Lecture 7 Heart and blood vessel- atheroma

Question 1

Define atheroma

Answer 1

Build up of fatty material on the inside wall of an artery

Question 2

Define atherosclerosis

Answer 2

Progressive narrowing and hardening within the artery potentially resulting in complete blockage.

Question 3

Atheroma contributes to how many deaths?

Answer 3

Almost half of all deaths in western countries

Question 4

Where atheroma may occur

Answer 4

Lower abdo aorta, cotonary arteries, popliteal arteries, internal carotid and circle of willis

Question 5

Why does athoma occur?

Answer 5

Chronic injury to the endothelium -> chronic inflammation

Question 6

What can cause injury to the endothelium?

Answer 6

Hyperlididaemia, disturbed flow, smoking, hypertension,

Question 7

Explain the development of a plaque fissure/thrombosis

Answer 7

Fatty streak -> plaque -> Obstructive atherosclerotic plaque -> Plaque fissure/thrombosis

Question 8

Define aneurysm and where it can occur

Answer 8

weakening of the wall (balloon), aorta

Question 9

Why may atherosclerotic plaques cause symptoms?

Answer 9

Aneurysm/rupture. Thrombosis, haematoma formation, embolism, critical stenosis

Question 10

How does atheroma normally grown?

Answer 10

outward preserving lumen caliber.

Question 11

How can atheroma lead to thrombosis?

Answer 11

When the atheromas plaque ruptures -> thrombosis

Question 12

Define TIA

Answer 12

Transient Ischemic attack. Mini stroke.

Question 13

Signs of peripheral vascular disease

Answer 13

Smoked most of life. Severe pain in both legs when walking >10 mins. Infected ulcers in feet. Due to muscles needing more oxygen because working.

Question 14

Signs of myocardial infarct (heart attack)

Answer 14

Central crushing chest pain, ECG showed ST elevation affecting V1 to V4.

Question 15

In case, what happened to gentleman with MI.

Answer 15

Gentleman was taken to cath lab for revascularisation procedure. Primary percutaneous coronary intervention (PCI))

Question 16

Other presentations of MI?

Answer 16

Bowel ischaemia (black), renal artery stenosis, emboli (common to feet).

Question 17

Define revascularization

Answer 17

Trying to get blood flowing through again

Question 18

What is the largest single cause of death in UK

Answer 18

Ischaemic heart disease

Question 19

By how much does one MI increase the risk of heart failure and stroke?

Answer 19

3-6 fold

Question 20

Define thyrotoxicosis

Answer 20

Hyperthyroidism

Question 21

Fixed risk factors of ischaemic heart disease

Answer 21

Family history, male, age, ACE gene deletion.

Question 22

Potentially reversible risk factors of ischaemic heart disease

Answer 22

Hyperlipidaemia, smoking, hypertension, diabetes, lack of exercise, obesity, heavy alcohol consumption.

Question 23

> 90% of ischaemia heart disease is caused by?

Answer 23

atherosclerotic obstruction of coronary arteries. (coronary heart disease)

Question 24

Signs and symptoms of ischemic heart disease?

Answer 24

Central crushing chest pain, SOB, palpitations, syncope, Nausea, sweating, pale.

Question 25

Define syncope

Answer 25

Temp loss of consciousness caused by ↓in BP

Question 26

Clinical presentation of ischemic heart disease?

Answer 26

Stable angina, unstable angine (no warning, no pattern), NSTEMI (Non-st elevation myocardial infarction), STEMi, Sudden death.

Question 27

Is stable angina reversible?

Answer 27

Yes

Question 28

What investigations can be done for ischemic heart disease?

Answer 28

Exercise tolerance test, bloods, x-ray and ECG.