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Questions and Answers
What is the primary reason for the development of coronary artery disease?
What is the primary reason for the development of coronary artery disease?
Which type of vasculitis is most common among older individuals in the US and Europe?
Which type of vasculitis is most common among older individuals in the US and Europe?
What is a characteristic feature of Takayasu arteritis?
What is a characteristic feature of Takayasu arteritis?
What is a common complication of temporal arteritis?
What is a common complication of temporal arteritis?
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What is the typical age range for Takayasu arteritis?
What is the typical age range for Takayasu arteritis?
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What is the characteristic feature of the thrombus in Buerger's disease?
What is the characteristic feature of the thrombus in Buerger's disease?
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What is the most common age group affected by Wegener's granulomatosis?
What is the most common age group affected by Wegener's granulomatosis?
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What is the characteristic laboratory finding in Wegener's granulomatosis?
What is the characteristic laboratory finding in Wegener's granulomatosis?
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What is the characteristic feature of the inflammation in Buerger's disease?
What is the characteristic feature of the inflammation in Buerger's disease?
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What is the prognosis of Wegener's granulomatosis if left untreated?
What is the prognosis of Wegener's granulomatosis if left untreated?
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Study Notes
Coronary Artery Disease
- Also known as ischemic heart disease
- Characterized by an imbalance between myocardial oxygen demand and blood supply
- Most common cause is a reduction in coronary artery blood supply
- Leading cause of death in developed countries
- Can manifest as angina pectoris, acute myocardial infarction, sudden cardiac death, or chronic ischemic heart disease
- Risk factors include hypertension, diabetes, high LDL cholesterol, and genetics
- Pathogenesis involves a >75% reduction in coronary artery lumen, changes in plaque morphology, platelet aggregation, and coronary artery thrombosis
Types of Vasculitis
Temporal Arteritis (Giant Cell Arteritis)
- Affects large to small arteries, primarily in older individuals
- Rare before age 50
- Granulomatous inflammation and fragmentation of internal elastic membrane
- Involves temporal, ophthalmic, vertebral arteries, and aorta
- May cause permanent blindness
- Presents with fever, weight loss, and fatigue
- Associated with polymyalgia rheumatica
- Diagnosed through biopsy and histologic confirmation
Takayasu Arteritis
- Granulomatous vasculitis of medium and larger arteries
- Ocular symptoms, weakening of upper extremity pulses, and BP discrepancy between arms
- Affects females under 40 years old, with a possible autoimmune etiology
- Characterized by giant cells and patchy necrosis of the media
- Presents with blindness, coldness, and numbing of extremities, hypertension, and neurologic deficits
- May progress rapidly or slowly
Buerger's Disease (Thromboangiitis Obliterans)
- Affects medium-small arteries, primarily in male smokers under 35 years old
- Sharply segmented acute and chronic vasculitis
- Inflammation permeates vessel wall and extends into arteries and veins
- Thrombosis occludes lumen and contains microabscesses
- Presents with chronic ulceration of toes, gangrene, and severe pain
Wegener's Granulomatosis (Granulomatosis with Polyangiitis)
- Necrotizing vasculitis of small-medium arteries, involving lungs and upper airways
- Characterized by necrotizing granulomas of the upper respiratory tract
- Focal necrotizing glomerulonephritis and inflammatory sinusitis
- Granulomas have necrosis surrounded by lymphocytes, plasma cells, macrophages, and giant cells
- Can mimic TB, with significant alveolar hemorrhage
- Renal lesions: focal to diffuse glomerular lesions that can progress to crescentic glomerulonephritis
- Most likely caused by an immunologic mechanism
- Affects males more than females, typically in the 40-50 year old range
- Presents with pneumonitis, sinusitis, and nasopharyngeal lesions
- PR3 ANCA (c-ANCA) is present in up to 95% of patients
- Rapidly fatal if left untreated, with an 80% mortality rate in the first year
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Description
Test your knowledge on coronary artery disease, its causes, symptoms, and risk factors. From angina pectoris to sudden cardiac death, understand the pathogenesis of this leading cause of death in developed countries.