Coronary Atherosclerotic

Heart Disease

DR.LIU LIXIN
Atherosclerosis
 Atherosclerosis is a syndrome
affecting arterial blood vessels. It
is a chronic inflammatory response
in the walls of arteries . It is
commonly referred to as a
hardening or furring of the
arteries. It is caused by the
formation of multiple plaques
within the arteries
Risk Factors for
Atherosclerosis
 Age:
 Male > 45 years
 Female > 55 years or premature
menopause without estrogen replacement
therapy
 Family History of premature
disease
 Male first-degree relative <55 years
 Female first-degree relative < 65 years
Risk Factors for
Atherosclerosis
 Hypertension
 Appears to weaken the artery
wall at points of high pressure
leading to injury and invasion of
cholesterol.
 Cigarette Smoking
 #1 cause of preventable death in
US
 1 in 5 CHD deaths attributable to
Risk Factors for
Atherosclerosis
 Diabetes
 50% of deaths related to
DM is due to CHD
Risk Factors for
Atherosclerosis
 Inactivity
 Sedentary person has 2x
risk for developing CHD as
a person who is active.
Risk Factors for
Atherosclerosis
 Obesity
Risk Factors for
Atherosclerosis
 Abnormal Blood Lipids
 LDL Cholesterol (low density
lipoprotein)

 HDL Cholesterol (high density

lipoprotein)
 Risk Factors
Uncontrollable Controllable

•Sex •High blood pressure

•High blood
•Hereditary
cholesterol
•Race •Smoking
•Age •Physical activity
•Obesity
•Diabetes
•Stress and anger
 Atherosclerosis

 Plaque is made up of
fat, cholesterol, calcium,
and other substances
found in the blood. 
Over time, plaque
hardens and narrows
your arteries.  The flow
of oxygen-rich blood to
your organs and other
parts of your body is
reduced.  This can lead
to serious problems,
including heart attack,
stroke, or even death.
 Plaque (the
build-up of
lipid/cholester
ol) in the
artery wall
forms as a
response to
injury to the
endothelium
in the artery
wall.
Plaque vulnerability
factors
Intrinsic factors
 Many people are able to manage
coronary artery disease with
lifestyle changes and medications.

 Other people with severe coronary

artery disease may need
angioplasty or surgery.
Treatment:

 Weight Loss
 Low cholesterol, low saturated
fat diet
 Increased physical activity
 Smoking cessation
 Management of Diabetes
 Restricted alcohol use
Medicine
 1. antiplatelet aggregation
Aspirin ,ticlopidine, clopidogrel, GPIIb/IIIa
receptor antagonist

2. regulate lipid
For hypercholesterolemia: Statins,
Cholestyramine, Colestipol, Nicotininc acid;
      For Hypertriglyceridema: Clofibrate.

3 .thrombolysis
streptokinase, urokinase
Angioplasty
Bypass surgery
•Get regular medical checkups.
•Control your blood pressure.
•Check your cholesterol.
•Don’t smoke.
•Exercise regularly.
•Maintain a healthy weight.
•Eat a heart-healthy diet.
•Manage stress.