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Goxidizedlipidsand possiblyinfectiousstimuli

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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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