Atherosclerosis is a common form of arterial disease in which lipid deposition forms a plaque Plaque Primary Skin Lesions in the blood vessel walls. Atherosclerosis is an incurable disease, for which there are clearly defined risk factors that often can be reduced through a change in lifestyle and behavior of the patient. Atherosclerosis manifests itself as vessel stenosis Stenosis Hypoplastic Left Heart Syndrome (HLHS) and a source of thromboembolic disease. The clinical manifestations depend on the specific vessels affected and include most notably coronary artery Coronary Artery Truncus Arteriosus disease, carotid disease, and peripheral vascular disease. Atherosclerosis is the most common primary disease of the arterial vascular system and is responsible for coronary heart disease Coronary heart disease Coronary heart disease (CHD), or ischemic heart disease, describes a situation in which an inadequate supply of blood to the myocardium exists due to a stenosis of the coronary arteries, typically from atherosclerosis. Coronary Heart Disease, the leading cause of death worldwide.
Last updated: 21 Jun, 2022
Atherosclerosis is a common form of arterial disease in which lipid deposition forms a plaque Plaque Primary Skin Lesions in the blood vessel walls.
Pathogenesis of atherosclerosis:
1) Activation of endothelial cells by oxidized LDLs
2) Expression of leukocyte
adhesion
Adhesion
The process whereby platelets adhere to something other than platelets, e.g., collagen; basement membrane; microfibrils; or other ‘foreign’ surfaces.
Coagulation Studies molecules and consequent monocyte
adhesion
Adhesion
The process whereby platelets adhere to something other than platelets, e.g., collagen; basement membrane; microfibrils; or other ‘foreign’ surfaces.
Coagulation Studies
3) Monocyte
transmigration
Transmigration
Leukocyte Adhesion Deficiency Type 1 into the intima
4) Differentiation of
monocytes
Monocytes
Large, phagocytic mononuclear leukocytes produced in the vertebrate bone marrow and released into the blood; contain a large, oval or somewhat indented nucleus surrounded by voluminous cytoplasm and numerous organelles.
Innate Immunity: Phagocytes and Antigen Presentation into
macrophages
Macrophages
The relatively long-lived phagocytic cell of mammalian tissues that are derived from blood monocytes. Main types are peritoneal macrophages; alveolar macrophages; histiocytes; kupffer cells of the liver; and osteoclasts. They may further differentiate within chronic inflammatory lesions to epithelioid cells or may fuse to form foreign body giant cells or langhans giant cells.
Innate Immunity: Phagocytes and Antigen Presentation
5)
Plaque
Plaque
Primary Skin Lesions formation by joining of the T
lymphocytes
Lymphocytes
Lymphocytes are heterogeneous WBCs involved in immune response. Lymphocytes develop from the bone marrow, starting from hematopoietic stem cells (HSCs) and progressing to common lymphoid progenitors (CLPs). B and T lymphocytes and natural killer (NK) cells arise from the lineage.
Lymphocytes: Histology and
macrophages
Macrophages
The relatively long-lived phagocytic cell of mammalian tissues that are derived from blood monocytes. Main types are peritoneal macrophages; alveolar macrophages; histiocytes; kupffer cells of the liver; and osteoclasts. They may further differentiate within chronic inflammatory lesions to epithelioid cells or may fuse to form foreign body giant cells or langhans giant cells.
Innate Immunity: Phagocytes and Antigen Presentation
6) Formation of lipid-rich foam cells
7) Migration and replication of vascular smooth muscle cells
8) Accumulation of smooth muscle cells in the
plaque
Plaque
Primary Skin Lesions, forming a fibroproliferative lesion
9, 10) Death of foam cells and formation of necrotic core
VCAM-1: vascular cell
adhesion
Adhesion
The process whereby platelets adhere to something other than platelets, e.g., collagen; basement membrane; microfibrils; or other ‘foreign’ surfaces.
Coagulation Studies protein 1
M-CSF
M-CSF
A mononuclear phagocyte colony-stimulating factor (M-CSF) synthesized by mesenchymal cells. The compound stimulates the survival, proliferation, and differentiation of hematopoietic cells of the monocyte-macrophage series. M-CSF is a disulfide-bonded glycoprotein dimer with a mw of 70 kda. It binds to a specific high affinity receptor.
