{"id":9832,"date":"2025-11-15T18:40:03","date_gmt":"2025-11-15T23:40:03","guid":{"rendered":"https:\/\/pressbooks.bccampus.ca\/pathology\/?post_type=chapter&#038;p=9832"},"modified":"2025-11-15T20:36:33","modified_gmt":"2025-11-16T01:36:33","slug":"clinical-manifestations-complications-of-atherosclerosis","status":"publish","type":"chapter","link":"https:\/\/pressbooks.bccampus.ca\/pathology\/chapter\/clinical-manifestations-complications-of-atherosclerosis\/","title":{"raw":"Clinical Manifestations &amp; Complications of Atherosclerosis","rendered":"Clinical Manifestations &amp; Complications of Atherosclerosis"},"content":{"raw":"<div class=\"textbox textbox--learning-objectives\"><header class=\"textbox__header\">\r\n<p class=\"textbox__title\">Learning Objectives<\/p>\r\n\r\n<\/header>\r\n<div class=\"textbox__content\">\r\n\r\nBy the end of this chapter, you will be able to:\r\n<ul>\r\n \t<li>List common signs and symptoms associated with restricted blood flow<\/li>\r\n \t<li>Correlate the screening blood tests and physical exams with the pathophysiology of atherosclerosis<\/li>\r\n \t<li>Identify possible complications of severe atherosclerosis<\/li>\r\n<\/ul>\r\n<\/div>\r\n<\/div>\r\nIn the beginning stages of atherosclerosis, it is often asymptomatic\u00a0 i.e. there are no overt signs nor symptoms, often for decades. Symptoms and signs develop when the atherosclerotic plaques begin to restrict blood flow.\u00a0 The manifestations often are associated with organs that are affected by the reduced blood flow as well as possible signs of lipid accumulation in the blood and other organs.\r\n\r\n&nbsp;\r\n<table class=\"grid\" style=\"border-collapse: collapse;width: 100%\" border=\"0\">\r\n<tbody>\r\n<tr>\r\n<td style=\"width: 33.3333%\">Area of reduced blood flow<\/td>\r\n<td style=\"width: 33.3333%\">Symptom<\/td>\r\n<td style=\"width: 33.3333%\">Sign<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"width: 33.3333%\">Head or neck (cerebral and\/or carotid arteries)<\/td>\r\n<td style=\"width: 33.3333%\">Acute neurologic symptoms:\u00a0 numbness, weakness in specific parts of body (stroke and\/or TIA)\r\n\r\nChronic changes in cognition:\u00a0 trouble with reasoning, planning, and judgment (dementia)<\/td>\r\n<td style=\"width: 33.3333%\">Acute:\u00a0 confusion, aphasia, loss of consciousness, muscle weakness,\r\n\r\nChronic: Memory loss, confusion; language<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"width: 33.3333%\">Heart (coronary arteries)<\/td>\r\n<td style=\"width: 33.3333%\">Anginal pain at rest vs upon exertion, fatigue<\/td>\r\n<td style=\"width: 33.3333%\">dyspnea, high HR, high BP<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"width: 33.3333%\">Thoracic or abdominal aorta<\/td>\r\n<td style=\"width: 33.3333%\">Acute: severe chest or upper back pain, lightheaded\/dizzy<\/td>\r\n<td style=\"width: 33.3333%\">dyspnea, fainting,\u00a0 different pulses &amp; bp between arms &amp; feet<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"width: 33.3333%\">Gastrointestinal tract (mesenteric arteries)<\/td>\r\n<td style=\"width: 33.3333%\">abdominal pain, nausea<\/td>\r\n<td style=\"width: 33.3333%\">vomiting, diarrhea, blood in stool<\/td>\r\n<\/tr>\r\n<tr>\r\n<td style=\"width: 33.3333%\">Lower Limbs (iliac\/femoral arteries)<\/td>\r\n<td style=\"width: 33.3333%\">Muscle weakness, pain, numbness,<\/td>\r\n<td style=\"width: 33.3333%\">affected limb would be cold &amp; pale with diminished pulses compared to the arms. Poor wound healing<\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\n<div>\r\n<p style=\"background-color: #f0f0f0;padding: 5px;text-align: left\"><sup><em><strong>\r\n<\/strong><\/em><strong>Signs and symptoms of restricted blood flow due to atherosclerosis<\/strong><\/sup><\/p>\r\n\r\n<\/div>\r\n<h3>Screening for atherosclerosis development<\/h3>\r\nAs it takes years for atherosclerotic plaques to develop, subtle changes in physical exams and composition of blood can suggest the risk of atherosclerotic plaque formation.