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A 24-hour ambulatory electrocardiographic (ECG) recording in a patient with coronary artery disease and episodes of lightheadedness. A: At 10:28:36 p.m., the ECG records ST depression in leads aVF and V5, with ST elevation in lead V1. Over the next 4 minutes, the changes of acute injury progress. B: The rhythm degenerates into polymorphic ventricular tachycardia, from which the patient was resuscitated. This demonstrates the interaction of myocardial ischemia and subsequent ventricular arrh...
A 24-hour ambulatory electrocardiographic (ECG) recording in a patient with coronary artery disease and episodes of lightheadedness. A: At...
Serial images before angioplasty and 6 months after angioplasty. A: Angioscopic appearance of a lesion before angioplasty in a patient with unstable angina discloses a yellow plaque (P) with a superimposed red thrombus (T). B: Angioscopy of the same lesion 6 months after successful angioplasty; angioscopy now discloses a white, smooth, concentric lesion without thrombus.
Serial images before angioplasty and 6 months after angioplasty. A: Angioscopic appearance of a lesion before angioplasty in a patient wit...
<bold>Figure 24-5. Pathophysiology of anginal syndromes. A.</bold> Normal coronary arteries are widely patent, the endothelium functions normally, and platelet aggregation is inhibited. <bold>B.</bold> In stable angina, atherosclerotic plaque and inappropriate vasoconstriction (caused by endothelial damage) reduce the vessel-lumen diameter, and hence decrease coronary blood flow. <bold>C.</bold> In unstable angina, rupture of the plaque triggers platelet aggregation, throm...
<bold>Figure 24-5. Pathophysiology of anginal syndromes. A.</bold> Normal coronary arteries are widely patent, the endothelium...
<bold>Figure 24-7. Pathogenesis of acutecoronary syndromes. A.</bold> A normal coronary artery has an intact endothelium surrounded by smooth muscle cells. <bold>B.</bold> Endothelial cell activation or injury recruits monocytes and T lymphocytes to the site of injury, leading to development of a fatty streak. <bold>C.</bold> Continued oxidative stress within a fatty streak leads to development of an atherosclerotic plaque. <bold>D.</bold> Macrophage apoptosis and co...
<bold>Figure 24-7. Pathogenesis of acutecoronary syndromes. A.</bold> A normal coronary artery has an intact endothelium surro...
Coronary Artery Disease Progression Labeled
Atherosclerotic coronary occlusion. A coronary artery of a patient who died from an acute myocardial infarction shows severe atherosclerosis and a recent thrombus in the narrowed lumen.
Atherosclerotic coronary occlusion. A coronary artery of a patient who died from an acute myocardial infarction shows severe atherosclerosi...