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Atherosclerosis and Ischaemic Heart Disease

Atherosclerosis is a type of arteriosclerosis where plaque builds up in the arteries. It involves the formation of atheromatous plaques containing lipid, cholesterol, and fibrous tissue. It most commonly affects the coronary, cerebral, and peripheral arteries. Risk factors include age, genetics, hypertension, hyperlipidemia, smoking, and diabetes. Atherosclerosis can lead to complications like stenosis reducing blood flow, plaque rupture exposing lipids and causing thrombosis, and vasoconstriction further reducing blood flow. Ischemic heart disease is caused by an imbalance between myocardial oxygen supply and demand, presenting as conditions like angina, myocardial infarction, or sudden cardiac death.

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Akshaya Mistry
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67 views13 pages

Atherosclerosis and Ischaemic Heart Disease

Atherosclerosis is a type of arteriosclerosis where plaque builds up in the arteries. It involves the formation of atheromatous plaques containing lipid, cholesterol, and fibrous tissue. It most commonly affects the coronary, cerebral, and peripheral arteries. Risk factors include age, genetics, hypertension, hyperlipidemia, smoking, and diabetes. Atherosclerosis can lead to complications like stenosis reducing blood flow, plaque rupture exposing lipids and causing thrombosis, and vasoconstriction further reducing blood flow. Ischemic heart disease is caused by an imbalance between myocardial oxygen supply and demand, presenting as conditions like angina, myocardial infarction, or sudden cardiac death.

Uploaded by

Akshaya Mistry
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPTX, PDF, TXT or read online on Scribd
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Atherosclerosis and

Ischaemic heart disease


Click to add text
Atherosclerosis

• Type of arteriosclerosis which is a general term for arterial thickening and

loss of elasticity.

• Greek root words for “gruel” and “hardening”

• Involved in pathogenesis of coronary, cerebral and peripheral Vascular

disease.
Atherosclerosis
• Form atheromatous plaque
• Raised lesion with soft grumous core of lipid (cholesterol and
cholesterol esters) covered by a fibrous cap.
Atherosclerosis
• Sites
• Coronary vessels of the heart
• Arteries in the brain (cerebral arteries)
• Peripheral vessels (iliac, popliteal, femoral vessels)
• Abdominal aorta
Atherosclerosis- Risk factors
Non-Modifiable Major Risks Modifiable Major Risks Additional Risks

1. Genetic abnormalities 1. Hyperlipidaemia 1. Hyperhomocysteinemia

2. Family history 2. Hypertension 2. Metabolic syndrome

3. Increasing in age 3. Cigarette Smoking 3. Lipoprotein a

4. more common in Male gender 4. Diabetes 4. Haemostasis

5. Inflammation
Non- Modifiable Risk Factors

Increasing age, male


Family history-
Genetics-Familial
hypertension,
Hypercholestrolemia
diabetes
Modifiable risk factors
Additional Risk Factors

1. Inflammation-

• Important in the formation of atherosclerotic plaque


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2. Hyperhomocystinemia-

• Increased risk of coronary atherosclerosis, stroke, Peripheral vascular disease

3. Metabolic syndrome-

• Dyslipidaemia, hypertension, pro-inflammatory state

4. Obesity and stressful lifestyle


Atherosclerosis- Complications
• Atherosclerotic stenosis-

• Plaque occludes the vessel lumen

• Blood flow is impaired

• Critical stenosis- occlusion is sufficiently

severe to produce tissue ischaemia

• Typically at 70%
Atherosclerosis- Complications

• Acute plaque change

• Rupture or fissuring- exposure the elements

• Erosion or ulceration- expose the endothelial underneath

• Bleeding into the plaque


Atherosclerosis- Complications

• Thrombosis:

• Combined with disrupted plaque can lead to acute coronary syndromes

• Can embolise to other small vessels causing micro-infarcts

• Vasoconstriction:

• Decreases lumen size

• Causes plaque disruption


Ischaemic heart disease

• Group of pathologically related syndromes resulting in myocardial ischaemia- imbalance between

myocardial supply (perfusion) and cardiac demand for oxygenated blood.

• Presents as:

• Myocardial infarction

• Angina pectoris

• Chronic IHD with heart failure

• Sudden cardiac death.


Ischaemic heart disease-Consequences
1. Stable angina-

• Myocardial oxygen demand is not met by the stenosed coronary artery

• No associated plaque disruption

2. Unstable angina-

• Plaque disruption present

• Thrombosis and vasoconstriction

• Causes micro-infarcts

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