Atherosclerosis

 High level of cholesterol in the blood, high blood pressure and cigarette smoke cause
damage to the arterial endothelium.
 The damage triggers the inflammatory response.
 Low density lipoproteins (LDLs) accumulate in tunica intima and are oxidized.
 Monocytes enter the tunica intima and differentiate into macrophages.
 Macrophages ingest cholesterol from oxidized LDLs and become foam cells.
 Foams cells release growth factors called cytokines which stimulate the division of
smooth muscle cells near the tunica intima.
 Smooth muscle cells start to ingest cholesterol.
 More white blood cells, lipids and connective tissues build up and harden to form a
fibrous plaque called an atheroma or atherosclerotic plaque.
 The atheroma formed can be hardened by deposition of calcium ions, causing the artery
to lose its elasticity.
 An atheroma can rupture the endothelium of an artery, leaving a roughened surface.
 Platelets stick to the exposed collagen fibres and trigger the blood clotting process.
 A blood clot called thrombus is then formed in the artery.
 The blood clot narrows the artery and restricts the blood flow.
 When the blood clot breaks free and is circulated in the blood, it is known as embolus.