By Richard J. Frink, 111 pp, with illus, Sacramento, Calif, Heart Research Foundation, 2002.In Inflammatory Atherosclerosis: Characteristics of the Injurious Agent, the author, an interventional cardiologist and founder and principal investigator of the Heart Research Foundation of Sacramento, has endeavored to provide an overview of the multiple factors that contribute to the development of coronary artery atherosclerosis. The result of his effort is a concise book in which he has identified some of the most exciting issues that have received attention from clinicians and researchers.The book is organized into 13 very brief chapters, most with 5 or fewer pages of text. Each chapter addresses a particular substance or process and provides a short summary of its putative role in the development of an atherosclerotic plaque: the smooth muscle cell, inflammation, the atheroma, and thrombosis, to name a few. Although there is some overlap in the discussion from one chapter to the next, the text is supplemented by a solid, albeit incomplete, selection of classic and current citations.In addition, there is a separate section of 24 color plates, which includes gross photographs, photomicrographs, and corresponding radiographs of coronary artery plaques. Unfortunately, the photomicrographs are of uneven quality, and several low-power images are used to illustrate detail that would be better demonstrated via higher magnification.While there is substantive discussion throughout the book's first 10 chapters, it essentially serves as a preamble to chapter 11, entitled “What is the Injurious Agent,” in which Frink presents his highly speculative hypothesis that in all affected individuals “atherosclerosis is caused by a single infectious organism (which) resides in a dormant state within a circulating cell.” The author repeatedly concludes, implicitly or explicitly, that his theory is a logical outgrowth of the scientific literature, when such a conclusion is either unsupported or at best highly contested by published data.From a pathologist's perspective, this book would not substitute for a comprehensive pathology textbook or atlas of coronary artery disease. Neither does this book provide all the answers to many basic and clinical questions about the natural history or biologic behavior of atherosclerosis, nor does it serve as a comprehensive source of references for further exploration of the primary literature. However, with its readability and its crisp, albeit uneven, presentation, Inflammatory Atherosclerosis: Characteristics of the Injurious Agent should serve as a useful starting point for students interested in the research aspects of this complex disease process. Some may feel shortchanged because of the sometimes oversimplified and sweeping summaries of complex processes. Nonetheless, the book does give a good introduction to many of the important and incompletely understood aspects of atherosclerosis, and with its many well-chosen citations invites the interested reader to explore greater detail in other texts.