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Query: UMLS:C0004153 (atherosclerosis)
 77,401 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Some features of the aortic intima were examined with the scanning electron microscope (SEM) and found to contribute to the etiology of dissecting aneurysm. The endothelium over intimal plaques was not as pendulous as endothelium surrounding plaques. The pendulous appearance of aortic endothelial cells could be associated with the contractile nature of these cells. Some undescribable factor, which has been termed stress or atherosclerosis, seemed to reduce the contractile nature of endothelial cells on the plaque areas. Analyses with SEM revealed a probable cause of a dissecting aneurysm. The effect of pulsating blood pressure on an inelastic endothelium could create a separation between endothelial cells and the fluid pressure of blood could then separate the tissue until the vessel ruptured into the body cavity or back into the aorta. Because all abdominal aortic segments examined had atherosclerosis, it was not possible to show the amount of intimal alteration between normal and atherosclerotic aortas. Each blood pressure line showed a similar change which was 4.52 and 4.95% for the high and low blood pressure lines, respectively. There were no demonstrable correlations in this study between either high or low blood pressure lines of turkeys and atherosclerosis.
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PMID:A comparison between aortic lumen surfaces of hypertensive and hypotensive turkeys. 51 58

We report two cases of an unusual cause of the acute onset of hypertension, a spontaneous dissecting aneurysm localized to the renal artery. Also reviewed are 16 reported cases from the literature. The mean age of the 18 patients was 52 years. The majority of these patients were males (78%). Hypertension was a presenting sign in 14 (78%), but was not usually a pre-existing feature. Loin pain, often severe, occurred in eleven patients (61%), whereas gross hematuria was recorded only in two (11%). The right renal artery was involved in ten cases (55%), the left in three (17%), and both in five cases (28%). Atherosclerosis of the renal arteries and the aorta was absent in 69%, and mild in 23%. There has been no report of renal artery rupture; however, vascular occlusion occurs frequently. Medical and surgical approaches to the management of this phenomenon have been reported and are reviewed.
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PMID:Isolated dissecting aneurysm of the renal artery. 65 17

A six year old girl complained of sudden severe headache, became hemiplegic and unconscious. A right carotid arteriogram revealed an obstruction of the right anterior cerebral artery and many sulvian branches. Death occurred four days later. At autopsy, a recent softening of nearly all the right middle cerebral arterial territory was found. Thrombus filled the sylvian artery and its main branches. Histologic examination of the vessel walls showed a dissecting infiltration of blood between the internal elastic lamina and the media. This particular form of dissecting aneurysm, occurring in young subjects, in the absence of atherosclerosis, high blood pressure and idiopathic medial necrosis, represents a distinct medial necrosis, represents a distinct nosologic entity that has been called "Obstructive parietal hemodissection of intracranial vessels." The pathogenesis of the disease is unknown: trauma has been mentioned, also congenital defects in the elastic lamina or other morphologic abnormalities of that lamina.
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PMID:[Obstructive parietal hemodissection of the intracranial vessels, a particular form of dissecting aneurysm]. 83 66

Thirty-two cases of fibrous-muscular dysplasial of renal arteries (including one autopsy case) were studied. Sections of renal arteries removed at reconstructive operations from patients suffering from renovascular hypertension were examined. Two morphological variants of the process were distinguished: medial dysplasia (perimedial fibroplasia, medial fibroplasia, and dissecting aneurysm) and intimal proliferation. Morphologically, fibrous-muscular dysplasia is a manifestation of proliferation of smooth muscle cell which appears to have various forms and stages. Diagnostically, fibrous-muscular dysplasia should be differentiated from atherosclerosis, nonspecific arteritis, proliferation of the intima due to hypovolemia, and perivascular sclerosis of different etiologies.
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PMID:[Fibromuscular dysplasia of the renal arteries]. 90 Dec 51

The clinical, roentgenologic and laboratory findings in 124 patients with dissecting aneurysm of the aorta are reported. In 53 patients the dissection occurred in the ascending aorta ("proximal" dissection), and in 71 patients the site of origin was the descending thoracic aorta ("distal" dissection). Certain distinct clinical differences between the groups were apparent. Although hypertension was an important predisposing factor, it was significantly more common in distal dissection, as was atherosclerosis. Back pain and hypertension on hospital presentation characterized patients with distal dissection. Conversely patients with proximal dissection were younger and had a significantly higher incidence of Marfan's syndrome, cystic medial necrosis, anterior chest pain, pulse deficits, neurologic compromise, aortic insufficiency and congestive heart failure. In both groups, syncope appeared to correlate well with the occurrence of cardiac tamponade. Chest roentgenograms almost always showed an abnormal aortic contour. Aortic angiography, when performed, was usually confirmatory of the diagnosis.
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PMID:The clinical recognition of dissecting aortic aneurysm. 102 Jul 50

Fatal haemopericardium in a 27 year old pregnant woman was caused by rupture of a dissecting aneurysm of the pulmonary artery. She had an uncorrected patent ductus arteriosus and severe pulmonary hypertension. The wall of the pulmonary artery showed atherosclerosis and cystic medionecrosis.
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PMID:Pulmonary artery rupture in pregnancy complicating patent ductus arteriosus. 146 58

