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Acute Myocardial Infarction Caused by Distal Embolization From a Proximal Ruptured Plaque

Sei Komatsu1, Chikao Yutani2, Satoru Takahashi1

  • 1Department of Cardiology, Cardiovascular Center, Osaka Gyoumeikan Hospital, Osaka, Japan.

JACC. Case Reports
|July 28, 2021
PubMed

Insights

Acute myocardial infarction can occur when plaque ruptures at non-obstructive sites, leading to blood clots. Coronary angioscopy identified these ruptures, revealing atheromatous materials in the plaque.

Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology

Background:

  • Acute myocardial infarction (AMI) is often associated with plaque rupture at the occluded site.
  • The precise location and mechanism of plaque rupture in AMI require further investigation.

Purpose of the Study:

  • To investigate plaque rupture characteristics in acute myocardial infarction using coronary angioscopy.
  • To determine if plaque rupture at non-obstructive lesions contributes to AMI.

Main Methods:

  • Coronary angioscopy was employed to visualize the coronary arteries.
  • Plaque samples were aspirated and analyzed for composition.

Main Results:

  • Coronary angioscopy detected plaque rupture at a non-stenotic lesion in a case of AMI.
  • Aspirated plaque material included atheromatous components, cholesterol crystals, and fibrin.
  • Thrombotic occlusion, potentially independent of rupture severity, was implicated in AMI.

Conclusions:

  • Plaque rupture at non-stenotic lesions can be a significant factor in acute myocardial infarction.
  • Coronary angioscopy is effective in identifying rupture sites in non-obstructive lesions.
  • The composition of ruptured plaques provides insights into thrombotic events during AMI.

Keywords:
CC, cholesterol crystalNOGA, nonobstructive general angioscopyacute coronary syndromecholesterol crystalscoronary arterynonobstructive general angioscopy

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