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Unformatted text preview: atherosclerotic plaque is arterial inflammation, caused by noninfectious (e.g., oxidized lipids) and, possibly, infectious stimuli, which can lead to plaque expansion and destabilization, rupture or erosion, and thrombogenesis. Activated macrophages and T lymphocytes located at the shoulder of a plaque increase the expression of enzymes such as metalloproteinases that cause thinning and disruption of the plaque, which in turn can lead to UA/NSTEMI. Unstable Angina
Unstable Angina Anginal pain of increasing severity occurring at rest or increasing in frequency or new onset severe angina over a short period
More ominous Suggests inflammation or plaque erosion/early rupture Need admission to hospital STEMI( Q wave MI)
STEMI Larger epicardial vessels
> 20/30 mins complete occlusion (angina = 10/15 min)
Complete occlusion with minimal collaterals Transmural infarct
Activation of primarily the coagulation system
Leads to the formation of a fibrin rich clot
The ‘red’ clotThrombin rich
Causes ST elevation on the ECG ST segment above baseline NON STEMI( NON Q Wave MI)
NON STEMI Occurs in epicardial vessels
Incomplete occlusion of the ves...
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This document was uploaded on 01/10/2014.
- Winter '14