What is the definition of atheroma?
It’s the build-up of fatty material on the inside of an artery
What is the definition of artherosclerosis
The progressive narrowing and hardening within an artery potentially resulting in a complete blockage.
What certain factors can cause injuries to the blood vessles and therefore putting them at risk of atheroma?
- Hyperlipidemia
- Disturbed Flow
- Smoking
- Hypertension
What artery can artheroma occur in?
It can occur in ANY artery, eg:
- Caronary Artery (heart attacks/angina-ischemic heart disease)
- Aorta (Aneurysm due to weakening of the wall)
- Carotid (narrowing causing strokes)
- Peripheral vascular disease
what are some complications that can result from having Atherosclerotic Plaques?
- Aneurysm/rupture
- Thrombosis
- Harmatoma Formation
- Embolisation
- Development of critical stenosis (significant narrowing of artery)
What things can present which shows signs of arterial disease?
- Stroke/TIA
- Leg ulcers/leg pain (Periferal Vascular Disease)
- MI
- Bowel Ischaemia
- Renal Artery Stenosis
- Emboli (can cause necrosis to toes if in foot vessles)
What are the treatment options for artherosclerosis
- Revascularization (stent, angioplasty)
- Secondary Prevention (diet, exercise, stop smoking, diabetes management)
What is ischemic heart disease?
Inbalance between supply (perfusion) and demand of the heart for oxygenated blood
Not just oxygen, but ischemic heart disease also covers decrease in nutrient substrates and inadequate removal of metabolited
What causes Ischemic Heart Disease?
- Decrease/no blood flow of oxygenated blood - atheroma (90%), embolism, spasm
- Increased demand in oxygen -thyrotoxicosis, myocardial hypertrophy (hight BP)
Name some risk factors associated with Ischmic Heart Disease..
FIXED:
- Family history
- Male sex
- Age
- Genetic (ACE gene)
REVERSIBLE:
- hyperlipidemia
- smoking
- High BP
- Diabetes
- Lack of excercise
- Obesity
- Heavy alcohol consumption
Symptoms of Coronary Heart Disease…
- Chest pain, often central/crushing or radiating to left arm/jaw (not always in elderly/diabetic)
- Shortness of breath
- Palpitations
- Syncope
- Nausia/sweating/pale
What are the characteristics of ‘Stable’ Angina?
- Plaque disruption and spasm
- Lasts less than 20 mins
- Induced by effort/excercise
- Resolves with rest of GTN
What are the characteristics of ‘Unstable Angina’
Partial thrombosis, possible emboli
- occurs at rest
- lasts longer than stable angina
- often happens before an MI
What investigations can you do to see if someone has Coronary Heart Disease
- OBS: BP, pulse, O2 sats, rr
- Bloods (Cardiac enzymes)
- Chest Xray
- ECG
- Excercise Tolerance Test
What are some of the complications of myocardial infarctions?
- Cardiac Arrest
- Arrythmias
- Pericarditis
- Valvular defects
- ventricular wall rupture
- DVT
- Pulmonary Embolus
Treatment for Ischemic Heart Disease + Angina…
- Immediate (Oxygen, Pain relief, Aspirin)
- Angina: Lifestyle, Nitrates, Bblockers
- Drugs: ACS (thrombolytic therapy) ext…
- Angioplasty. stenting and coronary artery bypass graft
What is Hyperlipidemia
It’s increased circulating fats (bad cholesterol) in the bloodstream:
- Increased LDL (bad cholesterol)
- Not enough HDL (good cholesterol)
Reduce cholesterol in diet and sat fats. Role of statins
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Cell injury & Inflammation29
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Immunity & Disease26
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Atheroma17
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Thrombosis, Embolism & Shock23
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Heart & Vessles - The rest38
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Disorders of Growth (Cancer)40
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Respiratory Pathology43
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Lung Tumours23
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UPPER GI Tract37
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LOWER GI tract42
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Diabetes32
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Endocrine System..43
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The Urinary System34
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Female Genital Tract34
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The breasts18
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Skin32
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Musculoskeletal system41
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Central Nervous System41
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Infections27
