Atheroma Flashcards
(24 cards)
What are some synonyms of atheroma?
atherosclerosis
hardening of the arteries
coronary artery disease
ischaemic heart disease
What is the aetiology of atheroma?
cigarette smoking
hypertension
hyperlipidaemia
diabetes
age
sex (males)
genetics
What is the pathogenesis of atheroma?
Primary endothelial injury
accumulation of lipids and macrophages
migration of smooth muscle cells
increase in size
What causes primary endothelial injury?
Smoking Hypertension Hyperlipidaemia Immune factors Toxins viruses
What mediates accumulation of lipids and macrophages?
Increased LDL
Reduced HDL
V-CAM, IL-1 and TNF
What causes migration of smooth muscle?
PDGF
FGF
TGFalpha
What is the process of atheromatous plaque complication?
fatty streak
fibrofatty plaque
complicated plaque with overlying thrombus
progression is associated with further loss of luminal patency and arterial wall weakness
When will narrowing of an artery cause critical disease?
it is the only artery suppling an organ or tissue
the artery diameter is small (eg coronary artery versus common iliac artery)
overall blood flow is reduced
What are the complications of atheroma?
stenosis
thrombosis
aneurysm
dissection
embolism
Describe the process of arterial stenosis?
narrowing of the arterial lumen
reduced elasticity
reduced flow in systole
tissue ischaemia
What are the clinical effects of cardiac ischaemic?
reduced exercise tolerance
angina
unstable angina
myocardial infarction
cardiac failure
Describe the process of cardiac fibrosis?
loss of cardiac myocytes
replacement by fibrous tissue
loss of contractility
reduced elasticity and filling
What arteries can arterial stenosis affect?
Any artery
What can carotid artery stenosis result in?
TIA
stroke
vascular dementia
What can renal artery stenosis result in?
hypertension and renal failure
What can peripheral artery stenosis result in?
claudication and foot/leg ischaemia
What are the clinical effects of a superadded thrombus?
myocardial infarction
cerebral infarction
renal infarction
intestinal infarction
What is an aneurysm?
abnormal and persistent dilatation of an artery due to weakness in its wall
Name aneurysm subtypes?
mycotic, atherosclerotic, dissecting, congenital, arteriovenous, traumatic, syphilitic
What is the commonest site of aneurysm?
AA
What are the complications of aneurysm?
rupture (6cm)
thrombosis
embolism
pressure erosion of adjacent structures
infection
What is arterial dissection?
splitting within the media by flowing blood
middle age +/- atheroma
false lumen filled with blood within the media
sudden collapse and high mortality
What are the complications associated with aortic dissection?
atheroma
hypertension
trauma
coarctation
marfan’s
pregnancy
What are the usual embolism sites
i. cerebral infarct
ii. renal infarct and renal failure
iii. lower limb infarction
