Dr

.Sh
raddh
aMi
shr
a’s
Ess
enceofPat
hol
ogynot
eson
Car
diov
asul
arpat
hol
ogypar
t-1

At
her
osc
ler
osi
s

1
. Cl
eftl
ikes
pac
esi
nat
her
omapl
aquei
sd/tc
hol
est
erol2016

2. Nec
rot
icc
oreofat
her
osc
ler
oti
cpl
aquec
ont
ains-
li
pidQ.

3. Foamc
ell
s(l
ipi
dladenmac
roph
age)i
nat
her
osc
ler
osi
s
201
4-1
5
c
ont
ainl
ipi
dint
hef
ormofox
idi
sedLDL.
201
5
4. Conv
expar
tofat
her
osc
ler
oti
cpl
aquei
sfor
medbyf
ibr
ousc
ap.

5
. Fi
brousc
apc
ont
ains–s
moot
hmus
clec
ellandi
nfl
ammat
oryc
ell
s.

6
.I nadvanceath
eros
clerot
icpl
aquesmoot
hmuscl
egoesapoptos
is(nothypert
roph)2014,
y
whic
hc ancaus
ethi
nningandrupt
ure.
Atthet
imeofrupt
ureofplaquef
ibrot
iccapisth i
n.

7. Nev
ers
eeni
nat
her
osc
ler
osi
s-l
ackofmac
roph
age/f
oamc
ell
s.

8. At
heros
cler
oti
cplaquefor mat
ioni
sduetoendothel
iali
nj y2015.
ur (ch
roni
cinf
lammat
ory
201
5
di
sor
derofvess
elwall duet oendot
hel
iuminj
ury)
201
4
9. I
nfec
tionsc
aus
esofat
her
osc
ler
osi
s–CMV,
myc
opl
asmapneumoni
ae.

1
0.Mci
nvol
vedar
ter
yinat
her
osc
ler
osi
s-abdomi
nalaor
ta

1
1.Mcc
oronar
yar
ter
yinv
olv
edi
nat
her
osc
ler
osi
slef
tant
eri
ordes
cendi
ngar
t y2015.
er
201
5
1
2.At
her
osc
ler
osi
saf
fec
thear
t(c
oronar
ybl
oodv
ess
els)
inear
lydi
seas
e.

1
3.Commons
ites–aor
ticbi
fur
cat
ion,
LADbr
anc
hofc
oronar
yar
ter
y,c
irc
leofWi
ll
is.

1
4.Ar
ter
iess
par
edf
romat
her
osc
ler
osi
s–mes
ent
eri
car
ter
ies2015,
upperex
tremi
tyar
ter
ies
.

1
5.Modif
iabl
eriskf
act
orsf
orath
eroscl
erosi
s-DM,
hyper
tens
ion,
hyper
lipi
demi
a,c
igar
ett
e
smoki
ng,i
nfl
ammati
on,phy
sic
alinact
ivi
ty

1
6.Nonmodi
fi
abl
eri
skf
act
orsf
orat
her
osc
ler
osi
s-f
ami
lyh
ist
ory2015,
agei
ng,
mal
egender
,

Fol
lowFac
ebookpag
e:“
Ess
enc
eofPat
hol
ogybyDrSh
raddh
aMi
shr
a”www.
fac
ebook.
com/dr
shr
addh
ami
shr
a.pat
hol
ogy
/

Subsc
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ideos:“
DrSh r
addhaMi sh
ra”
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ps:
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annel/UCKJ0kOFTjmu8E45
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 g
enet
icabnor
mal
it
y.

Monc
keber
gsmedi
alc
alc
ifi
csc
ler
osi
s

1
7.Medi
alc
alc
ifi
cat
ioni
sseeni
nMonc
keber
gss
cler
osi
s

1
8.Monc
keberg
smedi
alc
alc
ifi
cdeg
ener
ati
ondoes
n’tc
aus
evas
cul
arl
umennar
rowi
ng(h
enc
e
as
ymptomat
ic)
.

