…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…

…or another form of physiological stress, but it may also occur at rest or remain clinically silent. The underlying coronary disease may be obstructive or…

…of coronary calcification using four categories—none, mild, moderate, or severe—is recommended when such findings are available. Further diagnostic imaging solely because calcified plaque…

Myocardial ischemia and infarction ECG Definition and Pathophysiology Acute coronary syndromes (ACS) encompass a spectrum of clinical conditions characterized by a recent change in symptoms…

…myocardial bridging and radiation induced coronary disease. The distinction between UA and NSTEMI has become increasingly dependent on the use of highly sensitive cardiac troponin…

…of an epicardial coronary artery. A vulnerable atherosclerotic plaque and thrombogenic blood interact to initiate and extend thrombosis. Plaque vulnerability is influenced by inflammation, plaque…

…coronary blood flow sufficient to produce myocardial ischaemia and, when prolonged or severe, myocardial necrosis. It most commonly reflects atherothrombosis: disruption of an atherosclerotic plaque…

…and plaque architecture The major coronary risk factors—high LDL cholesterol, cigarette smoking, hypertension and diabetes mellitus—disturb endothelial function and favour the accumulation of…

…of these techniques rests on their ability to characterize the anatomy responsible for a stenosis, define plaque morphology, identify occult lesions, and optimize percutaneous coronary…

…also reduce production of apoB 100 containing lipoproteins and exert effects beyond LDL C reduction, including modulation of inflammation, oxidative stress, endothelial function, plaque stability…

…the context of a mismatch between myocardial oxygen supply and demand, which is not related to acute coronary atherothrombosis. By definition, acute atherothrombotic plaque disruption…

…of coronary artery disease. The most common initiating mechanism is rupture or erosion of a vulnerable (unstable) atherosclerotic coronary plaque. Upon such damage, the plaque…

…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…

…deposition and retention of LDL C and other apoB containing lipoproteins within the arterial wall. This initiates inflammatory reactions that promote plaque formation and progression…

…It forms part of multisite artery disease, defined as atherosclerosis affecting at least two vascular beds. Carotid disease therefore commonly coexists with coronary artery disease…

…can refine interpretation. Coronary plaque and future events Angiographic stenosis severity is an imperfect predictor of future myocardial infarction or sudden death. Lesions causing only…

…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…

…investigate coronary vasospasm. Intravascular ultrasound (IVUS) and optical coherence tomography (OCT) provide cross sectional information about plaque morphology and may clarify the mechanism of an…

…components of atherosclerotic plaque. These effects help explain why reductions in cardiovascular events are substantially greater than the usually modest anatomical regression of coronary atherosclerosis…

…Coronary mechanisms Coronary mechanisms include: Plaque rupture or plaque erosion with thrombosis, despite the absence of an angiographically obstructive lesion Coronary embolism or thrombus Epicardial…

…threefold higher risk of death. Evaluation and Procedural Recognition Recognition is primarily angiographic and clinical. No reflow should be suspected when distal coronary perfusion remains…

…perfusion is insufficient to meet the basal nutritional requirements of tissue. Typical symptoms include: Ischaemic rest pain. Coldness or numbness of the foot and toes…

…Coronary Occlusion and Myocardial Injury STEMI generally results from abrupt reduction in coronary blood flow caused by thrombotic occlusion of a previously atherosclerotic artery. Plaque…

…Coronary arterial thrombi are predominantly platelet rich because they form under high shear conditions. Disruption of an atherosclerotic plaque or injury associated with PCI exposes…

…size of the thrombus and the plaque. The patient will experience severe chest pain due to the abrupt reduction of coronary blood flow. Acute coronary…

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…

…disease, the majority of all ischemic episodes are asymptomatic (refer to The Ischemic Cascade). Acute coronary syndromes occur when atherosclerotic plaques rupture or erode, leading…

Cardiology Continous medical discussion: the ECG blog Infectious diseases Cardiovascular effects of COVID 19 Coronavirus disease 2019 (COVID 19) has caused a global public health…

…thickness, early plaque formation and coronary microvascular dysfunction. Women with RA were reported to have approximately twice the myocardial infarction risk of age matched controls…

…into the plaque through the disrupted surface. Type 2 MI: Attributed to an imbalance between myocardial oxygen supply and demand, without the presence of acute…

…with coronary microvascular dysfunction and major adverse cardiovascular events (MACE), whereas BMI alone often fails to capture these specific pathological drivers. 5 Physiological Mechanisms of…

…Causes of myocardial injury Important causes include: Mechanism or clinical setting Examples Acute coronary atherothrombosis Plaque disruption or erosion with thrombosis Reduced myocardial perfusion Coronary…

…be accompanied by haemorrhage into the plaque. The diagnosis is supported by the general criteria for acute MI together with evidence of acute coronary atherothrombosis…

…etc ) accelerate the atherosclerotic process and increase the number and size of atherosclerotic plaques. Typically, the first manifestation of coronary artery disease is stable angina…

…within minutes. Stable coronary plaques cause symptoms at the same level of myocardial workload and the symptoms disappear within minutes after stopping the activity. The…

…depression has an upsloping ST segment during exercise stress testing. Stable coronary artery disease (atherosclerotic plaque causing 70% stenosis or more) At rest No symp

…similar to acute coronary syndromes. An acute coronary syndrome is the result of a perfect storm scenario, where disruption of an atherosclerotic plaque coincides with…

…coronary syndromes when the structural stability of the plaque is acutely compromised [7] . Sub group analyses from longitudinal angiographic registries demonstrate that the severity of…

…etc ) accelerate the atherosclerotic process and increase the number and size of atherosclerotic plaques. Typically, the first manifestation of coronary artery disease is stable angina…

…TIA (transient ischemic attack), coronary artery occlusion, and peripheral embolization. Stroke is the third leading cause of death in Western countries, and ultrasound studies are…

…possible or known plaques, or stenosis. Diagnostics Electrocardiogram and Cardiac Monitoring An ECG should be performed if there is suspicion of syncope due to an…