Ischemic Heart Disease

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According to the latest World Health Organization (WHO) mortality report, ischemic heart disease is the current leading cause of death worldwide. It costs the United States alone over $100 billion annually. Despite this huge impact on economy and human life, studies have shown that the majority of these cases can actually be prevented if risk factors are identified and controlled as early as possible. These risk factors include, but are not limited to: Obesity, dyslipidemia, hypertension, smoking and diabetes mellitus. One of the most common etiologies of coronary artery disease is atherosclerosis. Atherosclerosis is a chronic inflammatory disease affecting mainly the large and medium-sized elastic and muscular arteries of the body, such as…show more content…
The intima, which is the innermost layer is a thin layer of squamous shaped endothelial cells, which are nourished and supported by a sub-endothelial layer of connective tissue. The middle media layer, mainly consists of a thick layer of smooth muscle fibers, collagen and elastic fibers. Lastly, the outermost layer, the tunica adventitia (also known as the externa), is composed of a dense connective tissue matrix and serves to protect the vessel. No spaces, bulges or narrowing exist in a normal, healthy vessel, which along with the previous structural components of the arterial wall, all work to facilitate the smooth and laminar blood flow despite its pulsatile, high pressure…show more content…
These LDL are vesicles which carry mainly cholesterol in the blood. After enough LDL has been deposited in the arterial wall to cause an inflammatory response, macrophages migrate to the site of deposition and ingest these particles, a process known as phagocytosis. These lipid laden macrophages resemble a dense foamy material, which is why they’re termed foam cells. In an attempt to stop the inflammation, the body creates a network of fibrin, known as a fibrin cap, to cover these areas where the foam cells have developed and stabilize the lesion. This thickening and hardening in the arterial wall, is known as an atheromatous plaque or an atheroma, and is the basis of all atherosclerotic events. The thickness and stability of the fibrin cap is what determines the risk of rupture, thrombosis, embolization, and other lethal events. Stable plaques that are not large enough to significantly obstruct the arterial lumen usually remain asymptomatic and cause no trouble, however, depending on where these plaques are in the body, unstable atheromatous plaques or significantly large plaques can cause many morbid outcomes, or even sudden cardiac death. The manifestations differ depending

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