What is the pathophysiology of atherosclerosis?

Atherosclerosis is the pathologic process of lipid accumulation, scarring, and inflammation in the vascular wall, particularly the subendothelial (intimal) space of arteries, leading to vascular wall thickening, luminal stenosis, calcification, and in some cases thrombosis.

What is the first step in the pathophysiology of atherosclerosis?

The atherosclerotic process is characterized, in its earliest stages, by perturbations in endothelial function. Atherosclerosis is likely initiated when endothelial cells over-express adhesion molecules in response to turbulent flow in the setting of an unfavorable serum lipid profile.

How atherosclerosis develops steps?

Atherogenesis can be divided into five key steps, which are 1) endothelial dysfunction, 2) formation of lipid layer or fatty streak within the intima, 3) migration of leukocytes and smooth muscle cells into the vessel wall, 4) foam cell formation and 5) degradation of extracellular matrix.

What is the pathophysiology of coronary artery disease?

Coronary artery disease is caused by plaque buildup in the wall of the arteries that supply blood to the heart (called coronary arteries). Plaque is made up of cholesterol deposits. Plaque buildup causes the inside of the arteries to narrow over time. This process is called atherosclerosis.

What is pathophysiology of angina?

Angina is caused by reduced blood flow to your heart muscle. Your blood carries oxygen, which your heart muscle needs to survive. When your heart muscle isn’t getting enough oxygen, it causes a condition called ischemia. The most common cause of reduced blood flow to your heart muscle is coronary artery disease (CAD).

What is the initiating event in atherosclerosis?

Because of differences in blood flow dynamics, there are preferred sites of lesion formation within the arteries. Fatty streaks are not clinically significant, but they are the precursors of more advanced lesions characterized by the accumulation of lipid-rich necrotic debris and smooth muscle cells (SMCs).

Where does atherosclerosis involvement begin?

Atherosclerosis occurs in elastic and muscular arteries and may occur iatrogenically in vein grafts interposed in the arterial circulation. The aorta is affected earliest, followed by the carotid arteries, coronary arteries, and iliofemoral arteries.

What are the three main forms of arteriosclerosis?

The three main types of arteriosclerosis include:

Atherosclerosis: In this type, the large arteries are hardened and narrowed.
Moenckeberg medial calcific sclerosis: The hardening of small to medium-sized arteries.
Arteriolosclerosis: The calcification of small arteries.

What are 8 risk factors of CAD?

Risk factors for coronary artery disease include: