Snapshot A 56-year-old man presents to the emergency department (ED) after being found unresponsive in his home. Advanced cardiovascular life support was instituted, failed, and the patient was pronounced dead. The family arrived at the ED and reported that the patient had a history of hypertension, hyperlipidemia, and hypercholesterolemia. Forensic studies in the coronary vessels demonstrated that a myocardial infarction with subsequent fatal arrhythmia was determined to be the cause of death. His coronary vessels demonstrated atherosclerosis. Introduction Definition arterial hardening that results from arterial wall thickening and a loss of vessel elasticity General Patterns of Arteriosclerosis Types Findings Arteriolosclerosis Sclerosis of the small arteries and the arterioles There are two variants hyaline pink hyaline thickening of the arteries with narrowing of the vessel lumen hyperplastic onion skinthickening with narrowing of the vessel lumen May result in distal ischemic injury Monkeberg medial sclerosis Calcifications of muscular arteries the internal elastic lamina andmediaof arteries are involved These calcifications do not encroach in the vessel lumen These are clinicallybenign Atherosclerosis Secondary to a build ofcholesterol plaques affecting elastic arteries and large and medium-sized muscular arteries