline,
Describe a stable plaque
Thick fibrous cap and thin lipid core
Describe an unstable plaque
Thick lipid core and thin fibrous cap
Presentation of ischemia heart disease
Angina pectoris (chest pain) (Stable, unstable, prinz metal (vasospasm))
MI - ischemia long enough to cause myocyte death
Chronic IHD + HF
Sudden cardiac death
What percentage stenosis does someone have if they have chest pain during exercise?
75 percent occlusion
What percentage stenosis does someone have if they have chest pain during rest?
90 percent occlusion
Define angina pectoris
Transient ischemia insufficient to cause myocyte necrosis
Unstable angina
Transient ischemia that comes on at rest
Which vessel is most commonly affect in mI?
50 percent in LAD
Symptoms
Patients do come in with vomiting
Cardiac enzymes
CK
Trops
Complications of MI
Contractile dysfunction
Arrhythmia
Myocardial rupture
Pericarditis - Dresler’s syndrome
What is the name for post MI pericarditis?
Dresler’s syndrome
When does Dresler’s syndrome occur?
day 2 or 3 after MI
Define sudden cardiac death
asystole or sustained ventricular dysfunction
What is the biochemical and histopathological feature of sudden cardiac death?
No enzyme changes, no ECG changes but atherosclerosis seen in post mortem
Heretiory - long QT syndrome (e.g. quetiapine can increase your QT interval)
