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Koronaratherosklerose, Fissurbildung der Plaque und Thrombose

  • Conference paper
Thrombolytische Therapie des akuten Herzinfarkts

Zusammenfassung

Bei der Autopsie von Patienten, bei denen sich nach einem thrombotischen Verschluß einer Koronararterie ein tödlich verlaufender Myokardinfarkt entwickelt hat, stellt der Pathologe im Normalfall eine hochgradige Atherosklerose am Ort der Läsion fest. Dieser Zusammenhang ist seit mehr als einem halben Jahrhundert bekannt, und er gilt auch weiterhin. Die ersten Untersucher erkannten, daß der Mechanismus der verursachenden Läsion komplex ist. Trotz dieser Erkenntnis führte die Annahme, Hauptursache seien Lipidablagerungen, zu dem weithin vertretenen Konzept der Atherosklerose als unabhängigem Krankheitsprozeß, bis er durch eine Thrombose kompliziert wird. Langsam setzt sich die Einsicht durch, daß dieses Konzept zu stark vereinfacht und daß nicht zum Verschluß führende Episoden einer Thrombusbildung — nicht nur beim Myokardinfarkt und anderen ischämischen Syndromen, sondern auch in der Pathogenese der Atherosklerose selbst — eine wichtige Rolle spielen. Das heißt, der Thrombus, welcher letztlich das Lumen vollständig verschließt und sich als Myokardinfarkt oder plötzlicher Herztod manifestiert, kann als Endpunkt einer Kette kleinerer thrombotischer Ereignisse verstanden werden. Hierbei kann sich der Thrombus auf der Lumenoberfläche oder innerhalb der Intima oder an beiden Stellen gleichzeitig gebildet haben. Im folgenden wird besonders auf die komplexen Wechselwirkungen zwischen Atherosklerose und Thrombose eingegangen.

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Authors
  1. W. F. M. Fulton
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Editor information

Editors and Affiliations

  1. Department of Cardiology, The Royal Infirmary, EH3 9YW, Edinburgh, Scotland, UK

    David P. de Bono M.D., F.R.C.P.

  2. Department of Cardiology, University Hospital, F-37044, Tours Cedex, France

    Mireille L. Brochier M.D.

  3. Akademisch Ziekenhuis, Thoraxcentrum, Erasmus University Rotterdam, Molewaterplein, NL-3015 DG, Rotterdam, The Netherlands

    Paul G. Hugenholtz M.D.

  4. Abteilung Innere Medizin III, Medizinische Universitätsklinik, Universität Heidelberg, Bergheimerstraße 58, D-6900, Heidelberg, Deutschland

    Wolfgang Kübler

  5. Center for Thrombosis and Vascular Research Campus Gasthuisberg, Katholieke Universiteit Leuven, Herestraat 49, B-3000, Leuven, Belgium

    Marc Verstraete M.D., Ph.D., F.R.C.P.

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© 1987 Springer-Verlag Berlin Heidelberg

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Fulton, W.F.M. (1987). Koronaratherosklerose, Fissurbildung der Plaque und Thrombose. In: de Bono, D.P., Brochier, M.L., Hugenholtz, P.G., Kübler, W., Verstraete, M. (eds) Thrombolytische Therapie des akuten Herzinfarkts. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-72754-2_2

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  • DOI: https://doi.org/10.1007/978-3-642-72754-2_2

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-17922-1

  • Online ISBN: 978-3-642-72754-2

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