Atherosclerosis Case Study

Atherosclerosis is a major problem for developed countries and it is a risk factor for many other cardiovascular diseases – including myocardial infarctions. Burke & Virmani (2007) investigated the causes of myocardial infarctions and found that atherosclerosis of the coronary arteries accounted for 80% of acute myocardial infarctions. Myocardial infarctions are life-threatening events, and current research suggests that 15-20% of patients develop depression during their stay in hospital (Shapiro, 2015, p. 79). This essay will explain the pathophysiological process of atherosclerosis and investigate the expected effects of cardiac rehabilitation on the patient’s psychosocial wellbeing.

Firstly, the report will use research-based evidence and

Atherosclerosis is a progressive condition, beginning in childhood, and usually only becomes problematic after the age of fifty for most men (Alique et al., 2015, p. 1). Interestingly, the case study is fifty-five years old which is consistent with the previous claim. The process of atherosclerosis is not yet fully understood and many theories have been proposed. The following section will explore the current, research-based, understanding of progression of atherosclerosis. In order to achieve this, a basic understanding of the artery structure must firstly be

As a result, monocytes, which do not normally adhere to the endothelium, move towards the rupture site and stick to the endothelium. To achieve this, surface adhesion molecules called VCAM-1 are secreted by endothelial cells (Skeoch et al., 2014, p. 819). Additionally, the endothelial layer becomes more porous which allows monocytes to move beyond the endothelium; more importantly, this change allows more LDL’s to accumulate beneath the endothelium. Next, the LDL’s become oxidised after coming in contact with nitric oxide, which is a chemical released by the endothelium to widen the artery. Once the LDL’s become oxidised, monocytes become macrophages and engulf the oxidised LDL’s (Collins, Tzima & Patterson, 2015, p.43). As illustrated in figure 2, once the macrophages have engulfed the LDL’s they become foam cells. Importantly, the foam cells release cytokines to attract more macrophages to the area. Another, very important, lipoprotein is the high density lipoprotein (HDL) which transport cholesterol away from cells to the liver to be metabolised (Parhofer, 2015, p. 109). As a result, HDL’s play key role in removal of cholesterol from the intima; however, if the HDL’s fail to remove the cholesterol, foam cells accumulate forming a fatty streak (see figure 3). Progressing onwards, vascular smooth muscle cells (VSCM’s) migrate from the media