Atherosclerosis: risk factors, complications

Big picture

Atherosclerosis is a chronic inflammatory disease of large and medium-sized arteries in which lipids, inflammatory cells, smooth muscle cells, and fibrous tissue accumulate in the arterial intima, forming plaques.

For the final exam, think of atherosclerosis as:

Endothelial injury + LDL entry/oxidation
        ↓
Inflammation + foam cells
        ↓
Fatty streak
        ↓
Fibrous atheromatous plaque
        ↓
Stable stenosis OR plaque rupture
        ↓
Ischemia, thrombosis, infarction, aneurysm, embolism

The examiner mainly wants you to know:

1. Risk factors, especially high LDL cholesterol.
2. Pathomechanism of plaque formation and rupture.
3. Major complications by vascular territory: myocardial infarction, stroke, peripheral arterial disease, aneurysm, gangrene.
4. Prevention logic: stop smoking, lower LDL, treat hypertension, diabetes, obesity, and metabolic syndrome.

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