ATHEROSCLEROSIS:

The etiology of atherosclerosis is unknown (Ladich, 2010). There are multiple factors that contribute to atherosclerotic plaque progression, these include genetic and acquired factors, other process like coagulation, inflammation, lipid metabolism, intimal injury, and smooth muscle cell proliferation are involve in atherosclerosis formation.

The vascular endothelium may be damaged by various factors lake hyperlipidemia, smoking, and hypertension.

The oxidation of LDL cholesterol cause endothelial damage, it can lead to monocytes and lipid infiltration into subendothelium, known as fatty streak; the release of growth factor (platelet derived growth factor and transforming growth factor β) leading to smooth muscle cell proliferation into intima forming proliferative plaque and subsequent development of foam cell and complex atheroma with calcification and ischemia of the intima (Le & Yeh, 2012).

Atherosclerosis preferably affects the branching point of arteries or areas of turbulent blood flow including abdominal aorta, proximal coronary arteries, popliteal arteries, carotid arteries, renal arteries, and arteries of circle of Willis.

Atherosclerosis can express as angina, claudication, or may present as an asymptomatic process.

Other manifestation of arteriosclerosis (Le, Bhushan, Tolles, & Hofmann, 2011) includes:

         Calcification of the arteries, especially located in radial and/or ulnar arteries, known as Mönckeberg’s arteriosclerosis; usually benign process without obstruction blood flow, and not involved of the intima.

Hyaline thickening of small arteries in essential hypertension or diabetes mellitus named Arteriolosclerosis.

Bibliography

Ladich, E. R. (2010, Aug 24). Medscape.com. Retrieved April 26, 2012, from Atherosclerosis pathology: http://emedicine.medscape.com/article/1612610-overview#aw2aab6b4

Le, T., & Yeh, J. S. (2012). First AID cases for the USMLE step 1. usa: McGraw Hill.

Le, T., Bhushan, V., Tolles, J., & Hofmann, J. (2011). Fisrt AID for the USMLE step 1. usa: McGraw Hill.