atheroma Flashcards
process of atherogenesis
atheroslcerotic plaque formation, leading to coronary heart disease
involves many immune cells, mainly T and B cells, monocytes and macrophages
induced by inflammatory damage of endothelial cells
how do atheromatous plaques form
early : young adults onwards, smooth yellow patches in intima, lipid-laden macrophages, progress to established plaques
fully developed : central lipid core with fibrous tissue cap, covered by arterial endothelium, collagens in cap provide structural strength, inflammatory cells reside in fibrous cap: recruited from arterial endothelium
components of atheromatous plaques
fibrous elements such as connective tissue, ECM matrix, collagen, proteoglycans and fibronectin elastic fibres
cholesterol
calcium
deposits of fatty substances
role of lipids in aetiology of atheroma
hypercholesterolaemia - most important risk factor
causes plaque formation and growth in absence of other known risk factors
importance of LDL cholesterol
signs of major hyperlipidaemia
familial/primary vs acquired/secondary biochemical evidence : LDL, HDL, total cholesterol, triglycerides corneal arcus (premature) tendon xanthomata (knuckles, Achilles) xanthelasma
risk/premature/FH MI/atheroma
recognise fundamental role of atheroma in coronary arterial disease
CAD usually caused by build-up of fatty deposits on walls of arteries around heart
makes arteries narrower, restricting flow of blood to heart muscle == atherosclerosis
role of atheroma in cerebrovascular disease
result of thickening and hardening of wall of arteries in brain
role of atheroma in peripheral arterial disease
deposits may narrow or block arteries
if plaques burst, clot forms
often caused by atherosclerosis
risk factors
smoking HTN diabetes male elderly
obesity sedentary lifestyle low socio-economic status low birthweight ?role of microorganisms
