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Related Concept Videos

Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations01:19

Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations

The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
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Coronary Artery Disease (CAD) originates from a series of events that impair the function of coronary arteries, the blood vessels responsible for delivering oxygen-rich blood to the heart muscle. The pathophysiology of CAD is closely linked to atherosclerosis, a chronic inflammatory and lipid-driven condition affecting the vascular endothelium.1. Endothelial DamageThe process begins with damage to the vascular endothelium, which serves as a protective barrier between the blood and the vessel...
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Acute Coronary Syndrome I: Introduction

Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
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Cardiac Magnetic Resonance for the Evaluation of Suspected Cardiac Thrombus: Conventional and Emerging Techniques
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Extensive coronary thrombus causing full thickness myocardial infarction.

Nicholas Curzen1, Robert Hatrick, Charles Peebles

  • 1Wessex Cardiac Unit, Southampton University Hospital, Southampton, UK. nick.curzen@suht.swest.nhs.uk

Acute Cardiac Care
|September 14, 2007
PubMed
Summary

This case study highlights a young male with ST-elevation myocardial infarction. Cardiac MRI confirmed infarction, indicating no further intervention was needed, with the patient recovering well.

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Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Cardiac Imaging

Background:

  • ST-elevation myocardial infarction (STEMI) requires prompt reperfusion therapy.
  • Thrombolytic therapy failure necessitates rescue angioplasty.
  • Extensive thrombus burden can complicate percutaneous coronary intervention.

Observation:

  • A young male presented with STEMI 22 hours after symptom onset.
  • Rescue angioplasty revealed extensive thrombus in the left anterior descending artery.
  • Symptoms resolved, and thrombectomy was deferred due to risks.

Findings:

  • Cardiac MRI with delayed gadolinium hyper-enhancement confirmed full-thickness infarction in the LAD territory.
  • No further intervention was indicated based on imaging findings.
  • The patient remained asymptomatic with minimal heart failure symptoms at one-year follow-up.

Implications:

  • Cardiac MRI is crucial for assessing myocardial viability and guiding intervention in complex STEMI cases.
  • Conservative management guided by imaging can be effective despite significant thrombus burden.
  • Successful management of STEMI with extensive thrombus can lead to favorable long-term outcomes.