…severe, myocardial necrosis. It most commonly reflects atherothrombosis: disruption of an atherosclerotic plaque followed by platelet activation and coagulation, with formation of an intraluminal thrombus…

… neovascularization and intraplaque haemorrhage; calcification and remodelling; episodic plaque disruption followed by thrombosis. Atherosclerotic disease usually evolves over decades. Intimal thickening may be present during…

Introduction to Coronary Atherosclerosis, Plaques, Atherothrombosis Coronary atherosclerosis is a chronic, progressive, and highly dynamic inflammatory disease of the arterial wall. It is characterized by…

…ischemia and infarction Definition and Pathophysiology Intravascular imaging comprises catheter based techniques that directly visualize the coronary lumen, vessel wall, plaque, thrombus, and implanted stents…

…Myocardial ischemia and infarction Definition and Pathophysiology Coronary artery calcium (CAC) scoring is a non invasive method for detecting and quantifying calcified coronary atherosclerotic plaque…

…tomographic angiography (CCTA) is a non invasive anatomical examination that depicts the coronary arterial lumen, atherosclerotic plaque, and the severity and distribution of coronary stenosis…

…oxidative stress, endothelial function, plaque stability, thrombogenic responses and immune activity. Statin intolerance refers to adverse effects attributed to statin treatment that improve or resolve…

…By definition, acute atherothrombotic plaque disruption is not a feature of Type 2 MI. The pathophysiology of Type 2 MI is fundamentally distinct from that…

…infarction Classification, diagnosis and definitions of acute coronary syndromes (ACS) and acute myocardial infarction (AMI) Acute coronary syndromes occur when atherosclerotic plaques disrupt, resulting in…

…rupture or erosion of a vulnerable (unstable) atherosclerotic coronary plaque. Upon such damage, the plaque exposes highly thrombogenic materials which activate circulating platelets and coagulation…

…subclavian artery. Penetrating atherosclerotic ulcer PAU is focal ulceration of an atherosclerotic plaque that penetrates through the internal elastic lamina into the media. The lesion…

…other apoB containing lipoproteins within the arterial wall. This initiates inflammatory reactions that promote plaque formation and progression. As the burden of retained atherogenic particles…

…to transient ischaemic attack (TIA) or stroke. The risk associated with asymptomatic disease depends substantially on stenosis severity and plaque characteristics. In the general population…

…disease may be obstructive or non obstructive. Atherosclerotic plaque accumulation in the epicardial arteries is a major pathological substrate, but ischaemia may also result from…

…Relevant determinants include: Lesion eccentricity Vessel tortuosity Calcification Plaque rupture or asymmetric filling defects Serial lesions Vessel size The relationship of the lesion to side…

…rehabilitation, ablative or surgical interventions The test does not define the structure or composition of coronary atherosclerotic plaque, identify plaques at high risk of rupture…

…IVUS) and optical coherence tomography (OCT) provide cross sectional information about plaque morphology and may clarify the mechanism of an acute coronary syndrome or guide…

…reduces thrombogenicity, and favourably modifies inflammatory and collagen related components of atherosclerotic plaque. These effects help explain why reductions in cardiovascular events are substantially greater…

…obstructive lesion Coronary embolism or thrombus Epicardial coronary vasospasm Coronary microvascular dysfunction Spontaneous coronary artery dissection (SCAD) Standard angiography may fail to demonstrate plaque disruption…

…Plaque or thrombus may be dislodged by: Balloon inflation Atherectomy Stent implantation Manipulation of friable SVG lesions Embolic debris obstructs the distal microcirculation and may…

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

…in coronary blood flow caused by thrombotic occlusion of a previously atherosclerotic artery. Plaque erosion or rupture exposes thrombogenic material to circulating blood. Platelets adhere…

…fibrin rich thrombus. In contrast, plaque erosion tends to occur in vessels with little or no lipid core, rich proteoglycans, and many smooth muscle cells…

…artery. A vulnerable atherosclerotic plaque and thrombogenic blood interact to initiate and extend thrombosis. Plaque vulnerability is influenced by inflammation, plaque morphology and location, comorbidities…

…platelet rich because they form under high shear conditions. Disruption of an atherosclerotic plaque or injury associated with PCI exposes thrombogenic material, promoting platelet activation…

…therefore be considered throughout assessment. Coronary disease is most commonly related to atheromatous plaque producing progressive narrowing or obstruction of epicardial coronary arteries. Endothelial dysfunction…

…performing an ultrasound is to scrutinize potential cardiac sources of emboli and to evaluate the carotid and cerebral arteries. Ultrasound may reveal atherosclerotic plaques, thrombi…

…setting of stable ischemic heart disease, an atherosclerotic plaque causes ischemia when myocardial oxygen demand exceeds the oxygen supply. The most characteristic manifestation of ischemic…

…in increased levels of circulating pro inflammatory cytokines that may cause plaque rupture (i.e the risk of atherosclerotic plaque rupture is increased during infections)…

…RA is associated with increased carotid intima–media thickness, early plaque formation and coronary microvascular dysfunction. Women with RA were reported to have approximately twice…

…plaque disruption (rupture or erosion). The dynamic thrombotic component can vary in burden and may lead to distal coronary embolization, resulting in myocyte necrosis. Plaque…

…smooth muscle cells, reducing cytokines like IL 6 and TNF α. 11 Plaque Stability: By reducing macrophage infiltration and inhibiting foam cell formation, they stabiliz

…and demand. The universal classification distinguishes infarction according to its mechanism: Type 1 myocardial infarction: acute atherosclerotic plaque disruption or erosion with coronary thrombosis. Type…

…usually related to plaque rupture or erosion Type 2 MI caused by oxygen supply–demand imbalance unrelated to acute atherothrombosis Type 3 Cardiac death with…

…should be performed under continuous ECG and blood pressure monitoring and must be avoided in patients with carotid bruits, possible or known plaques, or stenosis…

…progressive disease. NSTE ACS (Non ST Elevation Acute Coronary Syndrome) : NSTE ACS is an acute condition that occurs when an atherosclerotic plaque ruptures, which causes…

…smoking, hypertension, hyperlipidemia, diabetes, etc) modifies the progression rate in the atherosclerotic plaque. The more inflammation and more risk factors, the more aggressive atherosclerosis. Moreover…

…In stable angina pectoris, there are atherosclerotic plaques which limit coronary blood flow and cause symptoms during increased myocardial workload (exercise). The more severe the…

…thrombogenic and pro thrombolytic factors determines whether atherothrombosis occurs, and these factors vary from minute to minute. Only a minority of all plaque disruptions resul

…and biochemical stage for sudden, life threatening acute coronary syndromes when the structural stability of the plaque is acutely compromised [7] . Sub group analyses from…

…progressive disease. NSTE ACS (Non ST Elevation Acute Coronary Syndrome) : NSTE ACS is an acute condition that occurs when an atherosclerotic plaque ruptures, which causes…