DISEASES OF THE BLOOD VESSELS
Normal structure of the blood vessels
Terminology
Arteriosclerosis, Arteriosclerosis, Atherosclerosis, Atherogenic
ATHEROSCLEROSIS (ATHEROMA)
Definition
Macroscopic picture
The process of atherogenesis
Stages of Atheroma formation
Microscopic picture
Clinical manifestations of Atherosclerotic Vascular Disease
Clinical complication of atheroma
Atheroma and Lipid Metabolism
Atheroma and Apolipoprotein E
Familial Hyperlipidemia
Xanthelasma , xanthoma and xanthomatosis
Etiology: age, sex, stress, diet, plasma lipids, Hypercholesterolemia, Hypertension, Diabetes mellitus, Heredity, Cigarette smoking, and others (Soft risk factors)
Risk factors
Major risk factors
Minor Risk Factors
Modifiable
Non-modifiable
Lesser or uncertain
Pathogenesis
Old theories
Insudation theory
Thrombogenic/encrustation theory
Recent theory
Reaction to injury theory: original and modified
Other theories
Monoclonal hypothesis
Infection
Modern theory of atherosclerosis: Multifactor theory
ROLE OF ENDOTHELIAL CELL
ROLE OF LDL & CHOLESTEROL
ROLE OF BLOOD MONOCYTES
ROLE OF SMOOTH MUSCLES
ROLE OF THROMBOSIS
Role of Vascular Cell Adhesion molecule 1 (VCAM-1)
Role of Monocyte Chemoattractant Protein 1 (MCP-1)
Medial Calcification
(MONKEBERG’S SCLEROSIS)
Definition, Age, Gross and Microscopic Pictures, Clinical Features
ARTERIOSCLEROSIS
(DIFFUSE HYPERPLASTIC SCLEROSIS)
Hyaline arteriolosclerosis
Hyperplastic arteriolosclerosis
Vasoconstrictors
Vasodilators
SYSTEMIC HYPERTENSION
Definition and general consideration
Factors involved in regulation of blood pressure
Types of systemic hypertension
Primary or essential hypertension: Benign and malignant
Secondary hypertension: Benign and malignant
Classification and causes of secondary hypertension
Renal causes
Endocrine causes
Vascular causes
Neurogenic causes
Others: Pre-eclampsia, Alcohol abuse, Renin secreting tumors
ESSENTIAL HYPERTENSION
Definition and general consideration
Pathological Lesions
Vascular Lesions (benign arterioloscierosis): Hyalinosis and elastosis
Kidney Lesions (Benign nephrosclerosis)
Cardiac Lesions (Hypertensive Cardiomyopathy)
Retinal Lesions
Cerebral Lesions
Etiology
Pathogenesis of essential hypertension
Pathogenesis of essential hypertension
Causes of Death
MALIGNANT HYPERTENSION
General consideration
Pathological Lesions
Vascular lesions (Malignant Arterioloscierosis)
Arteriolar hyalinosis and elastosis
Cellular hyperplasia
Acute arteriolar necrosis (Fibrinoid necrosis)
Kidney Lesions (Malignant Nephrosclerosis)
Cardiac Lesions
Retinal Lesions
Cerebral Lesions
Causes of Death
Clinical presentation
Complications of hypertension
ANEURYSMS
Definition, Etiology, Pathogenesis
Types of aneurysms
True aneurysms
Atherosclerotic Aneurysm
Syphilitic Aortic Aneurysm
Dissecting Aneurysm
Mycotic aneurysms
Congenital aneurysms
False aneurysms
Pulsating hematoma
Arterio-venous fistula
Complications of aneurysms
Diseases of Veins
Varicose Veins
Definition, Sites, Causes, and Complications
Vasculitis (Angiitis)
Definition
General consideration
Classifications of vasculitis
Based on the site of the affected vessels
Based on the size of the affected vessels
Based on the size of the lesion
Etiological classification of small vessel vasculitis
ANCA associated vasculitis
Immune complex mediated vasculitis
Paraneoplastic small vessel vasculitis
Inflammatory bowel disease associated vasculitis
Mimicks of vasculitis
Clinical Manifestations of vasculitis
Etiology of Vasculitis
Pathogenesis of Vasculitis
Mechanism of vessel wall involvement
Laboratory testing in vasculitis
Antineutrophil cytoplasmic antibodies (ANCAs)
Types of ANCAs
Role of ANCA
Large vessel vasculitis
Giant cell (temporal) arteritis
Takayasu’s arteritis (pulseless disease)
Medium vessel vasculitis
Polyarteritis Nodosa; PAN (Periarteritis Nodosa)
Kawasaki’s disease (KD)
THROMBO-ANGITIS OBLITERANS (BUERGER’S DISEASE)
Small vessel vasculitis
Churg-Strauss Syndrome (Allergic granulomatous angitis)
Hypersensitivity (leukocytoclastic) vasculitis
Henoch Schonlein purpura (HSP)
Wegener Granulomatosis (WG)
Infectious vasculitis