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טרשת עורקים Atherosclerosis

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Presentation on theme: "טרשת עורקים Atherosclerosis"— Presentation transcript:

1 טרשת עורקים Atherosclerosis
המינוח הרפואי לטרשת עורקים בעבר היה: ARTERIOSCLEROSIS (הסתיידות עורקים)  והיום מקובל המונח ATHEROSCLEROSIS מהמילה  ATHEROMA - טרשת. יש להניח שזה קשור בין היתר למבנה העורק, הדפנות הפנימיות שלו (אינטימה) ובעיקר ללחץ הגבוה שקיים במערכת העורקית לעומת הורידית – כך שהתופעה מאפיינת עורקים ולא קיימת "טרשת ורידים". This is a normal coronary artery with no atherosclerosis and a widely patent lumen that can carry as much blood as the myocardium requires.

2 This is mild coronary atherosclerosis
This is mild coronary atherosclerosis. A few scattered yellow lipid plaques are seen on the intimal surface of the opened coronary artery traversing the epicardial surface of a heart. The degree of atherosclerosis here is not significant enough to cause disease, but could be the harbinger of worse atherosclerosis to come.

3 The degree of atherosclerosis is much greater in this coronary artery, and the lumen is narrowed by half. A small area of calcification is seen in the plaque at the right.

4 These cross sections of the left anterior descending coronary artery demonstrate more pronounced atherosclerosis with narrowing at the left, which is the proximal portion of this artery. Atherosclerosis is generally worse at the beginning of an artery where turbulence is greater.

5 Here is occlusive coronary atherosclerosis
Here is occlusive coronary atherosclerosis. The coronary at the left is narrowed by 60 to 70%. The coronary at the right is even worse with evidence for previous thrombosis with organization of the thrombus and recanalization such that there are three small lumens remaining.

6 Here is a coronary artery with atherosclerotic plaques
Here is a coronary artery with atherosclerotic plaques. There is hemorrhage into the plaque in the middle of this photograph. This is one of the complications of atherosclerosis. Such hemorrhage could acutely narrow the lumen.

7 This is the gross appearance of severe coronary atherosclerosis, which involves virtually 100% of the surface of the coronary. There is extensive calcification, especially at the right where the lumen is narrowed.

8 This is coronary thrombosis, one of the complications of atherosclerosis. The dark red thrombus is seen in the anterior descending coronary artery

9 Here is the coronary thrombosis at higher magnification
Here is the coronary thrombosis at higher magnification. The thrombus occludes the lumen and produces ischemia and/or infarction of the myocardium.

10 Look carefully at this aorta
Look carefully at this aorta. The white arrow denotes the most prominent fatty streak in the photo, but there are other fatty streaks scattered over the aortic surface. Fatty streaks are the earliest lesions seen with atherosclerosis in arteries. Increased total cholesterol and decreased HDL cholesterol contribute to this process.

11 A coronary thrombosis is seen microscopically occluding the remaining small lumen of this coronary artery. מקור: Golden Hour - Medical Information center


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