Essay On Coronary Arteries Disease

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1. Coronary Arteries Disease The primary impairment of coronary arteries disease is an imbalance of myocardial oxygen supply to myocardial oxygen demands. The decrease in myocardial oxygen supply is mainly due to a narrowing of lumen of coronary artery. The narrowing of lumen is usually due to the formation of atherosclerotic plaque at the wall of the vessels. Therefore, coronary arteries disease (CAD) is also known as atherosclerotic heart disease (ASHD). It is a progressive disease which is characterized by irregularly distributed lipid deposits in the inner layer of medium and large coronary arteries. 2. Pathophysiology of Coronary Arteries Disease Coronary arteries disease is caused by the accumulation of atherosclerotic plaque in coronary arteries. In order to understand the pathophysiology of coronary arteries disease, we need to understand the development of atherosclerotic plaque. When there is an injury to endothelial cell of blood vessels, endothelial cell dysfunction occurs. Defensive response of the body to tissue damage is activated. Inflammation occurs. Blood vessels start to undergo vasodilatation and increase permeability of cell membrane. Besides this, phagocytes including macrophages also appear in large number at the side of injury. At this moment, if there is an excessive low density lipoproteins (LDLs) seep into and accumulate at the inner layer of blood vessel wall, the formation of atherosclerotic plaques will begin. Lipids and proteins in the low density lipoproteins (LDLs) undergo oxidation which is the removal of electron. Proteins in the low density lipoproteins (LDLs) also bind to sugars. In response to this reaction, endothelial and smooth muscle cells of the coronary artery secrete some chemical subs... ... middle of paper ... ...ocysteine. a) C-reactive proteins are proteins produced by the liver. They are also present in the blood in inactive forms that are converted to active forms during inflammation. C-reactive proteins promote the uptake of low density lipoproteins (LDLs) by macrophage. b) Lipoprotein is an LDL-like particle that binds to endothelial cells, macrophages and blood platelets. It can promote the proliferation of smooth muscle fiber and also inhibit the breakdown of blood clot. c) Fibrinogen is a glycoprotein involved in blood clotting that may help regulate cellular proliferation, vasoconstriction and also platelet aggregation. d) Homocysteine is amino acid that may include blood vessel damage by promoting platelet aggregation and smooth muscle proliferation With the presence of these factors, the chance of developing coronary artery disease is increased significantly.

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