Mr. Joe Brown is a 60 year old Caucasian male who sought medical attention due to increasing problems with intermittent claudication and loss of color in the left leg. He was found to have absent pulses in the left foot even with Doppler studies. A femoral arteriogram showed complete occlusion of the femoral artery several inches above the left knee. Extensive collateral circulation could be seen and the dorsalis pedis artery was weakly outlined. Except for a history of tobacco smoking, no other risk factors were identified. No other atherosclerotic lesions were noted. A femoral popliteal bypass was recommended to restore circulation to the left foot.
1. Describe the process of atherosclerotic occlusion of a vessel.
2. What is the basis for the development of collateral circulation?
Mr. Charles Dow, a 43 year old, white business executive, was brought to the emergency room of a local hospital following successful resuscitation of collapse and ventricular fibrillation by advanced cardiac life support measures at his home. His wife indicated that he had in recent weeks complained of tightness in the chest following activity and eating. Mr. Dow is approximately 5’10” and weighs 265 pounds. He has a history of smoking one pack per day and is trying to quit. His serum cholesterol is 342 with an HDL of 38. He recently was laid off from his job. Lab data include a CPK of 1620. EKG reveals frequent PVCs and inverted T” wave.
1. What is the significance of the laboratory and EKG data in terms of time of disease onset?
2. What is the probable cause of the collapse and ventricular fibrillation suffered by the patient?
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