Topic: ischemic heart disease and diabetes mellitus
Question: Discuss the etiopathogenesis of Atherosclerosis. What are the possible complications
that may arise due to the presence of these plaques in different arteries. Draw a labelled
diagram depicting the histological appearance of the same.
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Atherosclerosis is a chronic inflammatory disease characterized by buildup of plaque in the intimal layer of large and medium-sized arteries.
Etiopathogenesis:
– Endothelial injury due to hypertension, dyslipidemia, diabetes, smoking leads to endothelial dysfunction.
– Lipoproteins like LDL enter the intima and get oxidized.
– Monocytes enter and differentiate into macrophages which take up oxidized LDL to become foam cells.
– Fatty streak forms which is accumulation of foam cells and T cells.
– Smooth muscle cells migrate and cause collagen deposition leading to a fibrous cap over the lesion.
– Platelets and thrombi deposit over this plaque.
– Plaque can rupture causing acute events like myocardial infarction or stroke.
Complications based on involved artery:
– Coronary arteries: Angina, myocardial infarction, ischemic heart disease.
– Cerebral arteries: Stroke, transient ischemic attack.
– Peripheral arteries: Peripheral vascular disease, intermittent claudication.
– Renal arteries: Renal artery stenosis, renovascular hypertension.
Histological appearance:
In summary, atherosclerosis causes flow-limiting stenosis and acute thrombotic events due to plaque rupture in major arteries leading to end-organ dysfunction like heart attacks, stroke, kidney failure etc
