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Pathophysiology of Atherosclerosis

  • Pathophysiology of Atherosclerosis is a chronic disease characterized by the accumulation of lipids, inflammatory cells, and fibrous elements in the large arteries.

Here's a brief overview of its pathophysiology:

1. Endothelial Injury:

  • Damage to the endothelial cells lining the arterial walls due to factors like hypertension, smoking, or high cholesterol levels.

2. Lipid Accumulation:

  • Low-density lipoprotein (LDL) particles infiltrate the damaged endothelium and accumulate in the intima, the inner layer of the artery.

3. Inflammatory Response:

  • The retained LDL undergoes oxidation, triggering an inflammatory response.

  • Monocytes adhere to the endothelium, migrate into the intima, and transform into macrophages.

4. Foam Cell Formation:

  • Macrophages engulf oxidized LDL, becoming foam cells.

  • These foam cells aggregate to form fatty streaks, the earliest visible form of atherosclerotic lesions.

5. Fibrous Plaque Formation:

  • Smooth muscle cells migrate from the media to the intima, proliferate, and produce extracellular matrix components, forming a fibrous cap over the lipid core.

6. Plaque Progression:

  • The plaque continues to grow, leading to a narrowing of the arterial lumen, reducing blood flow.

7. Plaque Rupture and Thrombosis:

  • Plaques may become unstable and rupture, exposing the underlying tissue to the bloodstream, which can result in thrombus (blood clot) formation.

  • This can further obstruct the artery or lead to embolism.


This process can lead to clinical manifestations such as coronary artery disease, stroke, and peripheral artery disease.

Key Risk Factors of Pathophysiology of Atherosclerosis

  1. Hyperlipidemia: High LDL, low HDL cholesterol.

  2. Hypertension: High blood pressure.

  3. Smoking: Contributes to oxidative stress and endothelial damage.

  4. Diabetes: Leads to endothelial dysfunction and inflammation.

  5. Obesity and Sedentary Lifestyle: Contribute to atherogenic profiles.

  6. Genetic Predisposition: Family history of atherosclerosis.

Understanding these processes helps in preventing and managing atherosclerosis effectively.


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