Rashidah is a 55-year-old female who is experiencing acute chest pain and shortness of breath. She describes the pain as "pressure and squeezing." When she becomes nauseous and light-headed, her son insists that he take her to the emergency room.

Health History: She started smoking when she was 18, attempted to quit several times in her 40s, and had her last cigarette on her 50 th birthday. She has been overweight for most of her adult life, but has gained 20 pounds in the last few years, which increased her BMI to 34. The last time she had a physical exam was when she turned 50. Her vital signs and blood test results from that exam are listed below.

BP: 178/90
HDL: 62 mg/dl
LDL: 190 mg/dl
Triglycerides: 174 mg/dl
Total cholesterol: 252 mg/dl
Fasting blood glucose: 128 mg/dl

Question: Given her last physical exam results, Rashidah’s physician believes she has likely had undiagnosed atherosclerosis for years. Briefly describe the pathophysiology of atherosclerosis.