1
9.Tr
ueaboutMonckeber
gsmedialc
alc
ificscl
erosi
s-seeninol
dag
e,i
nvol
vemus
cul
ar
ar
ter
ies
,cal
cif
icati
oninmedi
aandinternalel
asti
clamina.
201
5
20.NOTt
rueaboutMMCSi
scal
cif
icat
ionc
aus
esi
gni
fi
cantnar
rowi
ngofv
ess
ell
umen.

Ar
ter
ios
cler
osi
s

21
.Ch ar
acter
isti
chist
opat
hol
ogi
calf
indi
ngi
nbeni
gnh
yper
tens
ioni
shy
ali
ne
ar
teri
olos
cleros
is.

22.Char
acter
ist
ichi
stopat
hol
ogi
calfi
ndi
nginmali
gnanth
ypert
ensi
oni
shy
per
plas
tic
ar
teri
oscl
erosi
s/f i
bri
noi
dnecr
osis/oni
onpeeli
ngofves
sel

23.h
yperplas
ticar
ter
ios
cler
osisiss
eenin-ki
dney(mc
),per
ipanc
reat
icf
at,
per
icar
dialf
at,
i
ntes
tine,GB.
(rar
e/notinv
olv
ed-hear
t)

24.Hy
ali
near
ter
ios
cler
osi
s-i
nti
malpr
oli
fer
ati
onandh
yal
ini
zat
ionofmedi
a.

25
.Conc
ent
rich
yper
troph
yofh
ear
tisa/ws
yst
emi
chy
per
tens
ion.

Fol
lowFac
ebookpag
e:“
Ess
enc
eofPat
hol
ogybyDrSh
raddh
aMi
shr
a”www.
fac
ebook.
com/dr
shr
addh
ami
shr
a.pat
hol
ogy
/

Subsc
ribeYoutubeCh annelforv
ideos:“
DrSh r
addhaMi sh
ra”
htt
ps:
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annel/UCKJ0kOFTjmu8E45
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 Aneur
ysm

26
.Mc
c(ov
eral
l)ofaneur
ysmi
sat
her
osc
ler
osi
s.

27.Mcs
iteofaneur
ysm-abdomi
nalaor
tabel
owr
enalar
ter
yandabov
ebi
fur
cat
ion.

28.Mc
cofas
cendi
ngaor
ticaneur
ysm–c
yst
icmedi
aldeg
ener
ati
on/s
yst
emi
chy
per
tens
ion

29.Mc
cofaor
ticar
chaneur
ysm–at
her
osc
ler
osi
s.

30.Mc
coft
hor
aci
caor
ticaneur
ysm-h
yper
tens
ion.

31
.Mc
cofabdomi
nalaor
ticaneur
ysm–at
her
osc
ler
osi
s.

32.Mc
cdes
cendi
ngaor
ticaneur
ysm–at
her
osc
ler
osi
s.

33.Sy
phi
li
ti
caneur
ysmmci
nvol
vepr
oxi
malas
cendi
ngaor
ta.
(es
pec
ial
lyaor
ticr
ing
)

34.Tr
eebar
kli
kec
alc
ifi
cat
ioni
sseeni
n–s
yph
ili
ti
caneur
ysm

t
reebar
kcal
cif
icat
ion–s
yph
ili
s

35
.Lueti
caneurys
m/s yphi
li
ticaneur
ysmcommonl
yinvolv
eascendi
ng>
ar
ch>
descendi
ng.
(abdominalaort
aisr
aresi
teofinvol
vement).

Fol
lowFac
ebookpag
e:“
Ess
enc
eofPat
hol
ogybyDrSh
raddh
aMi
shr
a”www.
fac
ebook.
com/dr
shr
addh
ami
shr
a.pat
hol
ogy
/

Subsc
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ideos:“
DrSh r
addhaMi sh
ra”
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annel/UCKJ0kOFTjmu8E45
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 36
.Mar
fans
yndr
omeaneur
ysmmci
nvol
ve-as
cendi
ngaor
ta

37.Mcs
iteoft
uber
cul
ousaneur
ysm–t
hor
aci
caor
ta

38.Mcsi
teoft
raumaticaneur
ysm-des
cendi
ngt
hor
aci
caor
taj
ustbel
owl
igament
um
ar
ter
ios
uminser
tion.

