arthlerosclerosis Flashcards
what can vasoconstriction cause?
impaired blood flow, causing remodelling of the artery which then can cause hypertension and atherosclerosis
what is arthlerosclerosis?
its the thickening/ hardening of arteries caused by the build up of plaques in the inner lining of the vessel
what do atherosclerosis and hypertension increase the risk of?
- Myocardial infarction
- Heart failure
- Anureism
- Transient ischemia
- Angina
- Artery disease
- Stroke
- Renal failure
what is the development of atherosclerosis characterised by?
its characterised by a progressive narrowing of the blood vessel lumen, this reduces the flow of blood (and oxygen) to vital organs
what are the risk factors of arthlerosclerosis?
- obesity
- smoking
- hypertension
- activating endothelial cells
what are the stages of arthleroscelrosis?
- normal artery - 0% occlusion
- endothelial dysfucntion - 0% occlusion
- fatty streak - <30% occlusion
- increasing plaque- 65% occlusion
- obstructive plaque- 95% occlusion
what are the steps of plaque formation?
- endothelial cell injury (physical, reactive oxygen species, elevated blood glucose, infection
- increased endothelial permeability to lipids (low-density-lipoproteins (LDL))
- oxidation of trapped LDL by endothelial cells
- expression of endothelial adhesion molecules (ICAM & VCAM) and chemokines
- adhesion/ migration of monocytes, t-cells, platelets and smooth muscle cells
- fatty streak forms (macrophages and smooth muscle cells engulf oxidised lipids)
- plaque growth - continued uptake of lipids, lipid oxidation and inflammatory response, forming a necrotic core
- formation of fibrous cap over the foam cell layer
- growth, stiffening and calcification of artheroma, the plaques become brittle and may rupture, leading to thrombosis
what is the foam cell layer?
its the extracellular matrix proteins secreted by smooth muscle
what happens in the formation of fibrous cap?
the fibrous cap forms over the foam cell layer as platelets are release platelet derived growth factors, activating smooth muscle cells and then the muscle cells migrate into the plaque and form the fibrous cap (together with matrix proteins secreted by smooth muscle cells
what are some targets of the stabilisation and regression of arthleroscelrotic plaques?
plasma cholesterol concentration
endothelial cell function
platelet aggregation
smooth muscle cell migration
monocyte function
what happens if youre able to reduce the level of LDL?
you can reduce plaques and stop them growing
what is plasma cholesterol associated with?
its associated with an increased risk of arthleroscelrosis and cardiovascular disease
what does BAD HEART stand for?
BMI
Age
Diabetes
Hypertension
Excess fat (obesity)
Alcohol
Relatives with cardiovascular disease
Tobacco
what are the effects of having some of the risk factors of arthlerosclerosis?
reduced blood vessel lumen diameter, leads to lower blood flow at rest and a reduced oxygen supply
- vascular cell dysfunction leads to impaired vasodilation and faulty blood flow control
- increased risk of blood clots
what does ‘ischemia’ mean?
its where the blood flow is restricted to part of the body, it can be caused by blood clots in the blood vessels
what are the consequences of arthrosclerosis in cerebral arteries?
- stroke
- vascualr dementia
- transient ischemic attacks
what are the consequences of atherosclerosis in coronary arteries?
- angina
- myocardial infarction
- slient ischemia
- arrhythmias
what is the name given to artherosclerosis of coronary arteries?
coronary heart disease
what are the consequences of atherosclerosis in the body apart from the brain and heart?
-decline in renal function
- renal artery occlusion
- abdominal angina
- aortic rupture/ dissection
- peripheral arterial occlusion
what is the origins of ‘angina pectorus’?
its from latin, angere (to strangle) and pectus (chest), a strangling feeling in the chest
what does angina pectorus occur due to?
its due to ischemial, a reduction in blood flow
what is angina characterised by?
- episodes of pain/ pressure in the chest
- breathlessness
- impaired ventricular systolic performance
- reduced coronary blood flow
- irregular heartbeat (arrhythmia)
what is stable angina?
its brought on by effort and is short lived, only 2-3mins
what is unstable angina?
it can happen at rest and is an unpredictable increase in pain