Anatomic-pathological bases of coronary heart disease
Schneider, J.
Praxis 84(42): 1176-1180
1995
ISSN/ISBN: 1661-8157 PMID: 7481330 Document Number: 442594
Coronary artery disease is described by its extreme presentations. At one end we see the slowly growing fibrous plaque gradually occluding the artery. Collaterals develop and confine the loss of myocardium to the inner layer of the left ventricle. At the other end of the spectrum we see the rupture of a soft plaque. Blood breaking in an atheroma occludes a coronary artery suddenly. There is no time to develop collaterals. The myocardial infarction corresponds in its size to the perfusion-area of the occluded artery. Transmural infarctions lead to rupture of the free wall, ventricular septum or papillary muscle. The coronary morphology of our patients suffering from coronary heart disease lies between these two extremes. However, many patients die suddenly due to arrhythmia a long time before the loss of myocardium disturbs left ventricular pump function so severely that lethal heart failure may develop.