Cvs: Atherosclerosis Flashcards
Atherosclerosis is characterized by lesions called __________ or ______________ plaques
atheromas or atheromatous/fibrofatty
Atherosclerosis ___ & _____ vascular lumen weakening the underlying media
protrude into and obstruct
3 morphologic patterns of arteriosclerosis are
ATHEROSCLEROSIS
Monckeberg Medial Calcific Sclerosis
Arteriolosclerosis
AMERICAN HEART ASSOCIATION CLASSIFICATION OF ATHEROSCLEROSIS
Type 1
NOMENCLATURE
HISTOLOGY
GROWTH
ONSET
CLINICAL MECHANISM CORRELATION
Type I (initial) lesion
Isolated macrophages
By lipid accumulation
From first decade
Clinically silent
Type II
NOMENCLATURE
HISTOLOGY
GROWTH
ONSET
CLINICAL MECHANISM CORRELATION
Type II (fatty streak) lesion
Intracellular lipid accumulation
By lipid accumulation
From first decade
Clinically silent
Type III
NOMENCLATURE
HISTOLOGY
GROWTH
ONSET
CLINICAL MECHANISM CORRELATION
Type III (intermediate)
Type II changes + small extracellular lipid pool
By lipid accumulation
From third decade
Clinically silent
Type IV
NOMENCLATURE
HISTOLOGY
GROWTH
ONSET
CLINICAL MECHANISM CORRELATION
Type IV (atheroma)
Type II changes + core of extracellular lipid
By lipid accumulation
From third decade
Clinically silent or overt
Type 5
NOMENCLATURE
HISTOLOGY
GROWTH
ONSET
CLINICAL MECHANISM CORRELATION
Type V (fibroatheroma)
Lipid core and fibrotic layer, multiple or calcific or fibrotic mainly
Accelerated smooth muscle and collagen increase
From fourth decade
Clinically silent or overt
AMERICAN HEART ASSOCIATION CLASSIFICATION OF ATHEROSCLEROSIS
Type VI
NOMENCLATURE
HISTOLOGY
GROWTH
ONSET
CLINICAL MECHANISM CORRELATION
Type VI (complicated)
Surface defect, hematoma- haemorrhage, thrombus
Thrombus, hematoma
From fourth decade
Clinically silent or over
the cause of atheroma is ____& ______
complex and multifactorial
There are many risk factors. The various risk factors are considered in _____ main groups by some authors.
Name the groups
3
A) ENDOGENOUS FACTORS
B) ENVIRONMENTAL FACTORS
C) DISEASES
A) Endogenous factors include:
1 Age
2 Sex
3 Genetic factors
4 Racial differences
Endogenous factor:
1. Age
• atherosclerosis is a slow complex disease that typically starts in______ and often progresses when people grow older.
• In some people it progresses rapidly even in the ________ decades.
childhood
third
Endogenous factor:
2. Sex
• in men risk increases after the age of__ and in woman risk increases after the age __.
45
55
• The lower incidence of ischemic heart disease in women, especially in premenopausal age, is probably due to high levels of ________ & _________, both of which have anti- atherogenic influence.
oestrogen and high- density lipoproteins
• ENDOGENOUS FACTORS:
3. Genetic factors
• A well-established familial predisposition to atherosclerosis and ischaemic heart disease is most likely ______.
polygenic
Genetic defects in lipoprotein metabolism causing _________________ are associated with accelerated atherosclerosis,
• e.g homozygous familial hypercholesterolemia which often results in ____________ before age 20 years
hyperlipoproteinemia
myocardial infarction