\u00a0 The following physical &amp; blood tests are commonly performed to assess for each stage of plaque formation:\r\n\r\n<strong>Medical history<\/strong>:\u00a0 looking for possible damage to endothelium (e.g. familial history, exposure to smoke, alcohol, stress, etc)\r\n\r\n<strong>Blood pressure<\/strong>:\u00a0 looking for damage to vessels due to high blood pressure\r\n\r\n<strong>Blood test:\u00a0 Lipid panel<\/strong> (e.g. Total cholesterol, High vs low density lipoprotein): looking for the amount of cholesterol and fats in circulation as they contribute to foam cell formation and hence, plaque formation\r\n\r\n<strong>Blood test:\u00a0 Fasting glucose &amp; HbA1C<\/strong>:\u00a0 looking for untreated hyperglycemia (diabetes) which can injure the blood vessels. See\u00a0<a href=\"https:\/\/pressbooks.bccampus.ca\/pathology\/chapter\/diagnosis-of-diabetes\/\">Diagnosis of Diabetes<\/a> for more detail.\r\n<h2>Complications of Atherosclerosis<\/h2>\r\n<h3>Acute ischemic attack of the heart: angina &amp; myocardial infarction<\/h3>\r\nAtherosclerosis of the coronary arteries will slowly reduce prefusion to heart tissue. As the tissue is starved, pain and loss of function (contraction and electrical excitability) will ensue.\u00a0 This cardiac pain, also known as angina, can occur upon exertion (i.e. stable angina) because the plaque prevents sufficient blood flow to meet the increased demand in exertion.\u00a0 However, as the plaque grows, blood flow will be insufficient for the demand of everyday life - manifesting in unpredictable pain known as unstable angina.\r\n\r\nAs mentioned, atherosclerotic plaques are at risk for rupture which would cause serious alterations in blood flow.\u00a0 A full blockage of blood flow - whether due to the ruptured plaque or the ensuing clot - will result in infarct and tissue hypoxia of all the cardiac tissue downstream of the blockage.\u00a0 In addition to 'crushing' pain of the infarct, there will be decreased blood flow to the entire body - often manifesting in lack of mobility, nausea, and loss of consciousness. There will also be electrical disturbances in the cardiac tissue which can be recorded on EKGs. Myocardial infarction is a life-threatening event without medical intervention.\r\n<h3>Acute ischemic attack of the brain:\u00a0 stroke or transient ischemic attack (TIA)<\/h3>\r\nSimilar to myocardial infarct, a complete blockage to any cerebral arteries will manifest in a stroke. Clinical manifestations of a stroke would be acute changes in both neurological and cognitive abilities (see <strong>Signs and symptoms of restricted blood flow due to atherosclerosis<\/strong>).\u00a0 ..See\u00a0 for more detail <a href=\"https:\/\/pressbooks.bccampus.ca\/pathology\/chapter\/pathophysiology-of-neuromuscular-control\/\">Pathophysiology of Neuromuscular Control: CNS Issues in the Motor Cortex (Traumatic Brain Injury &amp;amp; Ischemic Stroke)<\/a>.\r\n\r\nTransient Ischemia Attack (TIA) are referred to as \"mini strokes\" where the blockage of blood flow is unpredictable\u00a0 with all of the aforementioned changes in neurological and cognitive abilities - but appears to resolve in a short amount of time. This is usually attributable to the brain's vasculature's amazing ability of rerouting blood. For more detail see\u00a0<a href=\"https:\/\/pressbooks.bccampus.ca\/pathology\/chapter\/circulation-and-the-cns-copied-but-not-cloned-from-gj-betts\/\">Circulation and the CNS<\/a>.\r\n<h3>Thrombosis of Atherosclerotic Aorta<\/h3>\r\nThe formation of a clot is one of the common clinical outcomes of severe atherosclerosis. Thrombosis-induced [pb_glossary id=\"3863\"]ischemia [\/pb_glossary] can result in heart attack or stroke, depending on location. Clot formation as a result of atherosclerosis in coronary vessels can block the blood flow to the heart, and cause tissue damage as a result of [pb_glossary id=\"3862\"]hypoxia[\/pb_glossary]. Similar scenarios can occur anywhere along the vascular tree, including the brain (stroke), lower limb (peripheral artery disease), etc.