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Diseases of cardiovascular system, Arteriosclerosis (hardening of the…

- - - - Thrombosis is the formation of a clot in a blood vessel.
        
        An embolus is a general term for any material obstructing blood vessels in the circulatory system.
        
        A thromboembolus is an embolus made of clotted material.
        
        Thromboembolism occurs when an embolus blocks a blood vessel.
- - - - The solution to provide oxygen to the heart muscle is the coronary arteries, which supply blood to the heart itself.
      - The heart muscle is too thick for oxygen to diffuse across entirely.
      - Even though the heart pumps blood, it cannot access an unlimited supply of oxygen from the blood it pumps.
      - It pumps about 100,000 times a day, requiring a significant amount of oxygen to function effectively.
      - The heart is a muscular pump that works continuously, pumping blood throughout the body.
  - - - Stable angina is a symptom of coronary artery disease.
      - It occurs when the heart muscle, when under exertion, doesn't receive sufficient oxygen.
      - The symptom, angina pectoris, feels like a tight, strangling sensation in the chest.
      - Exercise or exertion triggers this chest pain, while rest relieves it.
    - - ACS is a broader category that includes unstable angina and heart attacks.
        
        Unstable angina occurs when the plaque ruptures, leading to blood clots forming on the ruptured plaque.
        
        Unstable angina can result in chest pain at rest and is unpredictable.
    - - A heart attack, or myocardial infarction, occurs when a blood clot (thrombus) blocks an artery or embolizes to block a smaller artery.
      - When a section of the heart muscle doesn't receive oxygen due to the blockage, that muscle dies.
        
        What Happens During a Heart Attack
        
        Plaque buildup in a coronary artery can rupture, leading to clot formation (thrombus).
        
        The clot can obstruct blood flow in the artery, causing heart muscle cells to become oxygen-starved.
        
        Oxygen-deprived heart muscle cells send pain signals to the brain, often resulting in referred pain felt in the chest and sometimes radiating to the left arm or jaw.
        
        Adrenaline is released, causing the heart to beat faster and attempt to compensate for the reduced blood flow.
        
        The clot continues to grow, further reducing blood flow to the heart muscle.
        
        A shortage of oxygen and energy production leads to a reduction in the rate of heart muscle cell contractions.
        
        If not treated within about 20 minutes, a heart attack can lead to irreversible damage to the heart muscle, as heart muscle cells rupture and die.
      - Rapid medical intervention (within about 20 minutes) can save the affected heart muscle.
      - A heart attack is not the same as heart failure, which is a condition where the heart can't pump enough blood to meet the body's needs.
  - - - High blood cholesterol levels, especially LDL, contribute to plaque buildup.
        
        High triglycerides can lead to plaque formation.
        
        Hypertension damages blood vessel walls, predisposing them to plaque development.
        
        Smoking introduces toxins that directly damage blood vessel walls.
        
        Diabetes causes blood vessel damage through glycosylation.
        
        Regular physical activity can significantly reduce the risk of coronary artery disease.
        
        Obesity and a lack of physical activity increase the risk of coronary artery disease.
- - - - Endothelial Damage: The irritants damage the endothelium, a single layer of cells that acts as a barrier and secretes proteins to prevent clotting. When this barrier is damaged, it allows substances to enter the arterial wall.
      - Cholesterol Accumulation: Cholesterol from the blood, particularly LDL cholesterol, accumulates beneath the damaged endothelium. This buildup can form fatty streaks in the artery.
      - Macrophage Activation: The accumulated cholesterol becomes oxidized and triggers the immune system, attracting monocytes (white blood cells). Monocytes transform into macrophages and attempt to engulf the excess cholesterol, forming foam cells. This process indicates inflammation.
      - Inflammatory Response: The dead foam cells release cytokines that recruit more immune cells, perpetuating inflammation. Simultaneously, LDL cholesterol continues to deposit into the arterial wall.
      - Smooth Muscle Involvement: Smooth muscle cells migrate into the fatty plaque and secrete a fibrous cap of collagen and elastin to shield the plaque from the bloodstream. Additionally, they deposit calcium in the plaque, contributing to arterial hardening.
      - Plaque Rupture and Thrombosis: Sometimes, the plaque ruptures, exposing its thrombogenic components to the blood. This event can lead to the formation of a blood clot within the artery, potentially causing complete blockage. Such blockage results in insufficient blood supply to heart muscle tissue, leading to a myocardial infarction (heart attack).
- - - - Stenosis leads to restricted blood supply, known as "ischemia."
        
        Ischemia and heart failure
        
        Ischemia is a condition in which blood flow (and thus oxygen) is restricted or reduced in a part of the body
        Ischemia can lead to heart failure when the heart muscle does not receive sufficient oxygen.
        
        Heart failure is a condition where the heart struggles to perform its function effectively but doesn't necessarily mean the heart has completely stopped.
        Heart failure is related to the inability of the heart to pump blood properly due to ischemia caused by stenosis.
        
        heart failure
        
        Signs and Symptoms
        
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      - Ischemia occurs when the blood supply to a tissue is limited, leading to a loss of function.
      - In the context of heart health, ischemia can occur downstream from arterial stenosis and affect the heart muscle's oxygen supply.