Term
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Definition
| thinning and weakening of the walls of an artery causing bulging of the wall in the shape of a sack |
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Definition
| a chronic disease of the arteries of the circulatory system characterized by thickening and hardening of the arterial walls caused by atherosclerosis |
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Definition
| focal thickening of the wall of an artery caused by infiltration of mixtures of fibrous and fatty plaque |
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Definition
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Definition
| pain or weakness of muscles |
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Definition
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Definition
| a sudden obstruction of a blood vessel caused by an insoluble substance in the blood |
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Term
| endogenous lipid transport |
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Definition
| movement of lipid produced by the liver to other parts of the body |
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Term
| exogenous lipid transport |
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Definition
| movement of lipid absorbed from the intestines to the liver |
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Definition
| tissue death due to ischemia |
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Definition
| failure of the heart to pump blood effectively, resulting in back pressure and congestion of tissues with body fluids |
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Definition
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| cell death due to loss of blood supply |
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Definition
| temporary lack of blood supply that deprives tissues of nutrients and oxygen |
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Definition
| irreversible heart muscle damage and cell death usually called a heart attack |
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Term
| peripheral vascular disease |
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Definition
| disorders of the circulatory system including the arteries, veins, or lymph ducts but excluding the heart |
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Definition
| reversible ischemic heart disease that produces chest pain |
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Definition
| an enzyme produced by the streptococcus bacterium that dissolves blood clots |
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Term
| tissue plasminogen activator (TPA) |
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Definition
| an enzyme produced by endothelial cells that binds specifically to fibrin and therefore dissolves only clots that are localized rather than throughout the systemic circulation |
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Term
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Definition
| sudden more severe angina that lasts longer than stable angina and is associated with either coronary artery vasospasm or a transient thrombosis |
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Definition
| Number of US adults with diagnosed heart disease |
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Definition
| percent fo noninstitutionalized adults with diagnosed heart disease |
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- Number of deaths: 599,413
- Deaths per 100,000 population: 195.2
- Cause of death rank: 1 |
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Definition
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Term
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Definition
| Heart disease caused almost ____ of deaths in the United States. |
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Term
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Definition
| In 2010, coronary heart disease alone was projected to cost the United States _______3 This total includes the cost of health care services, medications, and lost productivity. |
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Term
More women than men die of cardiovascular disease each year
23% of women and 18% of men will die within 1 year of a first recognized heart attack; 22-23% of women and 15-27% of men heart attach survivors will die within 5 years.
12-25% of women and 7-22% of men heart attack survivors will be diagnosed with heart failure within 5 years.
Women are less likely than men to receive appropriate treatment after a heart attack.
Heart disease is the leading cause of death of American women, killing more than a third.
CVD caused 1 death per minute among women in 2007. That represents more female lives than were claimed by cancer, Alzheimer’s disease, and accidents combined. |
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Definition
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Term
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Definition
| thickening and hardening of the arteries, associated with fibrous and muscle cells infiltration into the inner wall of the arterial wall, mixed with arthesclerotic plaque |
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Term
elevated blood pressure due to progressing narrowing of the arteries
gradual occlusion resulting in ischemia or temporary lack of blood supply to tissues
sudden complete occlusion, usually in association with thrombosis, resulting in infarction or cell death |
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Definition
| what does arteriosclerosis result in |
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Term
coronary arteries (CHD) --> angina and myocardial infarction
cerebral arteries (CVA) --> ischemic stroke
renal arteries --> hypertension
peripheral arteries (PAD) --> claudication, limping, gangrene |
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Definition
| nature of arteriosclerosis injury or disease depends on vascular occlusion of the tissues of |
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Term
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Definition
| what is the leading cause of coronary artery and cerebrovascular disease |
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Term
| caused by the accumulation of lipid-laden macrophages within the arterial wall which lead to formation of a lesion called plaque |
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Definition
| what is atherosclerosis caused by |
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Term
| not a single disease entity, that can affect vascular systems throughout the body resulting in ischemic syndromes that vary widely in severity and clinical manifestations |
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Definition
| what is meant by the statement, atherosclerosis is a pathologic process |
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Term
- to serve as energy source
- to provide building blocks for body’s structure |
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Definition
| Foods human ingest is broken down and reorganized as it passes through the GI system and into the cardiovascular system for two purposes: |
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Term
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Definition
| In excess, _______ accumulates in deposits of atherosclerotic plaque on the walls of vessels in the circulation. This deposition leads to blockages in the circulation resulting in ANGINA MYOCARDIAL INFARCT DEATH |
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Term
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Definition
| carry fatty acids, nutrients used preferentially by muscle tissue and especially important as an energy source in the fasting state |
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Definition
| : center of lipid metabolism - exogenous transport - endogenous transport |
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Definition
critical part of eukaryotic cell membrane and precursor of synthesis of steroid hormones
used to synthesize plasma membranes, hormones, and bile salts. |
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Term
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Definition
| enzyme on the surface of capillary endothelium of muscle and fat tissue that breaks down triglycerides into fatty acids and glycerol to be used as energy |
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Term
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Definition
| are recycled to liver to synthesize VLDL |
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Term
| exogenous lipid transport |
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Definition
transports dietary lipids to the periphery and the liver, via CHYLOMICRONS (largest lipoproteins, carry fats that are absorbed form the gut).
lipoprotein lipase
chylomicrons remnants |
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Term
| endogenous lipid transport |
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Definition
transports hepatic lipids to the periphery in the following steps:
liver synthesizes fatty acids into VLDL.
as peripheral tissues remove fatty acids from VLDL, it is converted into LDL.
LDL particles bind to peripheral cells at a receptor and are taken in by endocytosis.
within the cell, LDL vesicles fuse with lysosomes releasing cholesterol and the LDL receptor is recycled back to the plasma membrane
LDL carries about 70% of plasma cholesterol, most of which in turn is made by the liver from excess fatty acids although some comes directly from dietary sources such as eggs and liver.
cholesterol is returned to the liver from cells by HDL
HDL is made in the liver.
it binds to an HDL receptor on cells and transports the cholesterol back to the liver for recycling as either VLDL or bile salts. |
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Term
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Definition
| ____ is the major cholesterol carrying lipoprotein in the plasma—causal agent in many forms of coronary artery disease |
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Term
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Definition
| excess LDL in the blood predisposes to _____ ____ |
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Term
dietary fats and cholesterol are absorbed from gut and assembled as triglyceride-rich chylomicrons
lipoprotein lipase in capillary walls of muscle or adipose tissue, releases free fatty acids and monoglycerides
as fats are removed, the chylomicrons reduce in size their density increases and remaining cholesterol is carried as high density lipoprotein (HDL)
HDL circulates in blood and is taken up by the liver cells where some is metabolized to very low density lipoprotein (VLDL)
circulating VLDL is a substrate for lipoprotein lipase and is converted via IDL or HDL or LDL
specific cell receptors allow the capture of LDL for cell membrane synthesis and energy requirement
excess LDL in the blood predisposes to artheroma formation |
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Definition
| the process of lipoprotein metabolism |
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Term
| low-density lipoproteins (LDLs) (light blue) and high-density lipoproteins (HDLs) (dark blue) (a). As shown in these simplified illustrations, both LDLs and HDLs can move from the liver to the circulatory system. Next, receptors (orange) can capture LDLs from the circulatory system and return them to the liver. The use of statins (b) blocks HMG-CoA reductase, which diminishes the production of both forms of cholesterol. With fewer LDLs manufactured in the liver, fewer enter the blood. In addition, the reduced level of LDLs in the liver triggers the expression of receptors that pull even more LDLs from the blood, which further decreases blood LDL levels. Remarkably, statins increase the level of HDLs in the blood, but the mechanism remains controversial. Regardless, the increase in HDLs further enhances the cardio-protective benefits of statins because the HDLs ferry cholesterol from other tissues, including artery walls, back to the liver for excretion, which further diminishes blood LDL levels. |
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Definition
| the liver makes two forms of cholesterol .... |
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Term
proteins that carry lipids
cell receptors that bind lipoproteins
enzymes that metabolize lipids |
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Definition
Genes modify lipid and cholesterol levels
Genes influence |
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Term
Chronic inflammation exits to some extent in almost all chronic illnesses in the body.
