Atherosclerosis The Arterial Wall Cross-section of an Arterial Wall Yellow Streak Development of Fibrous Plaque
Smith, Patrick, Contributing Writer has reference to this Academic Journal, PHwiki organized this Journal Atherosclerosis www-ermm.cbcu.cam.ac.uk/nfig003jal.gif The Arterial Wall Cross-section of an Arterial Wall
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Yellow Streak http://www.surrey.ac.uk/SBMS/MicrobialSciences/research/immunology.html Development of Fibrous Plaque
1. Abdominal obesity (waist circumference >40 inches as long as men, 35 inches as long as women) 2. Triglyceride levels >150 mg/dL 3. HDL cholesterol <40 mg/dL as long as men, <50 mg/dl as long as women 4. Blood pressure >130>85 mmHg (normal is about 120/80) 5. Fasting blood glucose >110 mg/dL (normal is 100 mg/dL) The Metabolic Syndrome Ischemic Heart Disease A mismatch between oxygen dem in addition to in addition to oxygen delivery What influences O2 Delivery O2 carrying capacity of blood. Coronary blood flow Influenced by neural, endothelial in addition to metabolic factors Can be compromised by atherosclerosis
What influences the myocardial O2 dem in addition to Heart Rate Inc. HR inc. O2 dem in addition to Cardiac contractility Inc. contractility inc. O2 dem in addition to Ventricular wall stress proportional to afterload in addition to the radius of ventricle => Law of Laplace Law of LaPlace The ventricular wall stress (T) is the energy required to pull the cardiac muscle fibers together, so that they can contract. Tension is proportional to the product of Intraventricular pressure (P), (which = afterload) in addition to Radius of ventricle (R) So, the greater the volume of the ventricle, the more energy required as long as contraction. What enlarges the volume of the ventricle A large blood volume (preload) => increase EDV, distends the ventricle Ventricular dilation a pathologic condition
Manifestations of ischemia Angina chest pain associated with intermittent myocardial ischemia. Myocardial infarction (MI) is irreversible necrosis of cardiac muscle cells resulting from a prolonged period with of insufficient myocardial blood flow. http://www.smbs.buffalo.edu/pth600/IMC-Path/images/yr2/Coronary-Thrombosis-Schematic-Robbins.jpg
Vulnerable plaques are most likely to rupture, causing a myocardial infarction or a stroke Pathophysiology of Heart Disease 3/e. Leonard S. Lilly, Ed. Lippincott Williams in addition to Wilkins. 2003
Serum Markers of Myocardial Infarction Pathophysiology of Heart Disease 3/e. Leonard S. Lilly, Ed. Lippincott Williams in addition to Wilkins. 2003 Sudden Cardiac Death aka: Cardiac arrest Often triggered by cardiac arrhythmia, which prevents the heart from contracting effectively. Cause is often coronary artery disease. Death of muscle tissue can make the heart more vulnerable to the type of arrhythmia that leads to SCD. There are two types of strokes Ischemic or occlusive strokes, which occur when a portion of the blood flow to the brain is blocked. Intracranial hemorrhages occur when a blood vessel in the brain ruptures.
A Complete Circle of Willis Protects Against Stroke
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