What is the definition of hemorrhagic infarction?
- They are INFARCTS
- COMMONLY Caused by VEIN OCCLUSION
- RBCs entering AREA of Infarct OR ARTERY Occlusion of Organ WITH Collaterals / Dual Circulation
What stages does atherosclerosis have when it comes to blood vessel changes?
Describe it.
- TYPE 1 = Initial Lesion where there’s ISOLATED MF Foam Cells
- TYPE 2 = FATTY STREAK Lesion, where there’s mainly INTRACELLULAR LIPID Accumulation
- TYPE 3 = INTERMEDIATE Lesion, where there’s TYPE 2 Changes AND EXTRACELLULAR Lipid Pools
- TYPE 4 = ATHEROMA Lesion, where there’s TYPE 2 Changes AND a CORE of EXTRACELLULAR Lipid Pools
- TYPE 5 = FIBROATHEROMA Lesion, where’s MULTIPLE LIPID Cores, and FIBROTIC Layers
- TYPE 6 = COMPLICATED Lesion, where there’s Surface DETECT / Hematoma-Haemorrhage / Thromb
What are the main risk factors for developing atherosclerosis?
Major Controllable
- Hyperlipidemia
- Arterial Hypertension
- Cigarette Smoking
- Diabetes Mellitus
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Major Un-controllable
- Age, as RF’s INCREASE with Risk
- Males
- Genetic Predisposition = Familial Hypercholesterolemia
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Minor
- LACK of Exercise
- Type A Personality (STRESS)
- Obesity
- Oral Contraceptives
- Gout
- HIGH Carbohydrate Intake
Describe the gross & histological changes in atherosclerosis
1) FATTY STREAKS / DOTS
- Grossly, the Lesion is FLAT, YELLOW, 1mm in ELONGATED Beaded Streaks
- Histo, they’re CLOSELY-PACKED:
0 Foam Cells
0 Lymphoid Cells
0 Lipid-Containing SM Cells
2) GELATINOUS LESIONS
- Grossly, they DEVELOP in the INTIMA of AORTA
- Histo, they’re a FOCI of INCREASED Ground Substance
3) ATHEROMATOUS PLAQUE
- Grossly it’s 1-2cm RAISED WHITE Fibrous Cap with YELLOW Centre CORE
- Histo, it’s a FIBROUS Cap mixed of
0 MFs
0 Foam Cells
0 Lymph - Central Core consists of Lipid Material, Cholesterol Cleft + Fibrin Debris
4) COMPLICATED PLAQUE
- Grossly consists of:
0 Calcification
0 Ulceration
0 Thrombosis
0 Haemorrhage
0 Aneurysm Formation
- Histo, there are Calcium Salts in NECROTIC Area
Systemic hypertension- the major organs involved and how the kidneys are
Systemic HT = HIGH Blood Pa in Systemic Arteries
Considered if Resting BP is MORE than 140 / 90 mmhg
Organs Involved = Eyes, Arteries, Heart, NS + Kidneys
Kidneys:
- Medium-Sized Renal Arteries / Arterioles show INITIMAL Proliferation AND HYALINISATION of Muscular Media
- PRODUCES Focal Areas of ISCHAEMIA with SCARRING LOSS of Tubules
- Cortical Surfaces are FINELY Granular
- Normal in Size OR Slightly ENLARGED
- SPECKLED Cortex with SMALL Pin-Point Haemorrhages
Organ changes related to Hypertension
DAMAGE TO:
1) Arteries:
- Cause DAMAGE + NARROWING as it DAMAGES the CELLS of Artery’s INNER LINING , becoming LESS Elastic, LIMITING BF
- ## Cause ANEURYSM, where SECTION of Wall ENLARGES + BULGES, which could POTENTIALLY RUPTURE, leading to LIFE-THREATENING Bleeding2) Heart:
- CAD = Narrowed + Damages Arteries, can cause TROUBLES Supplying Blood to Heart
- ENLARGED Left Heart = HIGH BP causes Heart to WORK HARDER to pump to rest of body, causing LEFT VENTRICLE to THICKEN
- ## Heart FAILURE = STRAINED Heart can cause heart Muscle to WEAKEN + WORK LESS Efficiently3) Brain:
- TRANSIENT ISCHAEMIC ATTACK = Mini-stroke where there’s TEMPORARY DISRUPTION of Blood Supply to the Brain
- STROKE = When PART of Brain is DEPRIVED of Oxygen + Nutrients, causing Brain Cells to DIE
- ## DEMENTIA = Narrowed / Blocked Arteries can LIMIT BF to the Brain leading to a CERTAIN TYPE of Dementia (Vascular)4) Kidneys:
- ## GLOMERULOSCLEROSIS = Tiny BVs in Kidneys become SCARRED + UNABLE to Effectively FILTER FLUID + WASTE from the blood5) Eyes:
- RETINOPATHY = DAMAGE to the RETINA can lead to BLEEDING in the eye, blurred vision / complete loss
- OPTIC NEUROPATHY = When the OPTIC NERVE becomes DAMAGED, leading to BLEEDING in eye + Vision Loss
Myocardial infarction definition and complications
- Types of pericarditis
DEFINITION = MI is IRREVERSIBLE NECROSIS of the Heart Muscle + is SECONDARY TO Prolonged ISCHAEMIA, DUE to CAD
COMPLICATIONS:
- Arrhythmias
- Congestive HF
- Cardiac Aneurysm WITH Mural Thrombosis
- Pericarditis (Inflammation of Pericardial Layer)
TYPES OF PERICARDITIS
1) ACUTE = Serous / Fibrinous / Purulent / Fibro-purulent / Haemorrhagic
2) CHRONIC = Tuberculous / Chronic Adhesive / Chronic Constrictive / Pericardial Plaques
