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Coronary microembolization

Gerd Heusch1, Rainer Schulz, Michael Haude

  • 1Institut für Pathophysiologie, Zentrum für Innere Medizin, Universitätsklinikum Essen, Hufelandstrasse 55, Essen 45122, Germany.

Journal of Molecular and Cellular Cardiology
|July 10, 2004
PubMed

Insights

Atherosclerotic plaque rupture can cause coronary microembolization, leading to arrhythmias and microinfarcts. This review explores evidence and prevention strategies for this condition in acute coronary syndromes.

Area of Science:

  • Cardiovascular Medicine
  • Pathophysiology
  • Interventional Cardiology

Background:

  • Atherosclerotic plaque rupture is central to acute coronary syndromes and interventions.
  • Rupture can lead to microembolization of debris into the coronary microcirculation, not always complete occlusion.

Purpose of the Study:

  • To review morphological, experimental, and clinical evidence of coronary microembolization.
  • To detail its pathophysiology, clinical features, and prevention.

Main Methods:

  • Review of morphological evidence in deceased patients with coronary artery disease.
  • Analysis of experimental pathophysiology in animal models.
  • Synthesis of clinical evidence in patients with acute coronary syndromes.

Main Results:

  • Morphological evidence supports microembolization in coronary artery disease.
  • Experimental models elucidate pathophysiology.
  • Clinical features include arrhythmias, contractile dysfunction, microinfarcts, and reduced coronary reserve.

Conclusions:

  • Coronary microembolization is a significant consequence of plaque rupture.
  • Clinical features in patients mirror experimental findings.
  • Prevention strategies involve mechanical devices and glycoprotein IIb/IIIa antagonism.

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