Atherosclerosis: Difference between revisions

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(Created page with "Summary: fatty streaks --> proliferative intima plaque --> complex atheromas --> plaque rupture --> atherotrombosis Proces: - endothelial dysfunction resulting in disturbed regu...")
 
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Proces:
Proces:
- endothelial dysfunction resulting in disturbed regulation between blood and vascular wall.
- endothelial dysfunction resulting in disturbed regulation between blood and vascular wall.
    a large number of factors contribute to this process, including:
a large number of factors contribute to this process, including:
      oxidated LDL
oxidated LDL
      shear-stress (chronic pressureload on vessel-wall)                   
shear-stress (chronic pressureload on vessel-wall)                   
      infectious microbes
infectious microbes
      toxines (e.g. nicotine)
toxines (e.g. nicotine)
      hyperglycemia
hyperglycemia
 
- foam cells and fatty streaks
- foam cells and fatty streaks
    - macrophages enter the subendothelial space, degrade oxidized LDL and result in the formation of foam cells. Apoptosis of macrophages  
- macrophages enter the subendothelial space, degrade oxidized LDL and result in the formation of foam cells. Apoptosis of macrophages  
      causes further damage the endothelial lining of the vessel wall.
  causes further damage the endothelial lining of the vessel wall.
    - thrombocytes attach to the endothelium, causing the release of factors promoting growth and proliferation of smooth muscle cells.
- thrombocytes attach to the endothelium, causing the release of factors promoting growth and proliferation of smooth muscle cells.
    - this results in the formation of fatty streaks, a combination of degenerated foam cells, smooth muscle cells and connective tissue
- this results in the formation of fatty streaks, a combination of degenerated foam cells, smooth muscle cells and connective tissue
 
- progression of fatty streaks to atheromas
- progression of fatty streaks to atheromas
    - this process gradually progresses, resulting in increased endothelial dysfunction, decreased elasticity of the vessel wall, build-up of  
- this process gradually progresses, resulting in increased endothelial dysfunction, decreased elasticity of the vessel wall, build-up of  
      fatty streaks and formation of a fibrous plaque. Eventually the fibrous plaque also expands into the lumen of the vessel, resulting in a  
  fatty streaks and formation of a fibrous plaque. Eventually the fibrous plaque also expands into the lumen of the vessel, resulting in a  
      atheromatous stenosis.
  atheromatous stenosis.
 
- plaque rupture and atherothrombosis
- plaque rupture and atherothrombosis
    - the intravascular plaque-structure will continue to increase in size, eventually resulting in occlusion or plaque rupture, depending on the structure and stability of the plaqye. Usually the "shoulder" of the plaque is most susceptable for rupture. When this happens, a atherothrombus is formed causing occlusion of the epicardial vessel "downstream"
- the intravascular plaque-structure will continue to increase in size, eventually resulting in occlusion or plaque rupture, depending on the  
  structure and stability of the plaqye. Usually the "shoulder" of the plaque is most susceptable for rupture. When this happens, a  
  atherothrombus is formed causing occlusion of the epicardial vessel "downstream"


--[[Special:Contributions/145.117.105.140|145.117.105.140]] 10:44, 11 January 2011 (CET)
--[[Special:Contributions/145.117.105.140|145.117.105.140]] 10:44, 11 January 2011 (CET)
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