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Harrison's Principles of Internal Medicine, 18e
| Part 10. Disorders of the Cardiovascular System > Section 5. Vascular Disease > |
Chapter 241. The Pathogenesis, Prevention, and Treatment of Atherosclerosis
Sections: Pathogenesis, Prevention and Treatment, Further Readings.
Topics Discussed: atherosclerosis; ischemic heart disease; peripheral arterial disease.
Excerpt:"Atherosclerosis remains the major cause of death and premature disability in developed societies. Moreover, current predictions estimate that by the year 2020 cardiovascular diseases, notably atherosclerosis, will become the leading global cause of total disease burden. Although many generalized or systemic risk factors predispose to its development, atherosclerosis affects various regions of the circulation preferentially and has distinct clinical manifestations that depend on the particular circulatory bed affected. Atherosclerosis of the coronary arteries commonly causes myocardial infarction (MI) (Chap. 245) and angina pectoris (Chap. 243). Atherosclerosis of the arteries supplying the central nervous system frequently provokes strokes and transient cerebral ischemia (Chap. 370). In the peripheral circulation, atherosclerosis causes intermittent claudication and gangrene and can jeopardize limb viability. Involvement of the splanchnic circulation can cause mesenteric ischemia. Atherosclerosis can affect the kidneys either directly (e.g., renal artery stenosis) or as a common site of atheroembolic disease (Chap. 248).An integrated view of experimental results in animals and studies of human atherosclerosis suggests that the "fatty streak" represents the initial..."
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