Lecture 10- Atherosclerosis Flashcards
What is atherosclerosis?
Accumulation of lipid in the intima and media of arteries leading to their thickening and hardening.
Macroscopic features of atherosclerosis?
Fatty streak
Simple plaque
Complicated plaque
Common atherosclerosis sites?
Carotid arteries Coronary arteries Aorta Leg arteries Cerebral arteries
Arterial anatomy?
Diagram
Early atherosclerosis features?
Foam cells
Smooth muscle proliferation
Later atherosclerosis features?
Fibrosis Necrosis Inflammatory cells Cholesterol clefts Plaque fissuring Damage to media
Clinical effects of atherosclerosis?
Angina Sudden death Myocardial infarction Arrhythmia Cardiac failure Cerebral ischaemia (mini stroke)
What is mesenteric ischaemia?
Atherosclerosis leading to blockage of mesenteric arteries which supply the gut leading to intestinal infarction as well as malabsorption and ischaemic colitis
Peripheral vascular effects of atherosclerosis?
Claudication, leriche syndrome, ischaemic rest pain and gangrene
What is claudication?
Pain in legs upon exercise as not enough blood flow
What is leriche syndrome?
Blockage of abdominal aorta as it transitions into common iliac arteries
What is ischaemic rest pain?
Pain in legs or feet when lying down relieved by standing. More severe than claudication
Atherosclerosis risk factors?
Age- older more likely Gender (males more likely women protected before menopause) Alcohol Smoking High BP High cholesterol Obesity Diabetes Infection
Family risk factor for atherosclerosis?
Hyperlipidaemia
Physical signs of hyperlipidaemia that would cause concern for atherosclerosis?
Corneal arcus
Tendon xanthoma
Xanthelasma (yellow plaque on eyelids)
Why can diabetes lead to atherosclerosis?
Associated with hyperlipidaemia due to fats being used instead of glucose.
Associated with hypertension
Processes involved in atherosclerosis?
Damage to endothelial cells by LDLs, toxins and hypertension.accumulation of lipids which are consumed by macrophages producing foam cells. Smooth muscle proliferates and inflammatory cells are recruited by cytokines produced by foam cells. Foam cells form a hard plaque with a fibrous surface formed by the smooth muscle cells. Intima and media of artery can be affected. Can lead to aneurysm and rupture of plaque can lead to blocking of arteries
Atherosclerosis prevention?
Stop smoking Reduce fat intake Lose weight Control diabetes Exercise Not too much alcohol Treat hypertension Lipid lowering drugs
