 |
|
 |
|
ACS |
| Overview |
|
Plaques |
| Properties |
| Role of acute changes |
| Erosion & Disruption |
| Types |
| Fissuring & Rupture |
|
MI |
| Different forms of MI |
| Q Wave MI |
| Non-Q MI & Unstable Angina |
| Treatment of ACS |
| ¡@ |
| ¡@ |
Plaque Fissuring and Rupture ¡@ |
|
| ¡@ |  |
Multifactorial in nature |
|
T lymphocytes in atheroma elaborate IFN, causing fibrous cap more vulnerable due to less collagen | |
|
Increased rate of formation of metalloproteinase enzymes, due to increased numbers of activated macrophages and mast cells in the plaque | |
¡@
|
|
||
|
Small Thrombus due to Endothelial Erosion Two small thrombi approximately 1.5 mm in diameter adherent to the endothelial surface of a plaque, which is intact and shows no disruption. |
|
Large Thrombus due to Endothelial Erosion
A thrombus large enough to influence flow and be visible on angiography is adherent to the endothelial surface of an intact plaque. |
| Plaque Disruption A plaque cap has torn and projects upward (arrow) into the coronary artery lumen. The bed of the exposed lipid core is filled with thrombus. |