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Diseases of the cardiovascular system

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  1. Diseases of the cardiovascular system Maliqin Department of Pathology and Pathophysiology School of Medicine, Zhejiang University

  2. atherosclerosis(AS) 1. etiology and pathogenesis Risk factors • Hyperlipemia:increased LDL, TG, VLDL, apoB,Lp(a) decreased HDL,apoA-I • Hypertension • Cigarette smoking • Elevated blood sugar levels • The other factors

  3. pathogenesis --Theory of inflammatory response to injury • The injury of the endothelium • The accumulation of lipid • The infiltration of macrophages • The proliferation of SMC

  4. 2.morphology Predilection for large arteries and medium-sized arteries Basic lesion • Fatty streak Accumulated lipid, foam cell • Fibrous plaque-- Fibrous cap

  5. 黄色脂质条纹

  6. 2.morphology Predilection for large arteries and medium-sized arteries Basic lesion • Fatty streak Accumulated lipid, foam cell • Fibrous plaque-- Fibrous cap

  7. 动脉粥样硬化的纤维斑块病变 正常主动脉

  8. 动脉管壁一侧明显增厚

  9. Atheromatous plaque (atheroma) Fibrous cap cholesterol crystal necnotic debris foam cell calcification neovascular formation

  10. atheroma

  11. complicated lesions • Hemorrhage in plaque • Rupture of the plaque • Thrombosis • Calcification • aneurysm: definition, lesion classification (true , pseudo-, Dissecting )

  12. Ulcer formation

  13. 3. Atherosclerosis of the • important organs • Aorta: abdominal aorta • Coronary arteries • Arteries of the brain • The other organs

  14. 动脉粥样硬化的纤维斑块病变 正常主动脉

  15. 3. Atherosclerosis of the • important organs • Aorta: abdominal aorta • Coronary arteries • Arteries of the brain • The other organs

  16. 基底动脉内血栓形成 基底动脉环硬化

  17. 脑动脉硬化致脑萎缩

  18. 3. Atherosclerosis of the • important organs • Aorta: abdominal aorta • Coronary arteries • Arteries of the brain • The other organs

  19. 新 鲜 足 坏 疽

  20. 足干性坏疽

  21. Coronary heart disease (C H D) Definition cardiac disease which result from insufficient coronary blood flows due to the narrowing of the coronary arteries

  22. Causes • Coronary atherosclerosis • Distribution(location) • features of the lesion • Spasm of the coronary arteris • Coronary arteritis

  23. 正常心脏

  24. 左冠状动脉 右冠状动脉

  25. 左冠状动脉 冠状动脉粥样硬化 右冠状动脉

  26. 冠状动脉狭窄 血栓形成

  27. 正常冠状动脉

  28. 冠状动脉粥样硬化,管腔狭窄

  29. 冠状动脉管壁增厚及钙化 ,管腔明显狭窄

  30. 斑块内钙化

  31. 动脉管腔狭窄血栓形成

  32. 冠状动脉近端狭窄 冠状动脉远端闭塞

  33. 冠状动脉硬化区

  34. 冠状动脉阻塞

  35. Causes • Coronary atherosclerosis • Distribution(location) • features of the lesion • Spasm of the coronary arteris • Coronary arteritis

  36. Classification 1. angina pectoris (AP) a symptom complex consisting of severe paroxymal chest pain resulting from transient ischemia

  37. Precipitating factors Exertion, emotion, pain, cold weather, cigarette smoking, heavy meals

  38. 心绞痛病人

  39. Classification • Stable (exerting ) AP • Instable (exerting) AP • (Spontaneous) variant AP

  40. 2. Myocardial infarction • Subendocardial MI • Multiple small lesion • Transmural MI • Distribution • Morphology:shape, color, • microscopic change • Biochemical changes:

  41. myocardial infarction granulation tissue

  42. Complications • Rupture of the heart • Ventricular aneurysm • Thrombosis • Acute pericarditis • Clinical complication

  43. rupture of Infarct area