Pathophysiology of atherosclerotic heart disease.
Coronary atherosclerosis is the major health problem of the twentieth century. Although there has been a recent decrease in mortality from this condition in many Western countries, the incidence has remained the same, and coronary atherosclerosis continues to be the leading cause of death. Our understanding of the disease process has been steadily increasing; however, much still needs to be clarified. The clinical presentations of coronary artery disease are diverse and not clearly linked to the severity or extent of the disease. Patients with similar coronary lesions present variously with stable and unstable angina or myocardial infarction, and all too many have sudden death as the initial clinical presentation. Recently, much attention has focused on the initial events leading to the development of atherosclerotic plaques. Current concepts unite formerly opposed views on the roles of intimal injury, platelets, lipids, and monoclonal smooth muscle cell proliferation in initiating atherogenesis. Progress has been made in understanding the early structural and functional alterations caused by myocardial ischemia. This understanding is leading to the development of interventions such as intracoronary thrombolysis to prevent or limit permanent myocardial injury. Measures to prevent serious complications of ischemic heart disease such as infarct rupture, aneurysm formation, and ischemic cardiomyopathy are still needed.
D000787:Angina Pectoris / Q000503:physiopathology; D001161:Arteriosclerosis / Q000150:complications / Q000473:pathology / Q000503:physiopathology*; D003097:Collateral Circulation; D003327:Coronary Disease / Q000150:complications / Q000209:etiology / Q000473:pathology; D003645:Death, Sudden / Q000209:etiology; D006321:Heart / Q000503:physiopathology; D006322:Heart Aneurysm / Q000209:etiology; D006331:Heart Diseases / Q000209:etiology; D006801:Humans; D009203:Myocardial Infarction / Q000150:complications / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D009206:Myocardium / Q000473:pathology; D009336:Necrosis; D012422:Rupture, Spontaneous; D013997:Time Factors