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Lecture 1

ECO 100 Lecture Notes - Lecture 1: Vascular Resistance, Pericarditis, Cardiac Output

7 pages73 viewsSpring 2018

Department
Economics (ECON)
Course Code
ECO 100
Professor
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Lecture
1

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Module 7 Atherosclerosis and Its Sequelae
Atherosclerosis = systemic disease affecting large and medium-sized arteries
3 characteristics of atherosclerosis =
1. atheromas
2. Stenose
3. Ischemia
Atheromas = fibrofatty plaques that narrow artery
Stenose = narrowing of artery due to atheromas in lumen
Ischemia = reduction of blood flow; can lead to necrosis
Atherosclerosis complications = account for more than half of all deaths in the
Western world
Onset of atherosclerosis = begins early in life but remains clinically silent until it
has progressed to the point where it results in disease
Atherosclerotic lesions =
1. fatty streak
2. fibro-fatty plaque
Fatty streak = earliest pathological lesion; can develop into fibrofatty PLAQUE
Fibrofatty plaque = mature pathological lesion
Pathogenesis of atherosclerosis steps =
1. Chronic endothelial injury (result from risk factors)
2. Endothelial damage/dysfunction
3. Accumulation of lipoproteins in the vessel wall
4. Monocyte/macrophage adhesion to endothelial wall
5. Platelet adhesion to endothelial wall
6. Release of growth factors and cytokines
7. Recruitment and migration of smooth muscle cells and fibroblasts
into the endothelium
8. Smooth muscle cell (SMC) proliferation and extracellular matrix (ECM)
production (eg. collagen is produced)
9. Macrophage also engulf lipid and cholesterol derived from the blood
10. Raised plaque forms, with both fibrous and fatty elements
11. Narrow vessel lumens
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Response to injury hypothesis” = explains atherosclerotic plaque development
as a chronic inflammatory response resulting from injury to the endothelial lining
of the artery
Modifiable risk factor = can be improved through prevention or treatment; change
in lifestyle/behaviour/habits
Modifiable risk factors of atherosclerosis include….=
- Hyperlipidemia high [ ] of fats in blood
- Hypertension high BP
- cigarette smoking
- diabetes mellitus
- elevated blood cholesterol
3 major modifiable risk factors of atherosclerosis =
1. smoking
2. hypertension
3. elevated blood cholesterol
relative risk = multiplied, not added when 2 or 3 risk factors present
Other potentially modifiable risk factors = obesity, lower socioeconomic class,
type “A” personality/stress, elevated blood (serum) homocysteine level,
inflammation (marker C-reactive protein)
Non-modifiable risk factor = cannot be controlled through prevention or treatment
Non-modifiable risk factors of atherosclerosis include…. =
1. age
2. gender (eg. premenopausal women at lower risk but catch up to men after
menopause)
3. family history (genetics multifactorial)
4. Ethnicity
Protective factors = aka reduced risk; eg. moderate alcohol consumption
Major sequelae of atherosclerosis =
- coronary artery disease
- angina
- myocardial infarction (MI)
- sudden cardiac death
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