Flashcards in Lecture 7 Heart and blood vessel- atheroma Deck (28)
Build up of fatty material on the inside wall of an artery
Progressive narrowing and hardening within the artery potentially resulting in complete blockage.
Atheroma contributes to how many deaths?
Almost half of all deaths in western countries
Where atheroma may occur
Lower abdo aorta, cotonary arteries, popliteal arteries, internal carotid and circle of willis
Why does athoma occur?
Chronic injury to the endothelium -> chronic inflammation
What can cause injury to the endothelium?
Hyperlididaemia, disturbed flow, smoking, hypertension,
Explain the development of a plaque fissure/thrombosis
Fatty streak -> plaque -> Obstructive atherosclerotic plaque -> Plaque fissure/thrombosis
Define aneurysm and where it can occur
weakening of the wall (balloon), aorta
Why may atherosclerotic plaques cause symptoms?
Aneurysm/rupture. Thrombosis, haematoma formation, embolism, critical stenosis
How does atheroma normally grown?
outward preserving lumen caliber.
How can atheroma lead to thrombosis?
When the atheromas plaque ruptures -> thrombosis
Transient Ischemic attack. Mini stroke.
Signs of peripheral vascular disease
Smoked most of life. Severe pain in both legs when walking >10 mins. Infected ulcers in feet. Due to muscles needing more oxygen because working.
Signs of myocardial infarct (heart attack)
Central crushing chest pain, ECG showed ST elevation affecting V1 to V4.
In case, what happened to gentleman with MI.
Gentleman was taken to cath lab for revascularisation procedure. Primary percutaneous coronary intervention (PCI))
Other presentations of MI?
Bowel ischaemia (black), renal artery stenosis, emboli (common to feet).
Trying to get blood flowing through again
What is the largest single cause of death in UK
Ischaemic heart disease
By how much does one MI increase the risk of heart failure and stroke?
Fixed risk factors of ischaemic heart disease
Family history, male, age, ACE gene deletion.
Potentially reversible risk factors of ischaemic heart disease
Hyperlipidaemia, smoking, hypertension, diabetes, lack of exercise, obesity, heavy alcohol consumption.
>90% of ischaemia heart disease is caused by?
atherosclerotic obstruction of coronary arteries. (coronary heart disease)
Signs and symptoms of ischemic heart disease?
Central crushing chest pain, SOB, palpitations, syncope, Nausea, sweating, pale.
Temp loss of consciousness caused by ↓in BP
Clinical presentation of ischemic heart disease?
Stable angina, unstable angine (no warning, no pattern), NSTEMI (Non-st elevation myocardial infarction), STEMi, Sudden death.
Is stable angina reversible?