Cardiovascular disease, the major cause of death in the elderly, is mostly ascribable to complications of coronary atherosclerosis: angina pectoris, myocardial infarction, and sudden death. However, other degenerative diseases involving several cardiac structures exist, and should be distinguished from age-related cardiac changes. Extensive dystrophic calcification determines aortic stenosis, and may affect either a normally tricuspid or a congenitally bicuspid valve. Surgical valve replacement is now a low risk option, even in elderly persons, whereas the efficacy of balloon valvuloplasty is questionable. Aortic incompetence in adults and aged persons is mostly the consequence of aortic tunica media atrophy with anular ectasia, in the setting of nearly normal aortic leaflets. Mitral valve prolapse is the main cause of mitral incompetence; spontaneous cordal rupture is a late complication in the natural history of this disease, thus warranting prompt surgical valve repair or replacement. The entire spectrum of cardiomyopathies is observed in the elderly: dilated, hypertrophic, restrictive, arrhythmogenic. Cardiac amyloidosis is by far the most frequent secondary form and leads to congestive heart failure by impairing ventricular compliance. Idiopathic fibrosis of the specialized AV junction or dystrophic calcification of central fibrous body are the usual substrates of AV block, which requires pace-maker implantation. Nonrheumatic atrial fibrillation, due to fibro-fatty degeneration of the atrial musculature or dilated left atrium, carries a high risk of thromboembolic complications and cerebral accidents; oral anticoagulants have proven to be effective in preventing stroke. Aortic dissecting aneurysm is a spontaneous laceration, and usually a complication of longstanding systemic hypertension; exceptionally, spontaneous dissection may primarily occur in the coronary arteries. In conclusion, longevity at present is mostly threatened by cardiovascular disease, among which the role of degenerative, non-atherosclerotic disorders may be greater than thought.
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PMID:Degenerative, non-atherosclerotic cardiovascular disease in the elderly: a clinico-pathological survey. 209 63

One hundred eleven autopsy cases of dissecting aneurysm were collected from western Japan. The ratio of males to females was 3:2 and the sixth and seventh decades of life were most frequently affected. All 11 cases of Marfan's syndrome were in patients under 40 years of age. DeBakey's type III dissections showed a male predilection and more severe atherosclerosis than in control cases. Many patients with types I and II dissections died of hemorrhage in the acute phase, while many patients with type III dissection died in the subacute or chronic phase, and half of the patients died of diseases other than hemorrhage. Hypertension was recognized in 73.7% of the 95 cases which showed no other obvious risk factors. Histologic examinations suggested that cystic medial necrosis was related to the pathogenesis of the disease in Marfan's syndrome, but was not so apparent in non-Marfan's syndrome. Laminar medial necrosis was found in many cases, but was considered to be a secondary ischemic change following dissection, as supported by other investigators. There were only a few cases in which dissection seemed to be directly caused by atherosclerosis.
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PMID:Dissecting aneurysm: a clinicopathologic and histopathologic study of 111 autopsied cases. 231 7

We report 133 cases of strokes in patients aged 9-45 (male: 68, female: 65), mean age: 33.5 years. There were 112 arterial infarcts (84%), 9 venous infarcts (7%), 12 hemorrhages (9%). Among the arterial infarcts, 23 (20.5%) were due to a dissecting aneurysm, 17 (15%) to atherosclerosis, 13 (12%) to cardiac embolism. Echocardiography with contrast was performed in 69 patients showing a patent foramen ovale in 15. Mitral valve prolapse was present in 8, among which 5 had in addition a patent foramen ovale. Among 16 migrainous patients there were 7 dissecting aneurysms and 3 patent foramen ovale. Twenty two of 65 women were taking oral contraceptives at the time of the stroke. Strokes in patients taking oral contraceptives or during the puerperium accounted for 43% of the strokes in women. Ten cases (9%) have had no explanation. Venous infarctions were mainly due to puerperium and oral contraceptives. Hemorrhages were mainly due to arterial hypertension. No cause was found in 4/12 cases. The most useful investigations were angiography and echocardiography with contrast. This study confirms that extensive and early investigations are necessary in strokes in the young and particularly in women taking oral contraceptives, migraine patients and patients with mitral valve prolapse.
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PMID:[Cerebral vascular accidents in young subjects. A study of 133 patients 9 to 45 years of age]. 279 9

The interest evoked by the Broad Breasted White Turkey (BBWT) as an animal model for studying the cardiovascular damages produced by hypertension and catecholamines is mainly due to the fact that hypertension is spontaneous and tissue and circulating catecholamines, especially norepinephrine, are extremely high. In this paper we focused our attention on three characteristic pathophysiological features displayed by these animals which are strictly related, as well as in humans, to the elevated blood pressure values and to catecholamine action. We also described the possibility of modifying the development of some of these lesions with pharmacological interventions liable to antagonize the peripheral effects of norepinephrine and epinephrine. The dissecting aneurysm of the aorta accounts for 5-10% of sudden deaths in this animal strain. It can be prevented by lowering blood pressure, especially with beta-blockers, and facilitated by MAO-inhibitors. The degree of cardiac hypertrophy is remarkably high and unexpectedly characterized by the synthesis of a "fast" V1-like isomyosin with high Ca++ activated ATPase activity, oxygen consumption and speed of muscle shortening. Neither the reduction of the degree of cardiac hypertrophy, nor treatment with labetalol alone were able to modify this peculiar pattern. In spite of having very high levels of high-density-lipoproteins, which are known to be protective against atherosclerosis, this animal develops a severe atheromatous disease especially in the abdominal aorta, where the cellular growth has also been proven to be in vitro more pronounced than in the thoracic tract. Treatment with beta-blockers reduced the severity and extent of the lesion even in absence of a significant reduction in blood pressure.
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PMID:Catecholamine-induced cardiovascular disease in the spontaneously hypertensive and atherosclerotic turkey. 304 59


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