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Flashcards in lecture 1 Deck (28):
1

what is affected in atherosclerosis?

Arteries, NOT veins

2

response-to-injury-hypothesis

atherosclerosis is a chronic inflammatory & healing response of the arterial wall to endothelial damage. Lesion progression occurs through interaction of modified lipoproteins, macrophages & T-cells with the normal cellular components of the arterial wall.

3

atherosclerotic pathogenic events

1. Endothelial injury (increased permeability)
2. LDL accumulation
3. monocyte adhesion->macrophages-> foam cells
4. platelet adhesion
5. recruiting factors released
6. SMC proliferation & ECM production
7. extra, intracellular accumulation of lipids

4

media is composed of:

smooth muscle cells

5

adventitia is composed of:

blood vessels (Vasoasum)

6

SMCs can go from media to ____ during inflammation

intima

7

in media, SMC

can not divide & do not produce ECM proteins
- only contract & relax

8

scavenger receptors for modified lipoproteins & other receptors for

oxidized LDL & VLDL

9

major components of atheromas

fibrous cap
core

10

atheroma acute changes

- rupture or fissuring
- erosion & ulceration
- hemorrhage into atheroma

11

thrombotic occlusion in coronary artery is the most common cause of

MIs

12

calcification

mineralization of the atherosclerotic plaauq recapitulates many aspects of bone formation
- stiff arteries; cannot respond to changes in BP

13

atherosclerosis manifestation

- no symptoms
- compensatory enlargement
- stenotic occlusive disease
- ectasia, aneurysm
- thrombosis
- rupture

14

intermittent claudication

- pain in calf when exercising
- arteries become narrowed & blood flow decreases in atherosclerosis

15

atherosclerosis in coronary arteries

->MI and angina pectoris

16

atherosclerosis in CNS

-> stroke, encephalopathy

17

atherosclerosis in peripheral circulation

->intermittent claudication & gangrene

18

atherosclerosis in splanchnic circulation

->mesenteric ischemia

19

atherosclerosis in kidneys

->renal artery stenosis

20

MI

-pain in the chest radiating up to the jaw or down the left, or less often, right arm might signal a heart attack
-necrosis of part of the heart

21

angina pectoris

insufficient blood flow to the heart muscle from narrowing of coronary artery may cause chest pain.

22

mesenteric ischemia

ischemia of intestines->necrosis

23

preferred sites of atherosclerosis

1. proximal left descending coronary artery
2. proximal portions of renal arteries
3. extracranial circulation of the brain
4. the carotid bifurcation
5. branching points of arteries
6. abdominal aorta (posterior wall)
- due to blood flow alterations (turbulent flow)

24

what is the major cause of death & premature disability in developed societies?

atherosclerosis

25

the mortality rate for ____ in the US is the highest in the world

ischemic heart disease (IHD)

26

constitutional risk factors for atherosclerosis

age
gender
family history

27

acquired risk factors for atherosclerosis

hyperlipidemia-hyperscholesterolemia
HTN
cigarette smoking
DM

28

additional risk factors for atherosclerosis

- inflammation, increased protein C as an biomarker
- hyperhomocysteinemia
- metabolic syndrome- insulin resistance
- lipoprotein A, altered form of LDL
- PAI-1 & thrombin increase
- Type A personality