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Pathology - Unstable angina
Definition: Severe acute myocardial ischemia without myocardial necrosis.
Epidemiology
• Extremely prevalent.
Aetiology
• Primarily attributable to coronary artery atherosclerosis.
Pathogenesis
• The erosion of the surface of an unstable atherosclerotic plaque prompts platelet aggregation on the plaque. • Platelet fragments may potentially dislodge and embolize downstream in the artery. The decrease in coronary blood flow results in acute ischemia of the afflicted myocardium, but does not lead to myocardial necrosis.
Presentation
• Acute coronary syndrome characterized by the abrupt onset of extended ischemic cardiac chest discomfort at rest or with modest exertion. • The electrocardiogram (ECG) reveals ischemia alterations, but lacks ST-elevation. Biochemistry • Blood troponin concentrations remain unchanged.
Macroscopy
• Significant narrowing of the affected coronary artery due to a complex atherosclerotic plaque. • No observable gross alterations in the myocardial. Histopathology • Absence of distinctive light microscopic characteristics in the myocardium.
Definition: Severe acute myocardial ischemia without myocardial necrosis.
Epidemiology
• Extremely prevalent.
Aetiology
• Primarily attributable to coronary artery atherosclerosis.
Pathogenesis
• The erosion of the surface of an unstable atherosclerotic plaque prompts platelet aggregation on the plaque. • Platelet fragments may potentially dislodge and embolize downstream in the artery. The decrease in coronary blood flow results in acute ischemia of the afflicted myocardium, but does not lead to myocardial necrosis.
Presentation
• Acute coronary syndrome characterized by the abrupt onset of extended ischemic cardiac chest discomfort at rest or with modest exertion. • The electrocardiogram (ECG) reveals ischemia alterations, but lacks ST-elevation. Biochemistry • Blood troponin concentrations remain unchanged.
Macroscopy
• Significant narrowing of the affected coronary artery due to a complex atherosclerotic plaque. • No observable gross alterations in the myocardial. Histopathology • Absence of distinctive light microscopic characteristics in the myocardium.
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