Atherosclerosis is a type of coronary artery disease and it causes myocardial ischemia. Myocardial ischemia occurs when there is an imbalance between the supply of oxygen to cardiac muscle and myocardial demand. The most common cause is coronary artery disease which causes obstruction of coronary blood flow. Atherosclerosis is a common coronary artery disease. Other causes include coronary artery thrombosis, spasm or ateritis. Thyrotoxicosis or myocardial hypertrophy are sequelae of coronary artery disease due to increased cardiac output from increased oxygen demand.

Atheroma consists of atherosclerotic plaques rich in cholesterol and other lipids surrounded by smooth muscle cells and fibrous tissue. Atherosclerosis or coronary artery disease presents clinically as stable angina to acute coronary syndromes of unstable angina and myocardial infarct.

Irreversible risk factors of atherosclerosis includes age, gender and familial history. Reversible risk factors are hyperlipidemia, smoking, hypertension, homocysteine, diabetes mellitus, lack of exercise and obesity.