Flashcards in Cardiovascular Disease Deck (267)
what is atherosclerosis?
a progressive build up of plaque within the arteries
what is athersclerotic plaque formed from?
what are the 2 main consequences of an artherosclerotic plaque?
(what do these both cause?)
1. bleeding into the plaque
2. rupture causing clot formation
(both can result in artery occlusion)
what is an atherothrombosis?
formation of an acute thrombosis superimposed on atherosclerosis
what are the stages from normal artery to atherothrombosis?
1. normal artery
2. fatty streak
3. fibrous plaque
4. atherosclerotic plaque
5. plaque rupture + thrombosis
why does the rupture of a atherosclerotic plaque cause clot formation?
platelets adhere to damaged area to try and heal the broken area
(especially since components such as collagen and vWF have been exposed)
why does a fatty streak form on the endothelium of a normal artery?
1. endothelial damage
2. protective response results in production of cellular adhesion molecules
3. monocytes and T-cells attach to the sticky surface of endothelial cells
4. migration into the subendothelial space
5. macrophages take up oxidised LDL-C
6. instead of clearing OXLDL, macrophages become lipid-rich foam cells
7. fatty streak forms
what factors can cause damage to the endothlium?
1. haemodynamic forces
2. vasoactive substances
3. cytokines from blood cells
4. cigarette smoke
5. atherogenic diet
6. elevated glucose levels
7. oxidied LDL-C
what type of haemodynamic force can cause endothelial damage?
(due to sheer stress)
what 4 things does OXLDL cause?
1. promotes damage of endothelial cells
2. promotes inflammatory response
3. causes vasodilatory impairment
4. induces prothrombic state (by affecting platelets and coagulation factors)
how does OXLDL cause vasodilatory impairment?
by modifying endothelial response to angiotensin II
why does a fibrous lesion form over the fatty streak?
a protective response to the endothelial damage
what are 4 major risk factors for cardiovascular disease
why do CVD risk factors (such as hypertension, dyslipidaemia, diabetes and smoking) cause endothelial cells to decrease production of some compounds and increase production of others? (endothelial dysfunction)
by causing oxidative stress in the vessel wall
what is intermittent claudication a symptom of?
peripheral arterial disease
why are many patients with PAD not diagnosed?
most are asymptomatic
what are the 4 minor risk factors for cardiovascular disease?
what type of cholesterol do statins reduce?
what is the statin with the greatest efficacy?
which is the statin with the least likelihood of side effects? (myopathy)
what are xanthelasma?
xanthomas of the eyelids
why do tendon xanthomas form?
infiltration of tendon by lipid: hypercholesterolaemia
where are the most common places for tendon xanthomas?
extensor tendons of fingers, patella, elbows
why do tuberous xanthomas form?
what are the 3 causes of tuberous xanthomas?
what do eruptive xanthomas suggest?
abrupt increase in serum triglyceride levels
where are eruptive xanthomas more likely to me?
for patients with diabetes, what is their target blood pressure?
what does smoking do to your blood pressure?
increases blood pressure