…Atherosclerotic lesions generally affect large and medium sized arteries. Pathological features include plaque formation with calcium deposition, medial thinning, destruction of muscular and elastic tissue…

…greater risk of progression or rupture than asymptomatic lesions. Predisposing conditions Aortic dissection and its variants are associated with conditions that cause medial degeneration or…

…particularly high risk and should influence the urgency of management: Recurrent or ongoing chest pain despite medical treatment Acute heart failure presumed to result from…

…to established reversible myocardial ischaemia in either of two settings: Obstructive coronary artery disease (CAD) that cannot be controlled despite escalation of antianginal medical therapy…

…CABG. Physical examination findings are not specific to left main disease. The examination should nevertheless assess the consequences of extensive myocardial ischaemia, including heart failure…

…decades, the lesion progresses from a simple fatty streak to a complex fibroatheroma. Smooth muscle cells (SMCs) migrate from the tunica media into the intima…

…infarction rates. Clinical presentation and symptoms The clinical presentation is determined primarily by the ACS syndrome and the haemodynamic consequences of the culprit lesion. Patients…

…followed by disruption of the intima. Intramural haematoma differs from classic dissection because haemorrhage occurs within the media without imaging evidence of an intimal tear…

…lesions Embolic debris obstructs the distal microcirculation and may be accompanied by microvascular constriction and endothelial or myocardial injury. Antithrombotic therapy may reduce embolization of…

…dysfunction (heart failure) and arrhythmias. The annual risk of sudden cardiac arrest is <1% and median survival is 3 years. Long term prognosis in aortiv…