Physical Findings

Stop & Think

Lab and X-Ray

Differential Diagnosis

The Disease

Treatment

Conclusions

Quiz & Evaluation

• Blood monocytes adhere to sites of endothelial injury, penetrate into the wall and transform into macrophages.
• Macrophages recruit other inflammatory cells.
• Macrophages produce toxic oxygen species resulting in the formation of oxidized LDL.
• Macrophages imbibe oxidized LDL to become foam cells.
• Macrophages elaborate growth factors that recruit smooth muscle cells.
• Smooth muscle cells elaborate extracellular matrix, including collagen, elastin and proteoglycans, adding to the bulk of the lesion.
• Smooth muscle cells proliferate in response to platelet derived growth factor (PDGF)
• The increasing size of the lesion contributes to increased  sheer stress from the circulating blood, resulting in more endothelial damage and propagation of the lesion.