Flashcards in Atheroma Deck (39):
A build up of fatty material on the inside of the wall of an artery
the progressive narrowing and hardening within an artery potentially resulting in a complete blockage
Where can atheromas occur?
Lower abdominal aorta
Internal carotid arteries
Vessels of circle of willis
How may atheromas be initiated?
By chronic injury to endothelium resulting in chronic inflam
What may cause injury to endothelium?
How do atheromas progress?
As white cells, constituents of blood and fat
How are plaques formed?
A: Platelets activated
B: Platelets deposit chemokines on endothelial cells that compromise surface of arterial wall
C: Adhesion of monocytes to vessel wall
D: Monocytes then migrate into wall and turn into macrophages
E: LDL circulate and macrophages ingest them causing lipid rich foam cells
F: Foam cells mature into atherosclerotic plaques
What is a type 1 lesion?
What is a type 2 lesion?
Fatty streak lesion
What is a type 3 lesion?
What is a type 4 lesion?
What is a type 5 lesion?
What is a type 6 lesion?
Clinical manifestation of an artery can cause...
Ischaemic heart disease
Clinical manifestation of the aorta can cause...
Clinical manifestation of the carotid artery can cause...
Symptoms of peripheral vascular disease...
Pain in both legs when walking
Infected ulcers on legs and feet needing abx
Symptoms of stoke (cerebral infarction)...
HTN with sudden onset
Left arm and leg weakness
What other presentations may signify atheroma?
Renal artery stenosis
Treatment of atheromas?
IHD is not only low o2 but...
Low nutrients substrates and inadequate removal of metabolites
IHD means there is an imbalance between the...
Supply and demand of the heart for oxygenated blood
Causes of IHD...
Low/no flow of oxygenated blood (due to atheroma, embolism, spasm)
High demand for o2 (thyrotoxicosis/htn)
90% of IHD is caused by...
Coronary artery disease
Fixed risk factors of IHD...
+ Fam history
Potentially reversible risk factors with treatment...
Lack of exercise
Signs and symptoms of IHD...
Chest pain (radiating to left and jaw)
*NOTE: diabetic/elderly may not get chest pain*
Clincal presentations of IHD...
How can stable angina be relieved?
Rest and GTN spray
Stable angina may be caused by...
Unstable angina may be caused by...
Partial thrombosis/possible emboli
STEMI/NSTEMI may be caused by...
Plaque rupture/occlusion with thrombus
Name the complications of MI...
Common treatment to all ACS and angina...
Treatment for angina is...
PTCA (procedure to open arteries)
CABG (bypass, improves blood flow to heart)
What does ACS include?
Unstable angina / MI
Major risk factors for developing atherosclerosis...
Low level of HDL