\r\n<div class=\"mceTemp\"><\/div>\r\n<h3>Aneurysm of Atherosclerotic Aorta<\/h3>\r\nSevere atherosclerosis can progress towards [pb_glossary id=\"3914\"]aneurysm[\/pb_glossary], where the muscular layer of the vessel weakens and creates a bulge that can rupture and lead to internal bleeding.\r\n\r\nThe increased resistance of a growing atherosclerotic plaque causes a backup of blood immediately upstream of the plaque.\u00a0 If a weakening of the arterial wall begins, a bulging deformity forms, known as an aneurysm.\u00a0 Aneurysms of the thoracic and abdominal aorta are the most common, but aneurysms can occur in any artery.\r\n\r\nDepending on the location, most aneurysms are asymptomatic when small.\u00a0 When symptoms to occur, they are non-specific (e.g. pain in a general area) unless they happen to <span class=\"TopicPara_topicText__CUB0d\" data-testid=\"topicText\">compression an adjacent structure (e.g. optic nerve in the cause of a brain aneurysm). As aneurysms grow, then cause visceral pain, often described as steady and deep.\u00a0 Some mistake abdominal aneurysms for a back ache.\u00a0 <\/span>\r\n\r\n<span class=\"TopicPara_topicText__CUB0d\" data-testid=\"topicText\">Aneurysms can become apparent if there is an abnormal prominent pulsation - especially in the case of abdominal aortic aneurysms. Rapidly enlarging aneurysms that are about to rupture can be tender in the area. With auscultation, a<\/span><span class=\"TopicPara_topicText__CUB0d\" data-testid=\"topicText\"> bruit (abnormal turbulent blood flow) may be audible over the aneurysm. There will also be signs of decreased blood flow to organs downstream of the dissection (e.g. feet will be pale &amp; cool due to lack of blood).\u00a0<\/span>\r\n<h3>Aortic Dissection<\/h3>\r\nAs a result of damage to the tunica media during atherosclerotic plaque formation, a weakening and separation between the tunicas develop.\u00a0 This can lead to aortic dissection which involves a tear in the tunica intima causing a separation of the intima and media layers. This creates a false channel for blood flow which does not reach its end destination (ie organs). Aortic dissection can occur anywhere along the aorta. Symptoms include an abrupt \"tearing pain\" along the area of the dissection. Because the aorta runs anterior to the spine, this pain can be confused for back pain. As well, there will be decreased blood flow to organs downstream of the dissection.\r\n<p id=\"v31786224\" class=\" TopicPara_topicParaWithScroll__UPc8N readable downloadContent TopicPara_topicPara__U9gFm para\" data-testid=\"topicPara\"><\/p>","rendered":"<div class=\"textbox textbox--learning-objectives\">\n<header class=\"textbox__header\">\n<p class=\"textbox__title\">Learning Objectives<\/p>\n<\/header>\n<div class=\"textbox__content\">\n<p>By the end of this chapter, you will be able to:<\/p>\n<ul>\n<li>List common signs and symptoms associated with restricted blood flow<\/li>\n<li>Correlate the screening blood tests and physical exams with the pathophysiology of atherosclerosis<\/li>\n<li>Identify possible complications of severe atherosclerosis<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<p>In the beginning stages of atherosclerosis, it is often asymptomatic\u00a0 i.e. there are no overt signs nor symptoms, often for decades. Symptoms and signs develop when the atherosclerotic plaques begin to restrict blood flow.\u00a0 The manifestations often are associated with organs that are affected by the reduced blood flow as well as possible signs of lipid accumulation in the blood and other organs.