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Coronary Artery Disease and Acute Coronary Syndrome Coronary Artery Disease 61607a type of blood vessel disorder that is included in the general category of atherosclerosis 61607The term atherosclerosis means fatty much and hard 61607It begins as soft deposits of fat that harden with age and is often referred to as hardening of the arteries 61607The atheromas fatty deposits have a preference for the coronary arteries Etiology and Patho 61607Atherosclerosis is the major cause of CAD 61607Characterized by a focal deposit of cholesterol and lipids primarily within the intimal wall of the artery 61607Plaque formation is the result of complex interactions between the components of the blood and elements forming the vascular wall 61607Endothelial lining can be altered as a result of chemical injuries such as hyperlipidemia or high-sheer stress such as HTN 61607There is evidence that some viral and bacteria infections play a role in damaging endothelium by causing a local inflammatory response 61607C-reactive protein CRP is a non-specific marker of inflammation and is increased in patients with CAD 61607Chronic exposure to CRP triggers the rupture of plaque 61607With endothelium alteration platelets are activates and they release a growth factor that stimulates smooth muscle proliferation that entraps lipids which are calcified over time and form an irritant to the endothelium in which platelets adhere and aggregate 61607Thrombin is generated and fibrin formation and thrombi occur 61607Endothelial replication is normal slow in adults but in the presence of HTN hyperlipidemia increased cell turn-over lead to transient repeated denuding of the endothelium Developmental stages CAD takes many years to develop When it becomes symptomatic the disease process is usually well advanced Stages of development are fatty streak raised fibrous plaque resulting from smooth muscle cell proliferation and complicated lesion 1Fatty streak aEarliest lesion characterized by lipid-filled smooth muscle cells bAs streaks of fat develop within smooth muscle a yellow tinged appears cFatty streaks are usually observed in the coronary arteries by age
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