The earliest visible lesions

Lipid deposition

Dot-like or striped yellow and slightly raised lesions can be seen on the surface of the intima, which are common on the posterior wall of the aorta and the branch openings.

A large number of foam cells accumulated under the intima, and lipid staining was positive.

Fatty lines develop from

Lipid organized scar repair

Yellow (lipid damage) or white (fiber repair) raised plaques scattered on the intimal surface

The surface of the lesion is a fibrous cap (mainly collagen fibers), and foam cells, SMC and inflammatory cells can be seen under the cap.

Typical lesions of AS

Cells deep in the fibrous plaque become necrotic and rupture, forming atherosclerotic material

naked eye

section

A large number of cells under the fibrous cap undergo necrosis and collapse, releasing intracellular substances, cholesterol deposition (crack-like), calcium salt deposition, etc., and the media of the blood vessel is compressed and atrophied.

Rupture of new capillaries within the plaque

The material in the plaque flows into the bloodstream and can easily cause blood clots

Plaque ruptures, collagen is exposed, and thrombus forms

Calcium salt deposition in fibrous plaque

The blood vessels where AS occurs have reduced elasticity and thin walls. They are squeezed and expanded by blood pressure and are prone to rupture and massive bleeding.

Expanded and narrowed by atheromatous material, corresponding to organ ischemia

Have all the changes of atherosclerosis

Most commonly occurs in the left anterior descending artery

Plaque lesions occur on the side of the heart wall and are crescent-shaped

Coronary heart disease (CHD)

Causes of myocardial hypoxia

clinical manifestations

The origin of the internal carotid artery, the basilar artery, the middle cerebral artery and the circle of Willis

Brain atrophy, dementia, encephalomalacia

Aneurysm forms, ruptures and causes brain hemorrhage

Renal artery plaque leads to luminal stenosis, renal ischemia, parenchymal atrophy, and mesenchymal tissue hyperplasia

Merger of plaques leads to renal tissue infarction. After organization, the plaques become large and sunken. The adhesion of multiple plaques causes the kidney to shrink.

Lower extremity arteries, buttock arteries

Intermittent claudication, narrowing of arteries in lower limbs, inability to walk, recovery can be achieved with rest

Complete occlusion, resulting in dry gangrene

Strongly constrict arterioles and increase peripheral resistance

Promote proto-oncogene expression, increase SMC proliferation, and increase peripheral resistance

Activate sympathetic nerves

Promote reabsorption and increase circulating blood volume

NE excites cardiac beta receptors, causing heart rhythm and contraction to increase

NE acts on blood vessels, causing contraction

Sympathetic nerves act on the kidneys, reducing their blood flow and increasing aldosterone release

Endothelial NO levels or activity are downregulated and local RAAS is overactivated.

Insulin can protect cardiovascular systems. When obese people develop AS, insulin levels increase significantly.

increased insulin

Characteristics of major diseases such as hypertension

Hyalinization of small arteries

The renal afferent arterioles, retinal arteries, and central splenic arteries are most likely to be involved

Resulting in arterial wall thickening and lumen narrowing to occlusion

Most likely to involve small muscular arteries, such as renal interlobular arteries

Causes thickening of the tube wall and narrowing of the tube lumen

No obvious lesions or complicated by AS

naked eye

under the mirror

First, there is hyalinization of the afferent arteriole, leading to glomerular ischemia. Secondly, hyalinization of the glomerulus leads to atrophy of the glomerular ischemia, mesenchymal tissue hyperplasia, and lymphocyte infiltration.

Kidney atrophy on the affected side and compensatory enlargement on the contralateral side

The renal section of the affected side shows that the renal cortex becomes thinner, the corticomedullary boundary is blurred, and the renal pelvis and perirenal fat tissue increase.

Cerebral edema or hypertensive encephalopathy

Encephalomalacia

cerebral hemorrhage

central retinal arteriosclerosis

The vegetation adheres firmly and is not easy to fall off

pericardial rub sound

Composition of platelets, fibrin, colonies, necrosis combination, and neutrophils

Embolism is most common in the brain