<\/p>\n<p>&nbsp;<\/p>\n<table class=\"grid\" style=\"border-collapse: collapse;width: 100%\">\n<tbody>\n<tr>\n<td style=\"width: 33.3333%\">Area of reduced blood flow<\/td>\n<td style=\"width: 33.3333%\">Symptom<\/td>\n<td style=\"width: 33.3333%\">Sign<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 33.3333%\">Head or neck (cerebral and\/or carotid arteries)<\/td>\n<td style=\"width: 33.3333%\">Acute neurologic symptoms:\u00a0 numbness, weakness in specific parts of body (stroke and\/or TIA)<\/p>\n<p>Chronic changes in cognition:\u00a0 trouble with reasoning, planning, and judgment (dementia)<\/td>\n<td style=\"width: 33.3333%\">Acute:\u00a0 confusion, aphasia, loss of consciousness, muscle weakness,<\/p>\n<p>Chronic: Memory loss, confusion; language<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 33.3333%\">Heart (coronary arteries)<\/td>\n<td style=\"width: 33.3333%\">Anginal pain at rest vs upon exertion, fatigue<\/td>\n<td style=\"width: 33.3333%\">dyspnea, high HR, high BP<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 33.3333%\">Thoracic or abdominal aorta<\/td>\n<td style=\"width: 33.3333%\">Acute: severe chest or upper back pain, lightheaded\/dizzy<\/td>\n<td style=\"width: 33.3333%\">dyspnea, fainting,\u00a0 different pulses &amp; bp between arms &amp; feet<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 33.3333%\">Gastrointestinal tract (mesenteric arteries)<\/td>\n<td style=\"width: 33.3333%\">abdominal pain, nausea<\/td>\n<td style=\"width: 33.3333%\">vomiting, diarrhea, blood in stool<\/td>\n<\/tr>\n<tr>\n<td style=\"width: 33.3333%\">Lower Limbs (iliac\/femoral arteries)<\/td>\n<td style=\"width: 33.3333%\">Muscle weakness, pain, numbness,<\/td>\n<td style=\"width: 33.3333%\">affected limb would be cold &amp; pale with diminished pulses compared to the arms. Poor wound healing<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<div>\n<p style=\"background-color: #f0f0f0;padding: 5px;text-align: left\"><sup><em><strong><br \/>\n<\/strong><\/em><strong>Signs and symptoms of restricted blood flow due to atherosclerosis<\/strong><\/sup><\/p>\n<\/div>\n<h3>Screening for atherosclerosis development<\/h3>\n<p>As it takes years for atherosclerotic plaques to develop, subtle changes in physical exams and composition of blood can suggest the risk of atherosclerotic plaque formation.\u00a0 The following physical &amp; blood tests are commonly performed to assess for each stage of plaque formation:<\/p>\n<p><strong>Medical history<\/strong>:\u00a0 looking for possible damage to endothelium (e.g. familial history, exposure to smoke, alcohol, stress, etc)<\/p>\n<p><strong>Blood pressure<\/strong>:\u00a0 looking for damage to vessels due to high blood pressure<\/p>\n<p><strong>Blood test:\u00a0 Lipid panel<\/strong> (e.g. Total cholesterol, High vs low density lipoprotein): looking for the amount of cholesterol and fats in circulation as they contribute to foam cell formation and hence, plaque formation<\/p>\n<p><strong>Blood test:\u00a0 Fasting glucose &amp; HbA1C<\/strong>:\u00a0 looking for untreated hyperglycemia (diabetes) which can injure the blood vessels. See\u00a0<a href=\"https:\/\/pressbooks.bccampus.ca\/pathology\/chapter\/diagnosis-of-diabetes\/\">Diagnosis of Diabetes<\/a> for more detail.<\/p>\n<h2>Complications of Atherosclerosis<\/h2>\n<h3>Acute ischemic attack of the heart: angina &amp; myocardial infarction<\/h3>\n<p>Atherosclerosis of the coronary arteries will slowly reduce prefusion to heart tissue. As the tissue is starved, pain and loss of function (contraction and electrical excitability) will ensue.\u00a0 This cardiac pain, also known as angina, can occur upon exertion (i.e. stable angina) because the plaque prevents sufficient blood flow to meet the increased demand in exertion.\u00a0 However, as the plaque grows, blood flow will be insufficient for the demand of everyday life &#8211; manifesting in unpredictable pain known as unstable angina.