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The role of thrombosis in acute coronary heart disease

  • Chapter
Triggering of Acute Coronary Syndromes

Part of the book series: Developments in Cardiovascular Medicine ((DICM,volume 170))

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Abstract

The most frequently recognized cause of ischemic syndromes is atherosclerotic disease. Atherosclerotic lesions in the coronary tree may cause stable syndromes of ischemia by means of direct luminal arterial narrowing (stable lesions) or unstable ischemic syndromes by inducing acute intraluminal thrombus formation (unstable lesions). Rupture of the surface of an atherosclerotic plaque with subsequent exposure of thrombogenic plaque components to flowing blood is the key event to initiate thrombosis within coronary arteries. Clinical consequences of intracoronary thrombus depend on many factors such as the degree and acuteness of blood flow obstruction, the duration of decreased perfusion and the relative myocardial oxygen demand at the time of atherosclerotic plaque rupture. Therefore, the amount and duration of intracoronary thrombus play a major pathophysiologic role in acute ischemic syndromes. In general, acute myocardial infarction is associated with larger and more persistent thrombus than is unstable angina. Superimposed vasospasm and presence of adequate collateral circulation may also contribute to determine the clinical outcome of the ischemic insult.

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Authors
  1. Antonio Fernández-Ortiz
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  2. Valentín Fuster
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Editors and Affiliations

  1. Institute for Epidemiology, Social and Preventive Medicine, Humboldt University of Berlin, Klinikum Charité, Berlin, Germany

    Stefan N. Willich

  2. Institute for Prevention of Cardiovascular Disease, Deaconess Hospital, Harvard Medical School, Boston, USA

    James E. Muller

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© 1996 Kluwer Academic Publishers

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Fernández-Ortiz, A., Fuster, V. (1996). The role of thrombosis in acute coronary heart disease. In: Willich, S.N., Muller, J.E. (eds) Triggering of Acute Coronary Syndromes. Developments in Cardiovascular Medicine, vol 170. Springer, Dordrecht. https://doi.org/10.1007/978-94-009-1577-0_13

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  • DOI: https://doi.org/10.1007/978-94-009-1577-0_13

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