nature and pathogenesis of atheroma Flashcards
Where is atheroma never seen?
low pressure systems such as pulmonary arteries
What is an atheromatous plaque made from?
fibrous tissue (fibrous cap_ lipids- cholesterol lymphocytes smooth muscle cells macrophages - foam cells
What are the risk factors for atheroma?
smoking
hypertension
diabetes
hyperlipidaemia
Why are endothelial cells susceptible to damage?
because they are delicate
What 3 substances in tobacco smoke cause endothelial damage?
free radicals
nicotine
carbon monoxide
What 2 substances cause endothelial damage from diabetes?
superoxide anions
glycosylation products
What are the complications of atherosclerosis?
cerebral infarction
carotid atheroma - emboli cause TIA/stroke
MI
cardiac failure
aortic aneurysms
peripheral vascular disease (build-up of fatty deposits in the arteries restricts blood supply to leg muscles) and claudication
gangrene
Where is atheroma common?
common in high pressure systems such as aorta and systemic arteries
What did the incorrect lipid insulation theory state?
leakage of lipid out from the blood into arterial walls
what is the current theory on formation of atheroma?
any factor that causes endothelial damage in arteries can lead to atheroma
What type of inflammation is involved in atheroma?
chronic - endothelial damage activates macrophages and fibroblasts
How do you prevent/treat atherosclerosis?
smoking cessation control of BP weight reduction exercise dietary modification statins low doses of aspirin surgical bypass percutaneous angioplasty (i.e. stent) endarterectomy