Increasing evidence, not proven, suggests potentially significant role in cardiovascular disease and even in the natural process of aging (AHA 2012).
Inflammation is common for heart disease and stroke patients and is thought to be a sign of atherogenic response.
Inflammation is a common component of many injuries that result from a multitude of diverse environmental hazards important to the field of public health. |
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Definition
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Term
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Definition
| The process of forming atheromas, plaques in the inner lining (the intima) of arteries |
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Term
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Definition
causes CHD, stroke, gangrene, aneurysm
contributes to hypertension and embolism |
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Term
| arteriosclerosis decreases |
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Definition
gradual reduction causes ischemia producing angina, transient ischemic attacks, claudication
sudden reduction causes infarction producing myocardial infarction, ischemic stroke, gangrene |
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Term
| damaged endothelium, response to injury, lipid core formation, fibrous plaque, complicated lesion |
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Definition
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Term
Hypertension
Smoking
Hyperlipidemia
Hyperhomocystinemia
Hemodynamic factors
Toxins
Viruses
Immune reactions |
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Definition
| chronic endothelial injury |
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Term
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Definition
begins with injury to endothelial cells that line artery walls
injured cells become inflamed and cannot make normal amounts of antithrombic and vasodilating cytokines, also
cells express adhesion molecules that bind macrophages, other inflammatory and immune cells |
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Term
macrophages adhere to injured endothelium and release enzymes and toxic O2 radicals that further injure vessel wall → oxidation of LDL
which is engulfed by macrophages, which then penetrate into intima of vessel
now FOAM CELLS accumulate in significant amounts and form a lesion called a FATTY STREAK
fatty streaks produce more toxic oxygen radicals; cause further immunologic/ inflammatory changes to vessel wall |
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Definition
| lipid core formation -> foam cells form fatty streak |
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Term
smooth muscle cells proliferate, produce collagen and migrate over the fatty streak forming a FIBROUS PLAQUE
results in further endothelial cell dysfunction, necrosis of underlying vessel tissue, and narrowing of vessel lumen as lesion protrudes out from wall
vessel obstruction can become significant enough to reduce blood flow to distal tissues |
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Definition
| atherogensis part 2, fibrous plaque |
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Term
as plaque develops, it becomes unstable
can result in ulceration and rupture, resulting in platelet adherence to lesion, becomes COMPLICATED LESION
platelet adhesion can initiate coagulation cascade and can result in:
- rapid THROMBUS FORMATION with complete vessel occlusion
- resultant tissue ISCHEMIA and INFARCTION |
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Definition
| atherogensis, part 3 complicated lesion |
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Term
| Atherosclerosis arises from a cascade of biochemical and cellular processes in which low-density lipoproteins (LDLs) trigger inflammation. When their levels in the blood are excessive, LDLs infiltrate the arterial wall where they accumulate and undergo chemical modifications, especially oxidation. The modified LDLs then stimulate the expression of receptors (red) on the innermost, or endothelial, cells lining the artery. In the blood, monocytes—immune cells that participate in general inflammatory responses—dock onto these receptors and enter the arterial wall. Inside the arterial wall, the monocytes mature into macrophages that engulf the modified LDLs to form fat-filled macrophages called foam cells. The foam cells secrete inflammatory substances that promote the production of a tough fibrous matrix that caps the fatty core to generate a plaque. Acute problems arise when the inflammatory substances secreted by the foam cells weaken the cap. If the cap springs a leak, blood enters, makes contact with foam-cell proteins that promote clotting and a blood clot develops in the artery. The clot that forms can plug the artery at the site of the plaque or travel downstream and obstruct blood flow at another location. |
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Definition
| A summary review of the inflammatory process of atherosclerosis depicted in the previous slide of an award-winning illustration. |
