Study note

Pathogenesis of acute coronary syndrome

THE CONTEXT

Acute coronary syndrome almost always occurs in patients with coronary atherosclerosis, with dynamic changes in the culprit lesion.

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The acute event is usually precipitated by a complex ulcerated or fissured atheromatous plaque.

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The plaque has an adherent platelet-rich thrombus and associated local coronary artery spasm.

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Obstruction may increase and progress to complete vessel occlusion.

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Obstruction may regress through platelet disaggregation and endogenous fibrinolysis.

NEETx

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