…of the chest or the epigastrium and occasionally radiates to the arms. Less common sites of radiation include the abdomen, back, lower jaw, and neck…

…anatomical examination that depicts the coronary arterial lumen, atherosclerotic plaque, and the severity and distribution of coronary stenosis. Modern cardiac CT can acquire a three…

…Location and radiation. Quality and intensity. Precipitating factors, including exertion, emotional stress, meals, or exposure to cold. Relieving factors, including rest or medication. Time of…

…Differential diagnoses and alternative causes of troponin release must therefore be considered throughout assessment. Coronary disease is most commonly related to atheromatous plaque producing progressive…

…single breath hold No intravenous line No premedication No special preparation Radiation exposure of approximately 1–1.5 mSv with contemporary techniques The total CAC…

…chest or epigastrium. Radiation may occur to one or both arms and less commonly to the abdomen, back, neck or lower jaw. Discomfort may extend…

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

…episodic plaque disruption followed by thrombosis. Atherosclerotic disease usually evolves over decades. Intimal thickening may be present during the second and third decades of life…

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

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

…oxygen supply and demand, which is not related to acute coronary atherothrombosis. By definition, acute atherothrombotic plaque disruption is not a feature of Type 2…

…the plaque exposes highly thrombogenic materials which activate circulating platelets and coagulation factors, which results in thrombus formation (Figure 1). Disruption of an atherosclerotic plaque…

…ulceration of an atherosclerotic plaque that penetrates through the internal elastic lamina into the media. The lesion may produce a localized medial haematoma and can…

…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…

…disease depends substantially on stenosis severity and plaque characteristics. In the general population, the prevalence of asymptomatic carotid stenosis of at least 70% is low…

…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…

…increases in heart rate, myocardial contractility and blood pressure. When coronary blood flow cannot increase adequately because of flow limiting disease, myocardial ischaemia may develop…

…margins and a narrow neck. These findings may reflect plaque disruption or thrombus. A rounded or polypoid intraluminal mass and lesion haziness raise suspicion of…

…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…

…dissection (SCAD) Standard angiography may fail to demonstrate plaque disruption, intraluminal thrombus, or dissection. Intravascular ultrasound (IVUS) and optical coherence tomography (OCT) can reveal lesions…

…is distal embolization of atheromatous and thrombotic material. Plaque or thrombus may be dislodged by: Balloon inflation Atherectomy Stent implantation Manipulation of friable SVG lesions…

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

…by thrombotic occlusion of a previously atherosclerotic artery. Plaque erosion or rupture exposes thrombogenic material to circulating blood. Platelets adhere, become activated, and aggregate through…

…high shear conditions. Disruption of an atherosclerotic plaque or injury associated with PCI exposes thrombogenic material, promoting platelet activation, aggregation, and fibrin formation. Within a…

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

…of the cap, leading to structural failure. Rupture exposes highly thrombogenic subendothelial matrix components, notably tissue factor and collagen, to the circulating blood [3] . Plaque…

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

…levels who had underlying cardiovascular disease, of which 69.4% died. Guo et al also report a significant association between troponin T levels and C…

…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…

…However, the emergence of incretin based therapies, starting with glucagon like peptide 1 receptor agonists (GLP 1 RAs) and evolving into multi receptor agonists, has…

…between myocardial oxygen supply and demand. The universal classification distinguishes infarction according to its mechanism: Type 1 myocardial infarction: acute atherosclerotic plaque disruption or erosion…

…myocardial infarction Definition and pathophysiology Type 1 MI results from acute coronary atherothrombosis. It is usually precipitated by disruption of an atherosclerotic plaque through rupture…

…STE ACS (ST Elevation Acute Coronary Syndrome) : STE ACS occurs when plaque rupture, and the ensuing atherothrombosis, causes a complete occlusion of the coronary artery…

…persons have some degree of atherosclerosis in the coronary arteries. Advanced atherosclerotic plaques contain inflammatory cells, smooth muscle cells, extracellular matrix, lipids and acellular debris…

…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…

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

…it sets the anatomical and biochemical stage for sudden, life threatening acute coronary syndromes when the structural stability of the plaque is acutely compromised [7…

…STE ACS (ST Elevation Acute Coronary Syndrome) : STE ACS occurs when plaque rupture, and the ensuing atherothrombosis, causes a complete occlusion of the coronary artery…

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

…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…