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Term
| Early in the development of atherosclerosis, low-density-lipoprotein cholesterol becomes oxidized, which results in endothelial cell dysfunction and the expression of vascular cell adhesion molecules and chemokines |
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Definition
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Term
elevated plasma cholesterol
high dietary fat especially saturated fat, elevate total and LDL cholesterol
high fibrinogen increases thrombosis
increased age and male sex
african american ethnicity due to higher prevalence of hypertension
family history and genetic factors
diabetes increases CHD risk 2-3 times
hypothyroidism
obesity adn sedentary lifestyle
hypertension
smoking
sedentary lifestyle
excessive alcohol consumption
hyperhomocystinemia |
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Definition
| Risk Factors for CHD, Stroke (CVA), and Peripheral Vascular Disease (PVD) |
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Term
leading cause of death among American men and women
Causes one-third of all U.S. deaths
deaths increase with age and are more common in men than women until 80 y/o
leading cause of death worldwide
prevalence high in U.S., U.K., Finland
prevalence low in Mediterranean and Japan |
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Definition
| CHD and Myocardial Infarction (MI) Epidemiology |
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Term
most common cause is atherosclerosis
early stages asymptomatic followed by ischemia that causes angina
stable or classical angina
unstable angina
myocardial infarction causes pain, dyspnea, nausea, hypotension
short term: arrhythmia, cardiac arrest, death
longer term: heart failure |
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Definition
| CHD and Myocardial Infarction (MI) Pathogenesis |
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Term
diagnosis utilizes electrocardiograms (EKG), angiography, sonography, radioisotope imaging, plasma biochemical markers
treatment involves stabilization of immediate damage and prevention of atherosclerosis to reduce the risk of further progression and more damage |
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Definition
| CHD and Myocardial Infarction (MI) Diagnosis and Treatment |
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Term
historical perspective
streptokinase
converts plasminogen into plasmin indiscriminately risking hemorrhage
antigenic
tissue plasminogen activator (t-PA)
binds to fibrin selectively dissolving clots
recombinant t-PA available and highly effective
only 25% of the world can afford t-PA |
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Definition
| thrombolytic treatment and CHD |
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Term
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Definition
converts plasminogen into plasmin indiscriminately risking hemorrhage
antigenic |
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Term
| tissue plasminogen activator (t-PA) |
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Definition
binds to fibrin selectively dissolving clots
recombinant t-PA available and highly effective
only 25% of the world can afford t-PA |
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Term
| Thrombolytic treatment and CHD (cont’d) Alternative “Clot Busters” |
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Definition
STAPHYLOKINASE
fibrin specific
less allergic risk
DESMOTEPLASE (DSPA) from bat saliva
fibrin specific
may be associated with less neurodegeneration
ASPIRIN
reduces CHD morbidity and mortality
may increase risk of hemorrhagic stroke |
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Term
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Definition
fibrin specific
less allergic risk |
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Term
| DESMOTEPLASE (DSPA) from bat saliva |
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Definition
fibrin specific
may be associated with less neurodegeneration |
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Term
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Definition
reduces CHD morbidity and mortality
may increase risk of hemorrhagic stroke |
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Term
smoking cessation
avoid or reduce obesity
reduce cholesterol by limiting dietary fat
regular exercise
cholesterol lowering drugs
ion exchange resins
fibric acid derivatives
statins
coronary artery surgery |
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Definition
| prevention of atherosclerotic progression of CHD |
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Term
Printed on the back of the
stamp sheet are tips for
maintaining a healthy
heart:
Eat a heart-healthy diet
Exercise and control your weight
Don’t smoke
Manage stress
Sleep well |
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Definition
| surgeon general benjamin joins 2012 social awareness stamp dedication |
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