Ischaemic heart disease

Question 1

what is the pathological basis of ischaemic heart disease

Answer 1

the formation of an atheroma in the coronary arteries

Question 2

what initially occurs in the formation of an atheroma

Answer 2

endothelial injury

Question 3

what accumulates at the site of endothelial injury during formation of an atheroma

Answer 3

lipids + macrophages

Question 4

describe what happens to the smooth muscle in the blood vessel as an atheroma is formed

Answer 4

smooth muscle cells migrate to the tunica intima

Question 5

what is an atheroma made up of

Answer 5

an accumulation of cholesterol(LDL) and ‘foamy’ macrophages

Question 6

what are the different stages of atheroma formation (3)

Answer 6

fatty streak
=> fibrofatty plaque
=> complicated plaque +/- thrombus overlying

Question 7

describe what happens to the blood vessel as atheroma formation progresses

Answer 7

vessel narrows and walls become weaker

Question 8

describe what happens to an atheroma in order for an acute MI to occur

Answer 8

when a large enough plaque ruptures, the clotting cascade is activated and the thrombus occludes a coronary artery

Question 9

what are the different types of ischaemic heart disease

Answer 9

angina, acute coronary syndromes(MI, unstable angina), heart failure

Question 10

what are some modifiable risk factors for ischaemic heart disease

Answer 10

smoking, hypertension, obesity, hypercholesterolaemia, diabetes

Question 11

what are some non-modifiable risk factors for ischaemic heart disease

Answer 11

family history, male, increasing age