High LDL, low HDL, HTN, cigarettes and cocaine, DM, bad genetics, increasing age, male, stress, obesity and couch potato predispose you for...
Atherosclerosis - would 160 systolic or a 120 diastolic be more worrisome?
Father or brother had complications before age ___. Mother or sister before age ___.
Being > age ____ for men. > ____ for women
1. Lipid infiltration (________) leads to _____ cell injury.
insudation, endothelial cell
2. Encrustation (_________) leads to adhesion of _____.
2. Adhering platelets attract inflammatory cells like ____ which will infiltrate vessel walls.
3. Response to injury - inflammatory factors cause migrations of ____ from ___ to _____ which become fibroblasts and deposit _____ leading to plaque formation.
smooth muscles cells, from media to intima, collagen
1. _______ 2. _______ 3. Response to injury - formation of plaque
1. Coronary arteries --> CAD --> Angina --> ___
2. Cerebral arteries, Circle of Willis --> ___ ___
3. Aorta --> ____
4, 5, 6. T/F - Other common sites of atherosclerosis include peripheral artery disease, renal artery, and mesenteric artery.
Name 5 complications of atherosclerosis. CUTAE.
calcification, ulceration, thrombosis, aneurysmal dilatation and embolization
A dark red "glistening zone" coronary artery is about to...
cause a heartattack
In aortic aneurysm, where does bulge appear?
just above aortic bifurcation
Aortic aneurysm is prone to rupture at size _________-__cm.
Pulsating mass in abdomen? What is it?
probably an aortic aneurysm
Ischemic Heart Disease
Inadequate O2 to heart muscle secondary to CAD.
ischemic heart disease
Atherosclerosis of coronary vessel, vasospasm of coronary vessel, aortic stenosis, rheumatic heart disease with mitral and aortic valve stenosis, degenerative calcific aortic stenosis, and aortic atresia.
ischemic heart disease
IHD most common in men > ___ and women > ___.
At what age are IHD rates equal between men and women?
IHD - greater than ___% lumen reduction is insufficient to meet moderate increases in demand of myocardium to oxygen.
Abrupt changes in plaque (stable angina --> acute MI)
Acute Plaque Changes
Plaque ruptures, thrombogenic lipids and subendothelial collagen exposed, wave of platelet aggregation.
Coronary Artery Thrombosis
There's a pre-existing plaque - perhaps releasing vasospastic mediators like thromboxane A2 from platelet aggregates
Coronary Artery Vasospasm
4 Clinical Manifestations.
AP, MI, Chronic ischemic heart disease, sudden cardiac death
Paraoxysmal, intermittent chest pain cause by transient, but reverise myocaridal ischemia. Attacks of substernal chest pain too. Coronary vessel not completely blocked. Falls short of inducing necrosis that defines infarction.
Episodic substernal chest pain with exertion - constricting, squeezing, knife-like stabbing lasting 15s to 15m, may radiate to left arm. Associated with fixed plaque occluding >75%. Pain is relieved with rest or NG.
Like stable angina, but increased frequency, more intense pain, and longer. Progressively less exertions. Harbinger of irreversible. Myocardial ischemia due to acute plaque changes --> Pre-infarction angina.
Prolonged ischemia, >20 minutes leads to...
US - per year - how many acute MI? how many die?
1 million, 1/2 million (and 1/2 of those die before they receive assistance)
Men age 45-55 are _________ times more likely to develop MI than women.