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DISEASES OF CARDIOVASCULAR SYSTEM Department of Pathology, Huaxi Hospital Xu Huan 2009.10

DISEASES OF CARDIOVASCULAR SYSTEM Department of Pathology, Huaxi Hospital Xu Huan 2009.10. SYSTEMATIC PATHOLOGY CAUSES OF DISEASE PATHOGENESIS BASIC PATHOLOGIC CHANGES PATHOCLINICAL RELATIONS. HOW TO STUDY BETTER REVIEW THE NORMAL STRUCTURE AND FUNCTION OF THE ORGAN

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DISEASES OF CARDIOVASCULAR SYSTEM Department of Pathology, Huaxi Hospital Xu Huan 2009.10

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  1. DISEASES OF CARDIOVASCULAR SYSTEMDepartment of Pathology, Huaxi HospitalXu Huan2009.10

  2. SYSTEMATIC PATHOLOGYCAUSES OF DISEASE PATHOGENESISBASIC PATHOLOGIC CHANGES PATHOCLINICAL RELATIONS

  3. HOW TO STUDY BETTER REVIEW THENORMALSTRUCTURE ANDFUNCTIONOF THE ORGAN REVIEW THE CONTENT OF THEGENERAL PATHOLOGY NOTICE THECORRELATIONSHIPBETWEEN THE MORPHOLOGY AND THE FUNCTION

  4. CARDIOVASCULAR SYSTEMTHE BLOOD VESSELSTHE HEART

  5. VASCULAR DISEASES Atherosclerosis (ATH) Aneurysm Hypertension Vascular tumor

  6. THE HEART DISEASES • Ischemic heart disease • Rheumatic heart disease • Infective heart disease • Virus myocarditis • Cardiomyopathy • Pericarditis

  7. Incidence and Mortality In the city • Brain vascular disease 93.7/106 17.7% 2 • Heart disease 90.7/106 17.1% 3 In the country • Brain vascular disease 105.5/106 2o.4% 2 • Heart disease 71.8/106 13.9% 4 Ministry of Health,China,2008

  8. NORMAL VESSELS artery veinlymphatics

  9. NORMAL ARTERY Large(elastic) arteryMedium-sized(muscular)arterySmall artery and arteriole

  10. Normal Aorta

  11. Elastic and muscular artery--------ATH • Small artery and arteriole---------- Hypertension

  12. vein and its valves

  13. Capillary Arteriole venule

  14. Vascular abnormalities • Narrowing or obstructing the lumen • Dilation or rupture of the wall

  15. Atherosclerosis

  16. Arteriosclerosis “hardening of the arteries” • Atherosclerosis-------most common • Arteriolosclerosis-----hypertension and diabetes mellitus • Medial calcific sclerosis-----rare

  17. DEFINITION Atherosclerosis is a degenerative disease of large and medium-sized arteries characterized by lipid deposition and fibrosis

  18. Affects the large and medium-sized arteries It is a chronic inflammatory response of the arterial wall initiated by injury to the endothelium Lesions comprise fatty streaks, fibrous plaque, atheromatous plaque and complicated lesions Major cause of organ ischaemia

  19. BASIC PATHOLOGIC CHANGES fatty streaks fibrous plaque Atheromatous plaque (atheroma)

  20. Fatty Streaks

  21. Gross view 1. elongated Yellow streaks on the intima 2. Lesions tend to be much more prominent around the origins of major branches

  22. Histological feature 1.Intimal thickening 2.Foamy cells accumulation

  23. Fatty streak

  24. Fatty Streaks The precursor lesion for atheromas? The relationship is uncertain !

  25. Fibrous Plaque

  26. Gross view 1.Plaques along the vessel length 2.gray fibrous cap can be seen

  27. Fibrous plaque

  28. Histological feature 1.Fibrous cap 2.foamy cells, Smooth muscle cells and fibrous tissue inflammatory cells can be seen 3.The structures of media are basically complete

  29. Atheromatous Plaque

  30. Gross view 1.Raised focal lesions with a soft, yellow grumous core of lipid and covered by a firm,gray fibrous cap. 2.Complications often can be seen

  31. Atheromatous Plaque

  32. Histological feature 1.A thick and hyalined fibrous cap. 2.Amorphous pink-staining core with blank fissure in it. 3.Granulation tissue, some foamy cell and lymphocytes can be seen by the border 4.The internal elastic lamina is destroyed and the media of the artery becomes thinner.

  33. Cholesterol clefts

  34. Cholesterol fissure

  35. inflammation calcification neovascularization

  36. Masson’s trichrome stain

  37. elastic fiber stain

  38. Eccentric thickening

  39. Cross section of coronary artery

  40. Mild,moderate and severe atherosclerosis

  41. Mild,moderate and severe ATH

  42. COMPLICATIONS Rupture and ulceration Hemorrhage Thrombosis Aneurysm calcification

  43. Rupture and ulceration

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