Endothelium, Plaque Rupture, & Vascular Injury Flashcards
1
Q
Stages of endothelial dysfxn
A
-fatty streak
-stable plaque (angina)
unstable plaque (acute myocardial event)
2
Q
Mechanisms of ischemia
A
- stroke: usually embolic
- CAD
- Renal artery disease
- aneurysm: atherosclerosis –> vessel degradation
- peripheral artery disease
3
Q
Stroke main mechanism of ischemia
A
- atheroembolism from carotid bifurcation ( sudden loss of vision = sx if plaques are embolizing
- thromboembolization from left atrial appendage in setting of atrial fibrillation
4
Q
CAD
A
thromboembolism
5
Q
angina mech
A
-stable, obstructive plaque
6
Q
MI
A
- exertional chest discomfort
- ruptured plaque, in-situ thrombosis, not necc. obstructive prior to rupture
- varied severity: non-occlusive thrombosis vs. occlusive thrombus
7
Q
Tx of MIs of different severity
A
- non-occlusive can usually be resolved w/anticoag and vasodilators
- occlusive=clinical emergency —> revascularization/stenting
8
Q
Varying severity of ruptured coronary plaques (diagram)
A
xx
9
Q
Peripheral arterial disase
A
- caludication
- acute limb ischemia
10
Q
claudication
A
- obstructive stable plaque
- ~angina @ periphery –> pain w/exercise due to limited flow
11
Q
acute limb ischemia
A
- acute obstruction of blood flow
- atheroembolization (e.g. from aortic aneurysm) or thromboembolization
- rarely in-situ thrombosis
12
Q
Stable plaques
A
- less biologically active
- cause angina/claudication (exertional ischemia) of
- less likely to cause thrombotic and embolic events
13
Q
unstable plaque
A
- more biologically active
- more likely to embolize/cause thrombosis
14
Q
Venous thrombosis
A
-fibrin rich
-RBC
0areas of stasis
-genetic predispostiation
-enviro predisposition
-treated w/antigcoagilation
15
Q
Arterial thrombosis
A
- platelet rch
- plaque rupture
- areas of high flow
- atherolsclerosis, traum, APLA
- focus on antiplatet therapy
