DR : RAMY AHMED SAMY M.D. INTERNAL MEDICINE DEPARTMENT BANHA UNIVERSITY

 Defenition  Pathogenesis  Aetiology and risk factors  Clinical picture  Diagnosis  Treatment

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.

Atheroma or plaque formation

Eccentric coronary stenosis

Risk Factors Uncontrollable Sex Hereditary Age Controllable High blood pressure High blood cholesterol Smoking Physical inactivity Obesity Diabetes Stress and anger

CLINICAL PRESENTATION  Cerebrovascular disease.  Coronary artery disease.  Peripheral vascular disease

CORNEAL ARCUS

XANTHELASMA

SCREENING FOR ATHEROSCLEROSIS LIPID PROFILE BLOOD SUGAR ECG STRESS ECG ECHO NUCLEAR STUDIES CORONARY ANGIOGRAPHY DUPPLER STUDY ON LARGE ARTERIES

General treatment options  Lifestyle/risk factor modification,  Exercise rehabilitation programs,  Pharmacologic therapy,  Interventional procedures,  Surgical revascularization.

 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

 Pharmacologic therapy:  Lipid lowering agents  Antihypertensives  Tight control of diabetes,  Antiplatelet agents (aspirin or clopidogrel).

 Interventional procedures:  Angioplasty, or Endovascular stenting  Surgical revascularization:  Bypass