What does atherosclerosis cause?
- Heart attack
- Stroke
- Gangrene of the extremities
What is the main problem with atherosclerosis?
The plaque ruptures which leads to thrombus formation and ultimately death.
List 7 risk factors for atherosclerosis
- Age
- Tobacco smoking
- High serum cholesterol
- Obesity
- Diabetes
- Hypertension
- Family history
Where are atherosclerotic plaques found?
Within peripheral and coronary arteries.
They have a focal distribution along the artery length.
What determines distribution of atherosclerotic plaques?
Changes in flow/turbulence (eg at bifurcations) causes the artery to alter endothelial cell function
Define neointima
A new or thickened layer of arterial intima formed especially on a prosthesis or in atherosclerosis by migration and proliferation of cells from the media
What causes neointima?
Altered gene expression in key cell types (endothelial cells, smooth muscle cells, macrophages and fibroblasts)
What does an atherosclerotic plaque consist of?
- Lipid
- Necrotic core
- Connective tissue
- Fibrous cap
What eventually happens with atherosclerosis?
Either:
- Plaque will occlude the vessel lumen and result in restriction of blood flow (angina)
2, Plaque may rupture and lead to thrombus formation.
Briefly describe the response to injury hypothesis of atherogenesis
- Injury to the endothelial cells leads to endothelial dysfunction
- Signals sent to circulating leukocytes which then accumulate and migrate into the vessel wall
- Inflammation ensues.
