CHART 402

Stressor Mechanical

Causes of Intimal Vessel Wall Injury

Source and Effect Sheer stress from blood flow at vessel branches/bifurcation due to HTN; injury secondary to PCI procedures Hypercholesterolemia; homocystinemia; hydrocarbons, nicotine, and carbon monoxide from cigarettes; free fatty acids, oxygen radicals, angiotensin, hormones; oxidized lipids; oxidant stress caused by cigarette smoking, hypertension, and advanced glycation end products in diabetes mellitus; estrogen deficiency; vasoactive amines Exposure to antigenantibody complexes; virally induced injuries; exposure to bacteria; activated macrophages; infectious microorganisms such as herpesviruses, Chlamydia pneumoniae Alterations Advancing age

Chemical

Immunologic

Genetic Biologic