Lecture 9- Atherosclerosis Flashcards
… dz is responsible for more morbidity and mortality than any other category of dz
vascular
2 principle mechanisms of vascular dz
- narrowing or obstruction of vasc. lamina
2. weakening of vasc. walls leading to dilation or rupture
…. is a condition where there are calcifications in the muscular walls but there is no encroachment on lumen therefore usually clinically insignificant
Medial calcific sclerosis (Monckebergs)
2 types of arteriosclerosis that affect arterioles
- hyaline
2. hyperplastic
hyaline arteriosclerosis is seen in … and …
HTN
diabetes
hyperplastic arteriosclerosis is seen in
malignant HTN
atherosclerosis affects…
larger arteries
atherosclerosis is associated with the formation of …. called…. which protrude into the lumen
intimal lesions
atheromas (atheromatous or atherosclerotic plaques)
atheromas can…. and obstruct blood flow, may weaken the underlying … of the artery and can also rupture resulting in catastrophic …
enlarge
media
vessel thrombosis
High prevalence of atherosclerosis is seen in… and low prevalence is seen in…
U.S., western Europe
Africa, far east
The peak death rate from MI was ….% in the late 1960s
54%
The current death rate is about …% for all atherosclerotic related complications (…% due to MI)
50%
25%
3 non-modifiable risk factors of atherosclerosis
genetics- family history
increasing age
being male
4 modifiable risk factors for atherosclerosis
diabetes
hypercholesterolemia
cigarette
HTN
6 additional rick factors of atherosclerosis
- inflammation
- hyperhomocysteinemia
- lipoprotein(a)
- metabolic syndrome (obesity)
- Type A personality
- lack of exercise
3 components of atherosclerosis response to injury hypothesis
- endothelial injury
- accumulation of lipoproteins
- monocyte adhesion
fatty streaks appear in most children independent of … and occurs at both sites prone and not prone to atherosclerosis. some may progress to…
geography, gender, race and environment
atheromas
5 complications of atherosclerosis
ischemic heart disease (MI) cerebral infarct gangrene renal artery stenosis aoritc aneurysm
HTN affects approx. …. % of the US population
25%
severe HTN is over
160/106
symptoms of HTN (none at low and moderate)
headache
fatigue
dizziness
palpitations
… HTN accounts for 90-95% of all patients with HTN
essential
6 contributing factors of essential hypertension
genetics obesity inactivity stress high salt intake smoking
…. hypertensive heart disease is when L. ventricular concentric hypertrophy provides normal CO
compensated
… hypertensive heart disease is when the hypertrophy is no longer adequate to provide normal CO due to decreased myocardial contractility resulting in LV dilation and gradual onset of CHF
decompensated
… is thickening of the L. ventricular wall at the expense of the L. ventricular chamber with little or no increase in the outside cardiac dimensions
concentric hypertrophy
…. hypertension has a relatively rapid onset, is often superimposed on previous HTN , and has very high systolic and diastolic pressures
accelerated malignant
5 complications of accelerated malignant HTN
- cerebral edema
- papilledema
- encephalopathy
- renal failure
- cerebral hemorrhage