<\/p>\n<p>As mentioned, atherosclerotic plaques are at risk for rupture which would cause serious alterations in blood flow.\u00a0 A full blockage of blood flow &#8211; whether due to the ruptured plaque or the ensuing clot &#8211; will result in infarct and tissue hypoxia of all the cardiac tissue downstream of the blockage.\u00a0 In addition to &#8216;crushing&#8217; pain of the infarct, there will be decreased blood flow to the entire body &#8211; often manifesting in lack of mobility, nausea, and loss of consciousness. There will also be electrical disturbances in the cardiac tissue which can be recorded on EKGs. Myocardial infarction is a life-threatening event without medical intervention.<\/p>\n<h3>Acute ischemic attack of the brain:\u00a0 stroke or transient ischemic attack (TIA)<\/h3>\n<p>Similar to myocardial infarct, a complete blockage to any cerebral arteries will manifest in a stroke. Clinical manifestations of a stroke would be acute changes in both neurological and cognitive abilities (see <strong>Signs and symptoms of restricted blood flow due to atherosclerosis<\/strong>).\u00a0 ..See\u00a0 for more detail <a href=\"https:\/\/pressbooks.bccampus.ca\/pathology\/chapter\/pathophysiology-of-neuromuscular-control\/\">Pathophysiology of Neuromuscular Control: CNS Issues in the Motor Cortex (Traumatic Brain Injury &amp;amp; Ischemic Stroke)<\/a>.<\/p>\n<p>Transient Ischemia Attack (TIA) are referred to as &#8220;mini strokes&#8221; where the blockage of blood flow is unpredictable\u00a0 with all of the aforementioned changes in neurological and cognitive abilities &#8211; but appears to resolve in a short amount of time. This is usually attributable to the brain&#8217;s vasculature&#8217;s amazing ability of rerouting blood. For more detail see\u00a0<a href=\"https:\/\/pressbooks.bccampus.ca\/pathology\/chapter\/circulation-and-the-cns-copied-but-not-cloned-from-gj-betts\/\">Circulation and the CNS<\/a>.<\/p>\n<h3>Thrombosis of Atherosclerotic Aorta<\/h3>\n<p>The formation of a clot is one of the common clinical outcomes of severe atherosclerosis. Thrombosis-induced <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_9832_3863\">ischemia <\/a> can result in heart attack or stroke, depending on location. Clot formation as a result of atherosclerosis in coronary vessels can block the blood flow to the heart, and cause tissue damage as a result of <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_9832_3862\">hypoxia<\/a>. Similar scenarios can occur anywhere along the vascular tree, including the brain (stroke), lower limb (peripheral artery disease), etc.<\/p>\n<div class=\"mceTemp\"><\/div>\n<h3>Aneurysm of Atherosclerotic Aorta<\/h3>\n<p>Severe atherosclerosis can progress towards <a class=\"glossary-term\" aria-haspopup=\"dialog\" aria-describedby=\"definition\" href=\"#term_9832_3914\">aneurysm<\/a>, where the muscular layer of the vessel weakens and creates a bulge that can rupture and lead to internal bleeding.<\/p>\n<p>The increased resistance of a growing atherosclerotic plaque causes a backup of blood immediately upstream of the plaque.\u00a0 If a weakening of the arterial wall begins, a bulging deformity forms, known as an aneurysm.\u00a0 Aneurysms of the thoracic and abdominal aorta are the most common, but aneurysms can occur in any artery.<\/p>\n<p>Depending on the location, most aneurysms are asymptomatic when small.\u00a0 When symptoms to occur, they are non-specific (e.g. pain in a general area) unless they happen to <span class=\"TopicPara_topicText__CUB0d\" data-testid=\"topicText\">compression an adjacent structure (e.g. optic nerve in the cause of a brain aneurysm). As aneurysms grow, then cause visceral pain, often described as steady and deep.\u00a0 Some mistake abdominal aneurysms for a back ache.