Atherosclerosis. Etiology, pathogenesis and general characteristics of atherosclerotic vessel alterations.
Arteriosclerosis is the hardening of arteries, there are three types:
- Arteriolosclerosis (affects small arteries and arterioles, may be hyaline or hyperplastic form)
- Monckeberg medial sclerosis (calcific deposits in muscular arteries
- Atherosclerosis (hardening of artery - most medically important)
Remember: Mönckeberg medial sclerosis calcifies the media of muscular arteries, usually after age 50; it does not narrow the lumen and is often clinically insignificant. Atherosclerosis is a disease of the intima and narrows the lumen.
Atherosclerosis
Defined by the presence of intima lesions known as atheromas (or atherosclerotic plaques). These plaques contain a soft lipid core (mainly cholesterol with necrotic debris) covered with a fibrous cap. These plaques obstruct the lumen, increase risk of rupture and weaken underlying media (can cause aneurysm).
Etiology
- Non-modifiable risk factors
- Age (40-60)
- Sex (male)
- Genetics
- Modifiable risk factors
- Hyperlipidemia
- Hypertension
- Smoking
- Diabetes mellitus
- Other factors that may play a role include stress, metabolic syndrome, and presence of inflammatory cells in vessels