White Myeloid Cells: Histology:
macrophage colony-stimulating factor
Macrophage colony-stimulating factor
A mononuclear phagocyte colony-stimulating factor (M-CSF) synthesized by mesenchymal cells. The compound stimulates the survival, proliferation, and differentiation of hematopoietic cells of the monocyte-macrophage series. M-CSF is a disulfide-bonded glycoprotein dimer with a mw of 70 kda. It binds to a specific high affinity receptor.
White Myeloid Cells: Histology
Composition of the atherosclerotic plaque Plaque Primary Skin Lesions
Image: “Neovascularization of coronary tunica intima Tunica intima The innermost layer of an artery or vein, made up of one layer of endothelial cells and supported by an internal elastic lamina. Arteries: Histology (DIT) is the cause of coronary atherosclerosis. Lipoproteins Lipoproteins Lipid-protein complexes involved in the transportation and metabolism of lipids in the body. They are spherical particles consisting of a hydrophobic core of triglycerides and cholesterol esters surrounded by a layer of hydrophilic free cholesterol; phospholipids; and apolipoproteins. Lipoproteins are classified by their varying buoyant density and sizes. Lipid Metabolism invade coronary intima via neovascularization from adventitial vasa vasorum Vasa vasorum Nutrient blood vessels which supply the walls of large arteries or veins. Arteries: Histology, but not from the arterial lumen: a hypothesis Hypothesis A hypothesis is a preliminary answer to a research question (i.e., a “guess” about what the results will be). There are 2 types of hypotheses: the null hypothesis and the alternative hypothesis. Statistical Tests and Data Representation” by Subbotin, VM/ Encyclopeadia Britannica. License: CC BY 2.0Atherosclerosis grade 1:
This mild form of atherosclerosis is caused by
connective tissue
Connective tissue
Connective tissues originate from embryonic mesenchyme and are present throughout the body except inside the brain and spinal cord. The main function of connective tissues is to provide structural support to organs. Connective tissues consist of cells and an extracellular matrix.
Connective Tissue: Histology proliferation in the
tunica intima
Tunica intima
The innermost layer of an artery or vein, made up of one layer of endothelial cells and supported by an internal elastic lamina.
Arteries: Histology, also known as intimal
fibrosis
Fibrosis
Any pathological condition where fibrous connective tissue invades any organ, usually as a consequence of inflammation or other injury.
Bronchiolitis Obliterans.
Toe gangrene Gangrene Death and putrefaction of tissue usually due to a loss of blood supply. Small Bowel Obstruction secondary to peripheral arterial disease of lower extremities
Image: “Education in wound care: Curricula for doctors and nurses, and experiences from the German wound healing Wound healing Wound healing is a physiological process involving tissue repair in response to injury. It involves a complex interaction of various cell types, cytokines, and inflammatory mediators. Wound healing stages include hemostasis, inflammation, granulation, and remodeling. Wound Healing society ICW” by Military Medical Research Research Critical and exhaustive investigation or experimentation, having for its aim the discovery of new facts and their correct interpretation, the revision of accepted conclusions, theories, or laws in the light of newly discovered facts, or the practical application of such new or revised conclusions, theories, or laws. Conflict of Interest. License: CC BY 4.0, cropped by Lecturio.History:
Physical exam:
Laboratory tests:
Electrocardiography Electrocardiography Recording of the moment-to-moment electromotive forces of the heart as projected onto various sites on the body’s surface, delineated as a scalar function of time. The recording is monitored by a tracing on slow moving chart paper or by observing it on a cardioscope, which is a cathode ray tube display. Electrocardiogram (ECG) (for findings of cardiac ischemia Ischemia A hypoperfusion of the blood through an organ or tissue caused by a pathologic constriction or obstruction of its blood vessels, or an absence of blood circulation. Ischemic Cell Damage):
Vessel imaging:
Angiogram of internal carotid artery Internal carotid artery Branch of the common carotid artery which supplies the anterior part of the brain, the eye and its appendages, the forehead and nose. Carotid Arterial System: Anatomy stenosis Stenosis Hypoplastic Left Heart Syndrome (HLHS) (arrow)
Image: “Review: Interventional radiology Interventional radiology Subspecialty of radiology that combines organ system radiography, catheter techniques and sectional imaging. Penetrating Abdominal Injury in peripheral vascular disease” by Imaging. License: CC BY 2.0, cropped by Lecturio.The following diseases are consequences of atherosclerosis: