Histopath - CVD Flashcards
Atherosclerosis
Atheromatous deposits in and fibrosis of the inner layer of the arteries
Atherosclerosis RFs
- Age
- Genetics
- Hyperlipidaemia
- HTN
- Smoking
- DM
Progression of atheroma
Raised lesion -> soft lipid core -> white fibrous cap
Ischaemic heart disease
Groupd of conditions which result from myocardial ischaemia
Oxygen supply < demand
Which conditions fall under ischaemic heart disease?
- Stable/unstable angina
- MI
- Chronic ischaemic heart disease w heart failure
- Sudden cardiac death
Ischaemic heart disease plaque sites
- First few cm of LAD (left anterior descending artery) or LCX
- Entire length of RCA
Angina
Critical stenosis (narrowing) when demand > supply
No muscle death -> no raised troponin/ECG changes generally
Stable v unstable angina
Stable: occlusion around 70%
Unstable: occlusion >90% + chest pain at rest
Prinzmetal angina
Uncommon, due to coronary artery spasm
Myocardial infarction
Death of cardiac muscle due to prolonged ischaemia
*Histopathology of MI at different times
- <6h
- 6-24h
- 1-4 days
- 5-10 days
- 1-2 weeks
- Weeks-months
- <6h: normal histology
- 6-24h: Flocculent densities form within mitochondria
- 1-4 days: Neutrophils begin to arrive at the area of coagulative necrosis
- 5-10 days: Macrophages begin to arrive at the area of coagulative necrosis
- 1-2 weeks: Granulation tissue begins to form
- Weeks-months: Collagen is deposited, forming a fibrous scar
MI Complications
- Death
- Arrhythmia
- Rupture
- Tamponade
- Heart failure
- Valve disease
- Aaneurysm
- Dressler syndrome
- Embolism
- Reperfusion injury
Right sided cardiac failure histopathology liver
Nutmeg liver
Histology of cardiac failure
- Dilated heart
- Scarring and thinning of walls
- Fibrosis and replacement of ventricular myocardium
Cardiomyopathy
Disease of muscle tissue