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Related Concept Videos

Imaging Studies for Cardiovascular System III: X-Ray01:20

Imaging Studies for Cardiovascular System III: X-Ray

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The most common cardiovascular diagnostic test is an X-ray. It produces images of the heart, blood vessels, and adjacent structures.
Definition and Purpose
An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular...
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Imaging Studies for Cardiovascular System IV: CMRI01:21

Imaging Studies for Cardiovascular System IV: CMRI

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Cardiovascular magnetic resonance imaging, or CMRI, is a non-invasive diagnostic test that employs a magnetic field and radiofrequency waves to create precise images of the heart and arteries. It provides comprehensive information about cardiac anatomy, function, perfusion, and tissue characterization without ionizing radiation.IndicationsCMRI diagnoses various heart conditions, including tissue damage from heart attacks, ischemic heart disease, myocarditis, aortic issues (tears, aneurysms,...
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Imaging Studies for Cardiovascular System V: CT01:28

Imaging Studies for Cardiovascular System V: CT

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Cardiac computed tomography (CT) scanning is an advanced cardiac imaging technique that utilizes CT technology, with or without intravenous (IV) contrast, to produce accurate cross-sectional virtual slices of specific areas of the heart, coronary circulation, and major blood vessels such as the aorta, pulmonary veins, and arteries. The computer processes these slices to generate three-dimensional images. Multidetector CT (MDCT) is a rapid form of CT scanning that captures multiple slices...
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Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT01:25

Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT

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Calcium-Scoring CT ScanA calcium-scoring CT scan, also known as coronary artery calcium (CAC) scan, detects calcium deposits in the coronary arteries. This test assesses the risk of coronary artery disease (CAD), which can lead to cardiovascular events such as angina, heart failure, and sudden cardiac arrest.A calcium-scoring CT scan is generally recommended for individuals at intermediate risk of CAD without symptoms. It includes:Men aged 40-75 and women aged 50-75: Especially those with a...
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Coronary Artery Disease IV: Preventive Measures01:26

Coronary Artery Disease IV: Preventive Measures

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Effective preventive measures for coronary artery disease (CAD) focus on controlling modifiable risk factors, including cholesterol abnormalities and lifestyle changes.Cholesterol ManagementFirst, the Mediterranean diet and the American Heart Association advocate for maintaining low-density lipoprotein (LDL) cholesterol levels below 100 mg/dL, with a more stringent recommendation of below 70 mg/dL for individuals at high risk. LDL cholesterol, often termed "bad cholesterol," can lead to the...
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Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

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Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
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Related Experiment Video

Updated: Apr 26, 2026

In vivo Near Infrared Fluorescence NIRF Intravascular Molecular Imaging of Inflammatory Plaque, a Multimodal Approach to Imaging of Atherosclerosis
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Vulnerable or High-Risk Plaque: A JACC: Cardiovascular Imaging Position Statement.

Rocco Vergallo1, Seung-Jung Park2, Gregg W Stone3

  • 1IRCCS Ospedale Policlinico San Martino, Genoa, Italy; Università di Genova, Genoa, Italy.

JACC. Cardiovascular Imaging
|February 28, 2025
PubMed
Summary

The definition of high-risk plaque is evolving beyond rupture-prone thin-cap fibroatheroma. A broader perspective is needed to include plaque erosion and other factors contributing to coronary thrombosis.

Keywords:
acute coronary syndromeerosionhigh-risk plaqueimaginglipid-lowering therapiesoutcomepreemptive stentingrupturethin-cap fibroatheromathrombosisvulnerable plaque

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Area of Science:

  • Cardiology
  • Pathology
  • Biomedical Engineering

Background:

  • High-risk plaque, traditionally defined as thin-cap fibroatheroma prone to rupture, has been linked to acute coronary syndromes.
  • Shifting patient risk profiles and evolving atherosclerotic disease due to preventive therapies necessitate a re-evaluation of high-risk plaque concepts.
  • Intracoronary imaging reveals superficial erosion causes up to 40% of acute coronary syndromes, challenging the sole focus on plaque rupture.

Purpose of the Study:

  • To propose a broader definition of high-risk plaque beyond traditional rupture-prone morphology.
  • To analyze key morphologic features, technological advancements in plaque imaging, and therapeutic strategies for plaque stabilization and regression.
  • To discuss the feasibility and efficacy of interventional treatments for high-risk atherosclerotic lesions.

Main Methods:

  • Review of pathologic and epidemiologic studies on plaque rupture and thrombosis.
  • Analysis of in vivo intracoronary imaging data on plaque erosion.
  • Synthesis of current knowledge on plaque composition, inflammation, healing, hemodynamics, and blood properties.
  • Evaluation of technological progress in plaque imaging and interventional treatments.

Main Results:

  • The concept of high-risk plaque needs expansion to encompass precursors of all coronary thrombosis substrates, not just plaque rupture.
  • Factors such as dynamic plaque changes, burden, inflammation, healing, hemodynamics, and blood properties are crucial.
  • Intracoronary imaging techniques have advanced significantly for plaque characterization.
  • Pharmacologic and interventional therapies show promise for plaque regression, stabilization, and sealing.

Conclusions:

  • A comprehensive approach to high-risk plaque should integrate morphologic features with biological activity of plaques and blood.
  • The traditional focus on thin-cap fibroatheroma is insufficient; a broader definition encompassing erosion and other thrombotic substrates is advocated.
  • Technological and therapeutic advancements offer new avenues for managing high-risk atherosclerotic disease and preventing adverse cardiovascular events.