39.Mcs
iteofv
isc
eralaneur
ysm-s
pleni
c>h
epat
icar
ter
y.

40.Mc
cofps
eudoaneur
ysmi
str
auma.

41
.Mc
cofmy
cot
icaneur
ysm–s
almonel
la.

42.Notac
aus
eofaneur
ysm–Monc
keber
gss
cler
osi
s

43.Si
zeofaneur
ysm>
5.5c
misi
ndi
cat
ionf
ors
urg
ery
,ev
ent
houg
has
ympt
omat
ic.

44.Si
zeofaneur
ysm >7c
misa/w>25
%inc
reas
edi
nrupt
ure.

45
.Mcc
ompl
icat
ionFol
lowi
ngr
epai
rofaneur
ysmi
sMI
.

Aor
ticdi
ssec
tion

46
.Mcpr
edi
spos
ingf
act
orf
oraor
ticdi
ssec
tion-h
yper
tens
ion.

47.2ndmcpr
edi
spos
ingf
act
orf
oraor
ticdi
ssec
tion–c
yst
icmedi
alnec
ros
is.

48.Cy
sti
cmedi
alnec
ros
isi
sseeni
nMar
fans
yndr
ome,
Ehl
erDanl
oss
yndr
ome.

49.aor
ticdi
ssec
tioni
snots
eeni
n–s
econdar
ysy
phi
li
s(maybes
eeni
nter
tiar
ysy
phi
li
s)

5
0.I
naor
ticdi
ssec
tionbl
oodent
ersi
nmedi
a.

5
1.I
OCf orac
uteaort
icdiss
ecti
on–t
rans
esoph
agealec
hoc
ardi
ogr
aph
y.(ac
utedi
ssec
tion
meanspati
enti
sunstable.

5
2.I
OCf
orc
hroni
c/s
tabl
eaor
ticdi
ssec
tion–CTang
iog
raph
yorMRang
iog
raph
y.

5
3.Cl
ass
ifi
cat
ionofaor
ticdi
ssec
tiondependsuponl
evelofaor
tai
nvol
ved.

Fol
lowFac
ebookpag
e:“
Ess
enc
eofPat
hol
ogybyDrSh
raddh
aMi
shr
a”www.
fac
ebook.
com/dr
shr
addh
ami
shr
a.pat
hol
ogy
/

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DrSh r
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 Hear
tfai
lur
e

 Mc
cofr
igh
thear
tfai
lur
e–c
orpul
monal
e

 Mc
cofl
efth
ear
tfai
lur
e–c
oronar
yar
ter
ydi
seas
e.

 Mci
nvol
vedor
gani
nRHFi
sli
ver
.(nugmegl
ivers
een)

 Mci
nvol
vedor
gani
nLHFi
slung(h
ear
tfai
lur
ecel
lss
een)

 I
nnutmegl
iverdar
kar
eah
aveh
aemor
rhag
icnec
ros
isandl
igh
tzoneh
avef
ibr
osi
s.

 Hear
tfai
lur
ecel
lsar
eseeni
nlung,
andt
heyar
ehemos
ider
inpi
gmentl
adenmac
roph
ages
.

Nutmegl
iver Haemorrhag
e Dar
kandlig
htz
onei
nnut
surr
oundedby megli
ver
fi
brosi
s

Fol
lowFac
ebookpag
e:“
Ess
enc
eofPat
hol
ogybyDrSh
raddh
aMi
shr
a”www.
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ebook.
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shr
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ami
shr
a.pat
hol
ogy
/

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 Heartf
ail
urecel
l-br
own Hear
tfai
lur
ecel
ls–Pr
uss
ianbl
ues
tai
n
hemosi
deri
ninmacroph
ages

Tet
raph
eylt
etr
azol
iums
tai
nofh
ear
t/nec
rot
icar
eav
isual
isedaf
ter2-
3hsqofi
r sch
emi
a.