\u00a0 <\/span><\/p>\n<p><span class=\"TopicPara_topicText__CUB0d\" data-testid=\"topicText\">Aneurysms can become apparent if there is an abnormal prominent pulsation &#8211; especially in the case of abdominal aortic aneurysms. Rapidly enlarging aneurysms that are about to rupture can be tender in the area. With auscultation, a<\/span><span class=\"TopicPara_topicText__CUB0d\" data-testid=\"topicText\"> bruit (abnormal turbulent blood flow) may be audible over the aneurysm. There will also be signs of decreased blood flow to organs downstream of the dissection (e.g. feet will be pale &amp; cool due to lack of blood).\u00a0<\/span><\/p>\n<h3>Aortic Dissection<\/h3>\n<p>As a result of damage to the tunica media during atherosclerotic plaque formation, a weakening and separation between the tunicas develop.\u00a0 This can lead to aortic dissection which involves a tear in the tunica intima causing a separation of the intima and media layers. This creates a false channel for blood flow which does not reach its end destination (ie organs). Aortic dissection can occur anywhere along the aorta. Symptoms include an abrupt &#8220;tearing pain&#8221; along the area of the dissection. Because the aorta runs anterior to the spine, this pain can be confused for back pain. As well, there will be decreased blood flow to organs downstream of the dissection.<\/p>\n<p id=\"v31786224\" class=\"TopicPara_topicParaWithScroll__UPc8N readable downloadContent TopicPara_topicPara__U9gFm para\" data-testid=\"topicPara\">\n<div class=\"glossary\"><span class=\"screen-reader-text\" id=\"definition\">definition<\/span><template id=\"term_9832_3863\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_9832_3863\"><div tabindex=\"-1\"><p>insufficient blood flow to the tissues<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_9832_3862\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_9832_3862\"><div tabindex=\"-1\"><p>lack of oxygen supply to the tissues<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><template id=\"term_9832_3914\"><div class=\"glossary__definition\" role=\"dialog\" data-id=\"term_9832_3914\"><div tabindex=\"-1\"><p>abnormal ballooning\/ widening of the blood vessel wall cause by it's weakness. Aneurysm rupture is very dangerous and often fatal<\/p>\n<\/div><button><span aria-hidden=\"true\">&times;<\/span><span class=\"screen-reader-text\">Close definition<\/span><\/button><\/div><\/template><\/div>","protected":false},"author":1232,"menu_order":10,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":["jen-2-8b3ju00vg8"],"pb_section_license":""},"chapter-type":[],"contributor":[349],"license":[],"class_list":["post-9832","chapter","type-chapter","status-publish","hentry","contributor-jen-2-8b3ju00vg8"],"part":322,"_links":{"self":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathology\/wp-json\/pressbooks\/v2\/chapters\/9832","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathology\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathology\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pathology\/wp-json\/wp\/v2\/users\/1232"}],"version-history":[{"count":10,"href":"https:\/\/pressbooks.bccampus.ca\/pathology\/wp-json\/pressbooks\/v2\/chapters\/9832\/revisions"}],"predecessor-version":[{"id":9844,"href":"https:\/\/pressbooks.bccampus.ca\/pathology\/wp-json\/pressbooks\/v2\/chapters\/9832\/revisions\/9844"}],"part":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathology\/wp-json\/pressbooks\/v2\/parts\/322"}],"metadata":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathology\/wp-json\/pressbooks\/v2\/chapters\/9832\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathology\/wp-json\/wp\/v2\/media?parent=9832"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pathology\/wp-json\/pressbooks\/v2\/chapter-type?post=9832"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pathology\/wp-json\/wp\/v2\/contributor?post=9832"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pathology\/wp-json\/wp\/v2\/license?post=9832"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}