Morphological Alterations of the Heart and Blood Vessels from Tobacco Smoke: the Steps of the Damage

Two cardiovascular structures are usually involved in the harm caused by cigarette smoke: myocardium and endothelium, which are mainly affected by carbon monoxide and nicotine. The harmful effects of smoking induce functional responses that eventually lead to morphological damage. With regard to the myocardium, three main steps have been well documented: myocardial alterations related to the hypoxia caused by increased concentrations in carboxyhemoglobin, reversible degenerative alterations of the cardiac muscle and irreversible myocardial necrosis. A typical experimental pattern due to smoking effects is the smoke cardiomyopathy. Endothelial dysfunction triggers a large number of responses, mainly consisting of blood and inflammatory cell migration and adhesion at the site of altered arterial wall,rupture of the muscular and elastic cells of the arterial wall and lipid infiltrates, which lead to atherosclerosis plaque. In addition, arteriosclerosis is the result of smoking on the resistance arteries. Evidence indicates that morphological alterations of the heart and blood vessels from smoking follow a well-defined way that allow us to tell the story of the cardiovascular alterations.