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Flashcards in Atheroma Deck (15)
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1
Q

Define atheroma

A

a build up of fatty material on the inside wall of an artery
initiated by chronic injury to endothelium by smoking/hypertension/hyperlipidaemia = chronic inflammation
progresses as WBC, fat and blood infiltrate injury

2
Q

Define atherosclerosis

A

the progressive narrowing and hardening within an artery potentially resulting in complete blockage

3
Q

Clinical manifestation

A

can occur in any artery:

  • coronary artery = heart attacks/angina
  • aorta = aneurysm due to weakening of walls
  • carotid = narrowing causes strokes
  • peripheral vascular disease
4
Q

Ischaemic heart disease

A

imbalance between supply and demand of the heart for oxygenated blood
- decrease O2 and nutrients substrates and inadequate metabolite removal

5
Q

Causes of IHD

A

decrease flow/no flow of oxygenated blood = atheroma, spasm, embolism
increased demand for O2 = thyrotoxicosis, myocardial hypotrophy

6
Q

Fixed and reversible risk factors of IHD

A
Fixed:
positive family history
male sex
age
genetic factors
Potentially reversible with treatment:
hyperlipidaemia
smoking
hypertension
diabetes
lack of exercise
obesity
alcohol consumption
7
Q

Signs and symptoms of IHD

A

chest pain (central, crushing, radiating to L arm/jaw)
shortness of breath
palpitations
nausea, sweating, pale

8
Q

Clinical presentation & diagnosis

A

Stable Angina - plaque disruption & spasm, induced by effort, resolved by rest/GTN
Unstable angina - + partial thrombosis, possible emboli, occurs at rest, lasts longer
NSTEMI, STEMI & sudden death- plaque rupture, thrombosis

9
Q

Investigations for IHD

A
obs = BP, pulse, sats, resp rate
bloods (inc cardiac enzymes)
chest X-ray
ECG
exercise tolerance test
10
Q

Consequences of MI

A

cardiac arrest, arrhythmias, pericarditis, valvular defects, deep vein thrombosis, pulmonary embolus

11
Q

Treatment of IHD

A
oxygen, aspirin, pain relief
Angina = lifestyle, nitrates, B-blockers
Acute coronary syndromes = thrombolytic therapy
angioplasty & stenting
coronary heart bypass graft
12
Q

Hyperlipidaemia

A
LDL = bad cholesterol that is delivered to tissues
HDL = good cholesterol, mobilizes cholesterol from tissues and transports it to liver to be excreted in bile
13
Q

How to prevent/modify an atheroma?

A
Stop smoking
Control hypertension
Weight reduction
Increase exercise
Moderation of alcohol
Increase HDL, decrease LDL
14
Q

What is stable angina?

A

plaque disruption and spasm, induced by effort, resolved with rest, GTN

15
Q

What is unstable angina?

A

plaque disruption, spasm, partial thrombosis and embolism, occurs at rest