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DR : RAMY AHMED SAMY M.D. INTERNAL MEDICINE DEPARTMENT BANHA UNIVERSITY
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Defenition Pathogenesis Aetiology and risk factors Clinical picture Diagnosis Treatment
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Defenition Chronic, progressive, multifocal disease of the vessel wall intima within large elastic arteries and large/medium sized muscular arteries Atherosclerosis is characterized by the deposition of lipid, inflammatory cells, cellular debris, calcium, extracellular matrix, and fibrin within the intima of the arterial wall.
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Atheroma or plaque formation
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Eccentric coronary stenosis
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Risk Factors Uncontrollable Sex Hereditary Age Controllable High blood pressure High blood cholesterol Smoking Physical inactivity Obesity Diabetes Stress and anger
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CLINICAL PRESENTATION Cerebrovascular disease. Coronary artery disease. Peripheral vascular disease
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CORNEAL ARCUS
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XANTHELASMA
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SCREENING FOR ATHEROSCLEROSIS LIPID PROFILE BLOOD SUGAR ECG STRESS ECG ECHO NUCLEAR STUDIES CORONARY ANGIOGRAPHY DUPPLER STUDY ON LARGE ARTERIES
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General treatment options Lifestyle/risk factor modification, Exercise rehabilitation programs, Pharmacologic therapy, Interventional procedures, Surgical revascularization.
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Risk factor modification: smoking cessation, exercise, diet Exercise rehabilitation programs: minimum of 30 minutes three times per week is useful in patients with intermittent claudication
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Pharmacologic therapy: Lipid lowering agents Antihypertensives Tight control of diabetes, Antiplatelet agents (aspirin or clopidogrel).
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Interventional procedures: Angioplasty, or Endovascular stenting Surgical revascularization: Bypass
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