Histogenesis of coronary arteriosclerosis

The coronary arteries of 250 individuals dying suddenly from traumatic or natural causes were studied. Many different histopathologic processes were found to participate in the development of coronary arteriosclerosis. The earliest changes which occurred, even in infants, were increased fibroblastic activity, deposits of mucopolysaccharide and degeneration of elastic tissue. These changes were not related to lipid deposition. Moderately advanced lesions were characterized by regeneration of elastic tissue, formation of collagen and lipid deposition. The far-advanced lesions showed hyalinization, abundant lipid deposition, calcification, intramural hemorrhage and thrombosis. The possible mechanisms involved in the development of coronary arteriosclerosis are discussed.