Pathophysiology of atheroma Flashcards
define atheroma
it is a reversible accumulation of degenerative material in the inner layer of an artery wall
what does the material in an atheroma consist of
mostly macrophage cells, or debris, containing lipids, calcium and a variable amount of fibrous connective tissue
what is atheroma essentially
the degradation of the walls of the arteries caused by accumulated fatty deposits and scar tissue
what does atheroma lead to
restriction of the circulation and a risk of thrombosis
what can atheroma be basically classed as
the fat material which forms deposits in the arteries
what coronary arterial disease
coronary heart disease is a disease in which a waxy substance called plaque builds up inside the coronary arteries
what is the role again of the coronary arteries
they supply oxygen-rich blood to your heart muscle
what is the role of atheroma in coronary arterial disease
when plaque builds up in the arteries, the condition is called atherosclerosis
when does the build up of plaque occur
over many years
what is cerebrovascular disease
it is a disease of the blood vessels, especially the arteries that supply the brain
what is the role of atheroma in cerebrovascular arterial disease
cerebrovascular disease is usually caused by atherosclerosis and can lead to stroke
what is peripheral artery disease
it is a common circulatory problem in which narrowed arteries reduce blood flow to your limbs
what occurs when you develop peripheral arterial disease
your extremities, usually your legs, don’t receive enough blood flow to keep up with demand
what is the role of atheroma in peripheral arterial disease
peripheral arterial disease happens when your arteries become narrowed by a gradual build-up of fatty material within their walls
what arteries are affected in peripheral arterial disease
it is nearly always the arteries in the lower part of the body, such as the legs, that are affected
what is hyperlipidaemia
it is a disorder characterised by an abnormally high concentration of fats or lipids in the blood
what are the 2 major types of lipids found in the blood
triglycerides and cholesterol
when is the lipid triglyceride made
when your body stores the extra calories it doesn’t need for energy
what is cholesterol
it is a lipid and is vital for the normal functioning of the body
where is cholesterol made and found
it is made by the liver but can also be found in some foods
what are the symptoms of hyperlipidaemia
most people will have no symptoms
what is a complication of having hyperlipidaemia
having this disorder increases the risk of developing heart disease, it is a major risk factor
what is the way to detect hyperlipidaemia
your doctor must perform a blood test called a lipid panel or a lipid profile, this is the only way to detect it
what is a lipid panel
it is a test that determines your cholesterol levels
what is considered high cholesterol levels
above 200mg per deciliter
what will your doctor use to make a hyperlipidaemia diagnosis
your lipid panel
what is atherogenesis
it is the process of forming atheroma, plaques in the inner lining of arteries
what is atherogenesis essentially
a disorder of the artery wall
what are atheromatous plaques
fatty deposits in the inner lining of an artery, resulting from atherosclerosis
what are atheromatous plaques also called
atheromas
what are the components of atheromatous plaques
plaques are made up of fat, cholesterol, calcium and other substances found in blood
what is the core of atheromatous plaques consisting of
lipid-laden cells with elevated tissue cholesterol and cholesterol ester content, fibrin, proteoglycans, collagen, elastin and cellular debris
what may atherosclerosis may be a result of
a specialised chronic inflammatory fibroproliferative process
what do monocytes and lymphocytes adhere to?
the endothelial cell surface
where to monocytes migrate to?
the sub endothelial space
what do monocytes differentiate into
macrophages
what does the ingestion of low density lipoproteins and modified or oxidised low density lipoproteins by macrophages lead to
the accumulation of cholesterol esters and formation of foam cells
what do the foam cells form with the T lymphocytes?
the fatty streak
describe the migration of vascular smooth muscle cells
vascular smooth muscle cells migrate from the media into the intima
when do the vascular smooth muscle cells proliferate
with the formation of the atherosclerotic plaques
what are the processes in atherogenesis regulated by
a complex network/cascade of cytokines and growth regulatory peptides
what do the processes of atherogenesis involve
cell adhesion migration differentiation proliferation cell interaction with the extracellular matrix
define an atheroma again
the formation of plaques in intima of large and medium-sized arteries
what are serious consequences of atheroma
angina due to myocardial ischaemia
what is atheroma complicated by
thromboembolism
what does the narrowing of the lumen in the coronary arteries from the atheromatous plaques lead to
ischaemia
where is atheroma
it is in the intima layer of the artery wall
what are complications of atheroma
haemorrhage into plaque
plaque rupture
thrombosis
what can also form on the plaque
thrombosis
what is the most important risk factor of atheroma
hypercholesterolaemia
what are risk factor for atheroma
smoking hypertension diabetes mellitus male elderly
what are less strong risk factors of atheroma
obesity
sedentary lifestyle
low socioeconomic status
low birthweight
what are the preventative and therapeutic approaches of atheroma
stop smoking control blood pressure weight loss regular exercise dietary modifications
what are the secondary preventions of atheroma
cholesterol lowering drugs
aspirin
what is other therapy of atheroma
surgical options
