BIOLOGY 2F03 Lecture Notes - Lecture 7: Acute Limb Ischaemia, Intermittent Claudication, Testicular Torsion
19 May 2018
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Department
Course
Professor
Histopathology Notes
Cardiovascular Disease
BP = CO x SVR
CO = HR x SV
Infarction
• Necrosis due to ischaemia
• Arterial
o MI
o Stroke
o Bowel infarction
o Acute limb ischaemia
• Venous
o PE
o Torsion of vascular pedicle
o Sigmoid volvulus
o Testicular torsion
Atherosclerosis
• Arterial wall thickening and loss of elasticity
Stages
• Endothelial cell injury
• Inflammatory response in vessel wall
o Oxidised LDL
• Formation of stable atherosclerotic plaque
o Vascular smooth muscle phenotype shift
• Complication of stenosis or plaque rupture
Risk Factors
• Non-Modifiable
o Age
o Sex
o Family history
o Others - Type A personality,
oestrogen deficiency
• Modifiable
o Hypertension
o Diabetes Mellitus
o Smoking
o Hypercholesterolaemia
o Others - physical inactivity,
lipoprotein Lp(a)
Complications
• Plaque-related Stenosis (angina, intermittent claudication)
• Plaque rupture
o Thrombosis (MI, stroke, acute limb ischaemia)
o Embolism (MI, stroke, acute limb ichaemia)
• Weakening of vessel wall (AAA)
Acute Coronary Syndrome
• Unstable angina
o No cardiac damage (normal
tropnin)
• NSTEMI/STEMI
o Cardiac damage (raised tropnin)
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Document Summary
Co = hr x sv: venous, pe, torsion of vascular pedicle, sigmoid volvulus, testicular torsion. Infarction: necrosis due to ischaemia, arterial, mi, stroke, bowel infarction, acute limb ischaemia. Atherosclerosis: arterial wall thickening and loss of elasticity. Inflammatory response in vessel wall: oxidised ldl, formation of stable atherosclerotic plaque, vascular smooth muscle phenotype shift, complication of stenosis or plaque rupture. Risk factors: non-modifiable, age, sex, family history, others - type a personality, oestrogen deficiency. Complications: modifiable, hypertension, diabetes mellitus, smoking, hypercholesterolaemia, others - physical inactivity, lipoprotein lp(a, plaque-related stenosis (angina, intermittent claudication, plaque rupture, thrombosis (mi, stroke, acute limb ischaemia, embolism (mi, stroke, acute limb ichaemia, weakening of vessel wall (aaa) Acute coronary syndrome: unstable angina, nstemi/stemi, no cardiac damage (normal, cardiac damage (raised tropnin) tropnin, embolism (30%, recent mi, atrial fibrillation, aneurysm, onset over seconds, no evidence of previous disease, soft artery, bruits.
