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Plaque rupture possibly induced by coronary spasm--an autopsy case of acute myocardial infarction
S Morimoto1, Y Shiga, S Hiramitsu
1Department of Internal Medicine, Fujita-Gakuen Health University School of Medicine, Toyoake, Japan.
Insights
Histopathological examination of coronary artery spasms revealed intimal bleeding and collagen fiber fractures. These findings suggest coronary spasms may contribute to acute myocardial infarction by causing plaque rupture and thrombus formation.
Area of Science:
- Cardiovascular Pathology
- Interventional Cardiology
Background:
- The histological characteristics of coronary artery spasm sites remain unclear.
- Acute myocardial infarction (AMI) can be refractory to treatment, sometimes linked to coronary spasms.
Observation:
- Histopathological examination of a patient with AMI and refractory coronary spasm was performed.
- The coronary artery site of spasm showed intimal bleeding and adventitial infiltration by lymphocytes and plasma cells.
Findings:
- Fracture of intimal collagen fibers and rupture of atheromatous plaque were observed at the spasm site.
- These histological changes indicate significant vascular damage associated with coronary spasms.
Implications:
- Coronary spasms may play a role in the pathogenesis of AMI, particularly in cases with plaque rupture and thrombus formation.
- Further research is needed to elucidate the precise contribution of coronary spasms to myocardial infarction.
Abstract:
The histological picture of sites of coronary spasms has not yet been made sufficiently clear. A histopathological examination was performed on the coronary artery of a patient who died of acute myocardial infarction after a refractory coronary spasm was identified by coronary arteriography. In the site of the coronary spasm, intimal bleeding as well as infiltration by lymphocytes and plasma cells in the adventitia were seen. In the same region, fracture of intimal collagen fibers and rupture of atheromatous plaque were observed. Although it is very difficult to prove in individual cases of acute myocardial infarction that spasms played a part, some cases involving spasms may possibly exist among the cases of acute myocardial infarction showing atheromatous plaque rupture--thrombus formation.