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.
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