ATHEROSCLEROSIS

ATHEROSCLEROSIS IS A CHRONIC INFLAMMATORY AND HEALING

RESPONSE OF AN ARTERY TO ENDOTHELIAL INJURY
ATHEROSCLEROTIC LESIONS ARE COMPOSED OF THREE MAJOR
COMPONENTS:
THE FIRST IS THE CELLULAR COMPONENT COMPRISED
PREDOMINATELY OF SMOOTH MUSCLE CELLS AND
MACROPHAGES.
THE SECOND COMPONENT IS THE CONNECTIVE TISSUE MATRIX
AND EXTRACELLULAR LIPID.
THE THIRD COMPONENT IS INTRACELLULAR LIPID THAT
ACCUMULATES WITHIN MACROPHAGES, THEREBY CONVERTING
THEM INTO FOAM CELLS.
ATHEROSCLEROTIC LESIONS DEVELOP AS A RESULT OF
INFLAMMATORY STIMULI, SUBSEQUENT RELEASE OF VARIOUS
CYTOKINES, PROLIFERATION OF SMOOTH MUSCLE CELLS, SYNTHESIS
OF CONNECTIVE TISSUE MATRIX, AND ACCUMULATION OF
MACROPHAGES AND LIPID.
GROSSLY
ECCENTRIC, WHITE TO YELLOW ENCROACHING LUMEN
RED TO BROWN IF SUPERIMPOSED THROMBUS OVER ULCERATED
AREA
MICROSCOPIC
FATTY STREAK :
A FATTY STREAK IS THE FIRST GROSSLY VISIBLE LESION IN THE
DEVELOPMENT OF ATHEROSCLEROSIS. IT APPEARS AS AN
IRREGULAR YELLOW-WHITE DISCOLORATION ON
THE LUMINAL SURFACE OF AN ARTERY. IT CONSISTS OF
AGGREGATES OF FOAM CELLS, WHICH ARE LIPOPROTEIN-
LOADED MACROPHAGES, LOCATED IN THE INTIMA. FATTY STREAKS
MAY ALSO INCLUDE T CELLS, AGGREGATED PLATELETS,
AND SMOOTH MUSCLE CELLS. ALTHOUGH FATTY STREAKS CAN
DEVELOP INTO ATHEROMAS (ATHEROMATOUS PLAQUES), NOT ALL
ARE DESTINED TO BECOME ADVANCED LESIONS.
SUPERFICIAL FIBROUS CAP(SMOOTH MUSCLE CELLS AND DENSE
COLLAGEN)
SHOULDER (JUST BENEATH AND ON THE SIDES OF CAP)- CELLULAR
AREA COMPOSED OF SMOOTH MUSCLE CELLS, MACROPHAGES AND
LYMPHOCYTES
NECROTIC CORE ,DEEP TO THE CAP CONTAINS CHOLESTEROL AND
ITS ESTERS, DEBRIS FROM FOAM CELLS ,MACROPHAGES, SMOOTH
MUSCLE CELLS, FIBRIN AND ORGANIZED THROMBUS
PERIPHERY OF THE PLAQUE SHOWS NEOVASCULARIZATION