Chapter 15; Atherosclerosis And Other Arterial Diseases

Macrophages

Femoral Artery

is pain that is alleviated by rest. occurs most frequently in the legs.

When left untreated, 33% of patients die within 24 hours. Aortic dissection requires surgical repair. In aortic dissection, layers of the aortic wall split and allow blood to flow between them.

Risk factors include obesity, tobacco use, and excessive alcohol intake. Diabetes mellitus accelerates the development of atherosclerosis. Diagnostic tests for atherosclerosis include those for hyperlipidemia.

Basic physiological change that results in cardiovascular disease Foam cell formation C-reactive protein and homocysteine levels are used for assessment Atherosclerosis is a form of arteriosclerosis in which the lumen of arterial wall becomes occluded with plaques. The plaques are formed from cholesterol and white blood cells forming foam cells. Although white blood cells are involved, formation of the plaques is not due to an autoimmune response. Elevated C-reactive protein (an inflammation marker) and homocysteine levels have been associated with atherosclerosis.

Weak arterial wall resulting in bulging of the artery Abdominal aorta most commonly affected Fusiform and saccular shapes An aneurysm is a bulge in an arterial wall. The most common location for an aneurysm is the abdominal aorta. An aneurysm may present in different forms including fusiform and saccular. Surgical repair is not always necessary with an aneurysm, and death does not occur at a high rate within the first 24 hours of development. Takayasu arteritis is a form of vasculitis, and is not a type of aneurysm.

Blood pressure differential between right and left arm Sudden onset of symptoms including chest pain and tearing sound Surgical repair required 33% of patients die within first 24 hours Aortic dissection is a life-threatening condition in which a tear in the inner layer of the aortic wall appears. Blood pours into the tear, separating (dissecting) the inner layer from the middle layer. If the tear ruptures, death may result. Almost one-third of patients with aortic dissection die within the first 24 hours. Surgical repair of the tear is needed. Signs and symptoms include a sudden onset of severe chest pain. Depending on the location of the dissection, blood flow to either arm may be compromised, resulting in a difference in pressure between the arms.

Immune complexes deposited in arterial walls Takayasu arteritis is an example Associated with autoimmune process Vasculitis is inflammation of the vessels, and both arteries and veins may be involved. The disease may be systemic or affect one area or tissue of the body. Several forms of vasculitis exist, and an autoimmune component, with immune complexes deposited in the arterial walls, has been found to play a role. Signs and symptoms of vasculitis vary, depending on the tissues involved. Takayasu arteritis is one example of vasculitis; it affects the aorta and pulmonary arteries.

Intermittent claudication Decreased peripheral pulses Ankle-brachial index used for assessment Peripheral artery disease results in decreased blood flow to the extremities. Most commonly, the arteries of the legs are affected. Depending on the extent of the blockage, peripheral pulses may be diminished. The ankle-brachial index (ABI) compares the blood pressure in the ankles with the blood pressure in the arms and may be reduced with peripheral arterial disease in the lower extremities. When blood flow through the narrowed arteries cannot match the metabolic demands of the tissues, intermittent claudication results.

Atherosclerosis

LDL cholesterol

Peripheral arterial disease

Aneurysm

Aortic Dissection