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ATHEROSCLEROSIS - Coggle Diagram

- - - - Myocardial infarction
        
        Collateral blood and dilation causes overfilling with stagnant blood
        
        When the myocardium can't sustain muscle function (cells have died)
      - Unstable angina (if no cell death occurs)
  - - - Can be especially prominent on exertion
      - Progressive constriction of coronary arteries
      - Stable means blood flow is occluded but no embolism occurs
  - - - Systolic stretch (ischemic portion is forced outwards)
      - Cardiac shock - heart is incapable of perfusing tissues
    - - Pulmonary edema can result a few days later
    - - Especially after MI
      - Due to loss of blood supply, injury current, sympathetic reflexes, muscle weakness leading to dilation
    - - Dead muscle degenerates
      - Systolic stretch --> rupture
      - Cardiac tamponade - compression of heart from the outside by blood collecting in the pericardial cavity
- - - - Increased production of inflammatory cytokines
      - Increased leukocyte adhesion molecules
      - Decreased vasodilatory molecules
      - Decreased production of antithrombotic molecules
      - Disrupted permeability barrier
    - - Inflammatory cytokines
      - Increased ECM synthesis
      - Increased migration/proliferation into subintima
  - - - Endothelial dysfunction allows lipids to enter the subintima
      - Lipoprotein entry and modification (oxidation, glycation)
      - Foam cell formation - macrophages that have taken up LDL
    - - Thickening of intima
      - Fibrofatty lesion
      - Calcification
      - Lipid core (foam cells), fibrous cap (fibrous tissue surrounding it)
    - - Cap ruptures --> formation of a thrombus