791872
Description
Mind Map by misbah.baig1993, updated more than 1 year ago
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Created by misbah.baig1993
about 11 years ago
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CORONARY HEART DISEASE
- CARDIOVASCULAR DISEASE
- vascular disorders: stroke, varicose veins
- coronary heart disease (CHD)
- congenital
- viral damage
- atherosclerosis
- angina myocardial infarction
- angina myocardial infarction
- atherosclerosis
- viral damage
- congenital
- vascular disorders: stroke, varicose veins
- PREVALENCE
- 2nd most common cause of death worldwide
- cause of greatest number of deaths in UK
- greatest effect in 'Western cultures'
- 2nd most common cause of death worldwide
- CHD attributable to risk factors?
- ...physical inactivity (37%)
- ...obesity (6%)
- ...blood pressure >140/90mmHg (13%)
- ...blood cholesterol >5.2mmol/l (46%)
- ...smoking (19%)
- ...physical inactivity (37%)
- ATHEROSCLEROSIS
- formation of plaque of cells in an artery wall
- initiated by damage to single-cell endothelium
- mechanical
- toxins
- viral infection
- metabolic stress e.g. hypercholesterolaemia
- mechanical
- formation of plaque of cells in an artery wall
- LOW DENSITY LIPOPROTEIN
- ~600
cholesterol
molecules
- ~1000 cholesterol
ester molecules
- ~600
cholesterol
molecules
- OCCLUSIVE CORONARY ATHEROSCLEROSIS
- the aortic atheromatous plaque is thicker than the
remaining media on the right. the plaque contains
amorphous pink material with slit-like 'cholesterol
clefts' of lipid material. there is overlying recent
haemorrhage at the left.
- the aortic atheromatous plaque is thicker than the
remaining media on the right. the plaque contains
amorphous pink material with slit-like 'cholesterol
clefts' of lipid material. there is overlying recent
haemorrhage at the left.
- FATE OF PLAQUE
- increase in size to totally
occlude artery
- rupture and subsequent loss of cap leads to blockage elsewhere or formation of a clot at the plaque
- haemorrhage due to lesion of vessel - aneurysm
- increase in size to totally
occlude artery
- CURRENT TREATMENT
- PHARMACOLOGICAL
- hypertension - lower stress of vessels
- vasodilators - dilating arteries
- b-blockers - reducing work
- anticoagulants - embolism
- statins - reduce cholesterol
- hypertension - lower stress of vessels
- LIFESTYLE/BEHAVIOUR
- diet: reduce cholesterol intake, increase antioxidants and fibre
- exercise
- diet: reduce cholesterol intake, increase antioxidants and fibre
- INVASIVE
- by-pass surgery
- angioplasty
- repair-ruptured vessel
- transplant
- by-pass surgery
- PHARMACOLOGICAL
- RECENT/CURRENT RESEARCH
- inflammatory response
- serum markers of inflammation: c-reactive
protein, leukocyte count, cytokines
- show qualitative relationship with severity and prognosis of disease
- serum markers of inflammation: c-reactive
protein, leukocyte count, cytokines
- enhanced affect of statins
- effect greater than expected by down
regulation of cholesterol production
alone
- effect greater than expected by down
regulation of cholesterol production
alone
- relevance of plasma triglyceride concentration
- inflammatory response
- CURRENT/FUTURE THERAPY
- increased use of ACE
inhibitors - better control
of hypertension
- maximise use of statins
- free radical
scavengers and
modulation of immune
response
- diet - homocysteine reduction:
level homocysteine increases
with cofactors vit b6 and folate
missiong from methionine
breakdown pathway
- better
diagnosis/prediction:
e.g. c-reactive protein
- increased use of ACE
inhibitors - better control
of hypertension
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