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Cardiovascular System > Pathophysiology of Atheroma > Flashcards

Pathophysiology of Atheroma Flashcards

1
Q

Atheroma/atherosclerosis

A

Formation of focal elevated lesions (plaques) in intimacy of large and medium-sized arteries

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2
Q

Serious consequence of atheroma

A

Atheroma can result in myocardial ischaemia which can lead to angina

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3
Q

Angina

A

Chest pain due to restricted blood supply to the heart

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4
Q

Atheroma can be complicated by

A

Thromboembolism

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5
Q

Arteriosclerosis

A

Age-related

Smooth muscle hypertrophy, apparent reduplicate of internal laminae and intimal fibrosis

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6
Q

Arteriosclerosis results in

A

Decrease in vessel diameter

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7
Q

Arteriosclerosis can cause

A

Cardiac, cerebral, colonic and renal ischaemia

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8
Q

Earliest significant lesion of atheroma

A

Fatty streak

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9
Q

Fatty streak

A

Yellow linear elevation of intimal lining

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10
Q

Fatty streak comprises

A

Masses of lipid-laden macrophages

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11
Q

Early atheromatous plaque

A

Smooth yellow patches in intima

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12
Q

Fully developed atheromatous plaque

A

Central lipid core with fibrous tissue cap, covered by arterial endothelium

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13
Q

What provides fibrous tissue cap of plaque with structural strength

A

Collagens

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14
Q

What resides in fibrous cap of plaque

A

Inflammatory cells (recruited from arterial endothelium)

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15
Q

Central lipid core of plaque contains

A

Cellular lipids and debris from macrophages

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16
Q

What occurs late in plaque development

A

Extensive dystrophic calcification

17
Q

Atheroma tend to form in areas of

A

Turbulent flow

18
Q

Areas of turbulent flow

A

Arterial branching points/bifurcations

19
Q

Late stage plaques

A

Confluent and cover large areas

20
Q

Complicated atheroma

A

Established atheromatous plaque plus haemorrhage into plaque (calcification), plaque rupture/fissuring and thrombosis

21
Q

Most important risk factor of atheroma

A

Hypercholesterolaemia

22
Q

Hypercholesterolaemia

A

High cholesterol in blood

23
Q

Hypercholesterolaemia can be a result of

A

Lack of LDL cell membrane receptors

24
Q

Signs of major hyperlipidaemia/hypercholesterolaemia

A 
Familial vs acquired
Biochemical evidence
Corneal arcus
Tendon xanthomata
Xanthelasmata
Risk/premature/family history MI/atheroma
25
Q

Risk factors for atheroma

A 
Hyperlipidaemia/hypercholesterolaemia
Smoking
Hypertension
Diabetes mellitus
Male
Elderly
26
Q

Two-step process of formation of atheromatous plaque

A
  1. Injury to endothelial lining of artery

2. Chronic inflammatory and healing response of vascular wall to agent causing injury

27
Q

Chronic inflammation results in

A

Accumulation of lipids and inflammatory cells in the intimal layer which results in plaque formation

28
Q

Causes of endothelial injury

A 
Heamodynamic disturbances (turbulent flow)
Hypercholesterolaemia
29
Q

Altered function of injured endothelial cells

A

Enhanced expressed of cell adhesion molecules
High permeability for LDL
Increased thrombogenicity

30
Q

Clinical manifestation of consequences of atheroma

A

Lumen stenosis
Acute atherothrombotic occlusion
Embolisation of distal arterial bed
Aortic aneurysm and rupture

31
Q

Vulnerable atheromatous plaque

A

Thin fibrous cap with large lipid core and prominent inflammation

32
Q

Result of pronounced inflammatory activity on plaque

A

Degradation and weakening of plaque, increasing the risk of plaque rupture

33
Q

Preventative and therapeutic approaches to atheroma

A 
Stop smoking
Control blood pressure
Weight loss
Regular exercise
Dietary modifications
34
Q

Secondary prevention of atheroma

A

Cholesterol lowering drugs
Aspirin - decrease risk of thrombosis
Surgical options

Cardiovascular System (27 decks)

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