Histopathology 6 - Vascular and Cardiac pathology Flashcards
What are the 3 stages of atheroma development?
- Raised lesion
- Soft lipid core
- White fibrous cap
Recall the 7 steps of atheroma pathophsyiology
- Endothelial injury
- LDLenters intima and gets trapped in intimal space
- LDL is converted into oxidised LDL –> inflammation
- Macrophages take up OxLDL via scavenger receptors –> foam cells
- Foam cell apoptosis –> inflammation and cholesterol deposition to form plaque core
- Endothelium expresses more adhesion molecules –> more macrophages and T cells enter plaque
- VSMCs form fibrous cap
What % atheroma of a vessel lumen is considered ‘critical stenosis’?
70%
What is prinzmental angina?
Coronary artery spasm
Which parts of the cardiac muscle are affected by an infarction of the LAD?
Anterior wall of left ventricle, anterior septum and apex
Which parts of the cardiac muscle are affected by an infarction of the RCA?
Posterior wall of left ventricle, posterior septum and posterior wall of right ventricle
Which parts of the cardiac muscle are affected by an infarction of the LCx?
Lateral wall of left ventricle
What are the 4 most important complications of MI?
- Contractile dysfunction (eg cardiogenic shock)
- Arrhythmia
- Myocardial rupture
- Pericarditis
What is Dressler’s syndrome?
Pericarditis occuring weeks-months post-MI
What is the average time between MI and myocardial rupture?
4-5 days
What is the prognosis of papillary muscle rupture following MI?
Rubbish - very high mortality
What is the most common cause of sudden cardiac death?
Lethal arrhythmia
What is restrictive cardiomyopathy?
Normal size heart but with large atria - may be due to amyloidosis
Recall 3 possible causes of aortic regurgitation
Infective endocarditis
Marfan’s
Ankylosing spondylitis
