Atherosclerotische

Atherosclerotische refers to atherosclerosis, a chronic vascular disease characterized by the buildup of plaques within arterial walls, leading to narrowing of the vessel lumen and impaired blood flow. Plaques consist of lipids, inflammatory cells, smooth muscle cells, fibrous tissue, and calcifications. The condition commonly affects medium- and large arteries, including the coronary, carotid, cerebral, and peripheral arteries.

Pathophysiology begins with endothelial dysfunction that allows lipoproteins, especially low-density lipoprotein (LDL), to enter the arterial intima. LDL becomes oxidized, triggering an inflammatory response with monocytes migrating into the vessel wall and transforming into macrophages that ingest lipids to form foam cells. This process creates a fatty streak that can evolve into a fibrous, calcified plaque. Plaques may be stable or rupture, and rupture can expose thrombogenic material that forms a clot, potentially causing acute ischemic events such as myocardial infarction or stroke.

Risk factors include non-modifiable factors like age and family history, and modifiable factors such as hyperlipidemia, hypertension, diabetes, smoking, obesity, physical inactivity, and an unhealthy diet. The disease progresses over years and is influenced by inflammation and metabolic factors.

Clinical presentation varies by affected vessels. Many individuals are asymptomatic until substantial stenosis or an acute event occurs. Symptoms include angina or myocardial infarction from coronary involvement, transient ischemic attacks or stroke from carotid or intracranial involvement, and claudication from peripheral artery disease. Diagnostics encompass lipid panels, imaging (carotid ultrasound, coronary calcium scoring, angiography), and functional assessments.

Management emphasizes risk factor modification and prevention of vascular events. Treatments include statins and other lipid-lowering therapies, antihypertensives, antiplatelet agents, lifestyle changes (smoking cessation, diet, exercise), and, in some cases, revascularization. Atherosclerotic disease remains a leading cause of morbidity and mortality worldwide but can be slowed with comprehensive care.