Atheroma Flashcards Preview

Cardiovascular 2018 > Atheroma > Flashcards

Flashcards in Atheroma Deck (24)
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1
Q

What are some synonyms of atheroma?

A

atherosclerosis

hardening of the arteries

coronary artery disease

ischaemic heart disease

2
Q

What is the aetiology of atheroma?

A

cigarette smoking

hypertension

hyperlipidaemia

diabetes

age

sex (males)

genetics

3
Q

What is the pathogenesis of atheroma?

A

Primary endothelial injury

accumulation of lipids and macrophages

migration of smooth muscle cells

increase in size

4
Q

What causes primary endothelial injury?

A
Smoking
Hypertension
Hyperlipidaemia
Immune factors
Toxins
viruses
5
Q

What mediates accumulation of lipids and macrophages?

A

Increased LDL
Reduced HDL
V-CAM, IL-1 and TNF

6
Q

What causes migration of smooth muscle?

A

PDGF
FGF
TGFalpha

7
Q

What is the process of atheromatous plaque complication?

A

fatty streak

fibrofatty plaque

complicated plaque with overlying thrombus

progression is associated with further loss of luminal patency and arterial wall weakness

8
Q

When will narrowing of an artery cause critical disease?

A

it is the only artery suppling an organ or tissue

the artery diameter is small (eg coronary artery versus common iliac artery)

overall blood flow is reduced

9
Q

What are the complications of atheroma?

A

stenosis

thrombosis

aneurysm

dissection

embolism

10
Q

Describe the process of arterial stenosis?

A

narrowing of the arterial lumen

reduced elasticity

reduced flow in systole

tissue ischaemia

11
Q

What are the clinical effects of cardiac ischaemic?

A

reduced exercise tolerance

angina

unstable angina

myocardial infarction

cardiac failure

12
Q

Describe the process of cardiac fibrosis?

A

loss of cardiac myocytes

replacement by fibrous tissue

loss of contractility

reduced elasticity and filling

13
Q

What arteries can arterial stenosis affect?

A

Any artery

14
Q

What can carotid artery stenosis result in?

A

TIA
stroke
vascular dementia

15
Q

What can renal artery stenosis result in?

A

hypertension and renal failure

16
Q

What can peripheral artery stenosis result in?

A

claudication and foot/leg ischaemia

17
Q

What are the clinical effects of a superadded thrombus?

A

myocardial infarction

cerebral infarction

renal infarction

intestinal infarction

18
Q

What is an aneurysm?

A

abnormal and persistent dilatation of an artery due to weakness in its wall

19
Q

Name aneurysm subtypes?

A

mycotic, atherosclerotic, dissecting, congenital, arteriovenous, traumatic, syphilitic

20
Q

What is the commonest site of aneurysm?

A

AA

21
Q

What are the complications of aneurysm?

A

rupture (6cm)

thrombosis

embolism

pressure erosion of adjacent structures

infection

22
Q

What is arterial dissection?

A

splitting within the media by flowing blood

middle age +/- atheroma

false lumen filled with blood within the media

sudden collapse and high mortality

23
Q

What are the complications associated with aortic dissection?

A

atheroma

hypertension

trauma

coarctation

marfan’s

pregnancy

24
Q

What are the usual embolism sites

A

i. cerebral infarct
ii. renal infarct and renal failure
iii. lower limb infarction