Atherosclerosis

66 Pages·2011·12.25 MB·English

by  Dr. Charles Steenbergen

ARTERIOSCLEROSIS
ATHEROSCLEROSIS

MONCKEBERG’S MEDIAL CALCIFIC
SCLEROSIS

ARTERIOLOSCLEROSIS
Objectives
• Discuss the etiology of atherosclerosis and plaque enlargement

• Enumerate the clinical presentations of atherosclerosis in the following organ
systems:
Heart
Central Nervous System
Peripheral vasculature/Extremities
Kidneys
Intestines

Define and discuss the concepts of
“Critical Stenosis” and “Plaque Rupture and
Thrombosis” in relation to the above.

• Compare and contrast thoracic and
abdominal aortic aneurysms including
dissections on the basis of:
Etiologic factors
Incidence
Complications
900,000
800,000
700,000
Alzheimer
600,000
CLRD
Deaths 500,000
Cancer
400,000
All Other CVD
300,000
Stroke
200,000 Heart Disease
100,000
0
All Ages <85 85+
CVD and other major causes of death: both sexes.
(United States: 2006). Source: NCHS and NHLBI.
Cardiovascular Disease Deaths vs.
Cancer Deaths by Age
United States: 2006
1,000
s 831
d
800
n
a
s
u 560
o 600
h
T

n
400 315
i
s 242
h
165
t 138
a 200 120
81 101 85
e
48 50
D 25 21
0
<45 45-54 55-64 65-74 75-84 85+ Total
Ages
CVD Cancer
Source: NCHS
500,000
398,563
432,709
400,000
290,069
269,819
s 300,000
h
t
a
e
D 200,000
78,941 65,323 42,658
100,000 59,260
36,006 51,281
0
A B C D E A B D F C
Males Females
A CVD (I00-I99; Q20-Q28) D Chronic Lower Respiratory Diseases
B Cancer E Diabetes Mellitus
C Accidents F Alzheimer’s Disease
CVD and other major causes of death for all males and

females (United States: 2006). Source: NCHS and NHLBI.
Percentage Breakdown of Deaths
From Cardiovascular Diseases
United States:2003*

53%
13%
0% 17%
1%
4% 6% 6%
Coronary Heart Disease Stroke HF
High Blood Pressure Diseases of the Arteries Congenital Cardiovascular Defects
Rheumatic Fever/Rheumatic Heart Disease Other
Source: CDC/NCHS and NHLBI. *Preliminary
Estimated Direct and Indirect Costs of
Major Cardiovascular Diseases and
Stroke
United States: 2006

160 142.5

s
140
r
a
l 120
l
o
D 100

fo 80 57.9 63.5

s 60
n
29.6
o
40
i
l
l
i 20
B
0
Source: Heart Disease and Stroke Statistics – 2006 Update.
Atherosclerosis
Atherosclerotic Lesions
• Progression
– Fatty Streaks
►Lipid filled myointimal cells
►Starts in second decade – Intimal Process
– Fibrous Plaques
►Subendothelial fibrous cap over extracellular lipid pool
– Complicated Plaques
►Fibrous plaque with erosion, intramural hemorrhage,
thrombus, calcification
Relatively Normal Muscular Artery