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atherosclerosis is a slow Progressive disease process that commonly affects the coronary arteries atheroscl lesions begin with an endothelial injury due to chronic hemodynamic stress and circulating oxidized LDL cholesterol the resulting endothelial cell dysfunction facilitates monocyte and lymphocyte migration and allows LDL particles to pass into the intima where they become oxidized oxidized LDL is phagocytized by infiltrating macrophages resulting in lipid-laden foam cells that accumulate in the intima and form fatty streaks the earliest visible lesion of atherosclerosis as the disease progresses growth factors release by surrounding cells promote migration and proliferation of vascular smooth muscle cells into the intima the infiltrating smooth muscle cells secrete collagen and proteoglycans that form a fibro fatty plaque also known as a mature atheroma continued accumulation of cholesterol within foam cells promote cellular dysfunction and necrosis that produces a core of necroti