Natural History Of Human Atherosclerotic Lesions

Question 1

What is the WHO definition of atherosclerosis?

Answer 1

Atherosclerosis is a variable combination of changes in the intima of arteries consisting of the focal accumulation of lipids, complex carbohydrates, blood and blood products, fibrous tissue and calcium deposits, and associated with medial changes

Question 2

Atherosclerosis is the most common underlying cause of which diseases?

Answer 2

Heart infarction, Brain infarction, peripheral gangrene

Question 3

In which part of the artery does atherosclerosis begin its development

Answer 3

The intima

Question 4

Name the two types of early lesions

Answer 4

Fatty streaks

Focal intimal thickening

Question 5

What is a fatty streak?

Answer 5

These are intimal lesions which are superfically yellow / yellow-grey. They are focal lesions, made of accumulations of lipid laden cells in the subendothelial space

Question 6

What is a focal intimal thickening?

Answer 6

This is a thinkening of the intima confined in an area of the artery (not all around the vessel - diffuse thickening)

Question 7

Name the 2 types of advanced lesions

Answer 7

Fibrous plaque

Fibro-fatty plaque

Question 8

Describe the fibrous plaque

Answer 8

It is the development of the focal intimal thickening. Made of a large area rich in cells and ECM. Doesn’t contain substantial amounts of lipids. It appears fibrotic (hard)

Question 9

Describe the fibro-fatty plaque

Answer 9

It is a soft plaque, filled with atheroma material at the centre. On top of which there is an area rich in cells called the ‘lesion cup’ and on the side there is an area which is the richest in cells called the ‘shoulder of the atheroma’
Inside the atheroma there is a large amount of lipids and necrotic material

Question 10

What can advanced lesions develop onto? Triggered by?

Answer 10

They can become complicated lesions if there are additional changes or alterations such as hemorrhage, thrombosis, ulceration or calcareous deposits