Nor
malh
ear
t Br
ickr
ed(d/tdeh
ydr
ogenas
eenz
yme)

I
nfar
cti
on pal
e/y
ell
owi
shz
one(uns
tai
ned)

Bl
ood/h
aemor
rhag
e/t
hrombus br
own

Sc
ar/ol
dheal
edMI Wh
ite

MISTAGES

Upt
o30mi
n Rev
ers
ibl
einj
uryq

40MI
N I
rrev
ers
ibl
einj
ury

½t
o4h
r LM-Wav
ines
soff
ibr
e(ear
lies
tli
ghtmi
cros
copi
cch
ang
e)

EM-mi
toc
hondr
ialamorph
ousf
loc
cul
entdens
iti
esand
sar
col
emmaldisr
upti
on

4-
12h
r Coag
ulat
ivenec
ros
isbeg
ins
q
Ti
ll1
2hr
snoc
hang
esi
ngr
ossappear
anc
e.

1
2-24h
r Neut
roph
ili
cinf
il
trat
ion,
myoc
yteeos
inoph
ili
a

1
-3day Yel
lowt
ani
nfac
t,br
iskneut
roph
ils

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e:“
Ess
enc
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ogybyDrSh
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 3-
7day
s Mac
roph
agesi
nfi
lt
rat
ion

7-
10day
s Ear
lyg
ranul
ati
ont
iss
ue

1
0-1
4day
s Wel
lst
abi
li
sedg
ranul
ati
ont
iss
ue,
col
lag
endepos
iti
on

2-
8weeks Col
lag
en

>
8week/2mont
h Dens
ecol
lag
en

I
nfac
tmodi
fi
cat
ionbyr
eper
fus
ion

Reper
fus
ioni
njur
y Ex
tradamag
eaf
terr
est
orat
ionofbl
oodf
low

 Mc
c–r
eac
tiv
eox
ygens
pec
ies/FRdamag
e

 Mci
onc
aus
ingr
eper
fus
ioni
njur
y–c
a++

Reper
fus
ioni
nfar
ct  Duet
oreper
fus
ioni
njur
y.

 Reper
fus
ioni
nfar
ctar
emch
aemor
rhag
ici
nfar
ct.

Hi
ber
nat
ion  St
ateofdec
reas
edmet
abol
ism

 Seeni
nch
roni
csubl
eth
ali
sch
emi
a.

Compl
icat
ionofMI

Ar
rhy
thmi
a  Mccofsuddenc
ardi
acdeat
hisar
ryt
hmi
a(mc
cofar
ryt
hmi
aismy
ocar
dial
i
schemi
a) .

 Mct
ypeofar
rhy
thmi
a<1
hrofMIi
svent
ric
ularf
ibr
ill
ati
on.

 Mct
ypeofar
rhy
thmi
a>1h
rofMIi
ssupr
avent
ric
ulart
ach
ycar
dia.

My
ocar
dial  Mct
ime-af
ter3-
7day
sofMI
r
upt
ure  Mcl
ocat
ion-ant
erol
ater
alwal
lofl
eftv
ent
ric
le(v
ent
ric
ularf
reewal
l)

 Leas
tcommonl
ocat
ion–papi
ll
arymus
cler
upt
ure

Per
icar
dit
is Pos
tMIper
icar
dit
isi
sk/aDr
ess
lers
yndr
ome–

 Mct
imeofDr
ess
lers
y ome-2ndt
ndr o3rddayofMI

 Et
iol
ogyDr
ess
lers
yndr
ome–aut
oimmuner
eac
tion

 Typeofperi
car
dit
isi
nDr
ess
lers
yndr
omei
sfi
bri
noh
aemor
rhag
ic
peri
cardi
ti
s

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enc
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Fol
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enc
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ogybyDrSh
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Fol
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enc
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ogybyDrSh
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