9. Write short notes on the pathogenesis of atheromatous 
Complications of atherosclerosis are the leading cause of death in the U.K. 

Major risk factors for coronary atherosclerosis include hyperlipidemia, hypertension, and diabetes, all of which may be familial, and smoking. Increasing age and male sex also have predisposition to atherosclerosis. Other risk factors include increased dietary fat (particularly cholesterol), decreased exercise, obesity, oral contraceptive use, and stress.

Pathogenesis of atherosclerosis may be related to endothelial injury with increased permeability to lipids, increased intimal smooth muscle proliferation, and macrophage emigration and proliferation in the intima. Another theory holds that smooth muscle proliferation initiates plaque formation. Fatty lipid streaks, seen even in children, may not be precursors to atheromatous plaques in all cases. Resultant intimal plaques can increase in size, leading to increasing lumenal obstruction. Plaques can be complicated by ulceration, hemorrhage, thrombosis, and calcification.

The consequences of coronary atherosclerosis can be ischemia with angina, myocardial infarction with greater degrees of occlusion, and sudden death from severe occlusion or thrombosis is of atheromatous plaques. 

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