Trigger - Atherosclerosis Flashcards
thromboresistant layer
endothelium (inner lining of tunica intima)
Modulates tone, growth, hemostasis and inflammation throughout circulatory system
endothelium of the artery
Consists of smooth muscle cells and an elastic membrane
tunica media
Composed of fibroblasts, mast cells and nerve terminals
tunica externa/adventitia
accumulation of what type of cells causes focal thickening of tunica intima and eventual developement of fatty streaks
foam cells!
fatty streaks can also contain t lymphocytes!!!
this protein can trap VLDL and LDL
biglycan (created by coronary arteries)
describe the process of fatty streak formation
- Vascular injury precipitates monocyte binding to endothelium
- Monocytes cross endothelium and become activated tissue macrophages
- Macrophages “eat” oxidized LDL, becoming foam cells
- T cells release cytokines, which further activates macrophages and cause smooth muscle cells to proliferate
- Smooth muscle cells move to subendothelial space, producing collagen and taking up LDL, adding to foam cell accumulation
A dense, collagen-based layer of connective tissue that covers the well-defined lipid core of an atherosclerotic plaque
fibrous cap
accumulation of connective tissue, lipid containing smooth muscle cells and extracellular lpid pool
fibrous plaque
Characterized by a necrotic lipid–rich core and calcified regions that develop over time
advanced lesions
this type of remodeling is associated with unstable angina
positive remodeling
negative remodeling is associated with stable angina
what does oxidized LDL do in the pathogenesis of atherosclerosis?
precipitates endothelial vasodilator dysfunction
this is associated with hypercholesterolemia, HTN, DM , and smoking
endothelial dysfunction (the first step to developing atherosclerosis!)
corrected with high doses of antioxidants, ACEI, and correction of HLD
endothelial vasodilator dysfunction
why does endothelial vasodilator dysfunction occur
loss of endothelial-derived nitric oxide
if a patient has unstable/ruptured plaques what type of inflammation is it likley assocaited with
active inflammation
characterized by repeated ruptures and thrombosis followed by wound healing
silent plaque erosion/rupture
what is considered premature CHD
Age <55 men
Age <65 women
At what age do people become at risk for Atherosclerosis
Men >45
Women >55
What is the MOA of cigarrette smoking promoting atherosclerosis
- increases platelet adhesiveness
- raises endothelial permeability
- stimulates SNS
what populations will benefit with the use of a statin in regards to decreasing risk of CHD
- Individuals with clinical ASCVD (secondary prevention)
- Individuals with primary elevations of LDL–C ≥190 mg/dL
- Individuals 40-75 yrs with DM and LDL–C 70 to 189 mg/dL w/out clinical ASCVD
- Individuals w/out clinical ASCVD or DM who are 40-75 yrs with LDL–C 70-189 mg/dL and have an estimated 10-year ASCVD risk of >7.5%
How does hypertension increase the risk of atheroclerosis/CHD
- mechanical injury to vessel wall
- thickens and stiffens heart muscle
who is AAA screening reccomended in?
men 65-75 who have smoked
who is HTN screening reccomended in
adults 18+ w/o known HTN
who is DM screening reccomended in?
asymptomatic adults aged 35-70 years old who have overweight or obesity
yayyyyy done
