Atherosclerosis: Pathogenesis

1- Endothelial injury due to risk factors or trauma 2- LDLs accumulate & aggregate, entering tunica intima 3- Macrophages oxidise LDLs via free radicals 4- Oxidised LDLs stimulate further leukocyte recruitment via chemoattractants releases by endothelial & SM cells 5- Monocytes engulf LDLs; accumulation of lipids and fatty streak development; cause cytotoxic damage to endothelial cells and cause dysfunction 6-Intimal smooth muscle proliferation &↑leukocyte recruitment result in atherosclerotic plaque formation 7- If plaque reaches coronary arteries, it can keep growing and cause stenosis OR rupture off; thrombosis/ embolism OR cause aneurysm by wall damage 8- ↓ O2 supply to myocardium, cellular acidosis and lactate release; in time it can cause ischemia and is called IHD