Pathology: Cardiovascular Diseases
Pathophysiology of heart disease, hypertension, atherosclerosis, and vascular disorders.
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What is the initial step in the pathogenesis of an atherosclerotic plaque?
Endothelial injury or dysfunction, which increases permeability and allows lipid accumulation.
What are the lipid-laden macrophages found within an atherosclerotic plaque called?
Foam cells.
Describe the role of smooth muscle cells in the progression of a stable atherosclerotic plaque.
Smooth muscle cells migrate from the media to the intima and secrete collagen to form a fibrous cap.
Which cardiac biomarker is the most specific for diagnosing an acute myocardial infarction?
Cardiac Troponin (I or T).
Distinguish between a STEMI and a NSTEMI based on the depth of myocardial involvement.
STEMI usually indicates transmural (full thickness) ischemia, while NSTEMI is typically subendocardial (partial thickness) ischemia.
What is the characteristic histological finding 1 to 3 days after a myocardial infarction?
Extensive coagulative necrosis and a heavy infiltrate of neutrophils.
Which coronary artery is most commonly occluded in a myocardial infarction?
The Left Anterior Descending (LAD) artery.
What is the primary difference between systolic and diastolic heart failure regarding ejection fraction?
Systolic heart failure features a reduced ejection fraction (HFrEF), while diastolic heart failure features a preserved ejection fraction (HFpEF).
What is the most common cause of right-sided heart failure?
Left-sided heart failure.
Explain the mechanism of 'forward failure' in systolic heart dysfunction.
Decreased cardiac output leads to reduced tissue perfusion and activation of the renin-angiotensin-aldosterone system (RAAS).
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