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An atheroma, or atheromatous plaque, is an abnormal accumulation of material in the inner layer of an arterial wall. [1] [2]The material consists of mostly macrophage cells, [3] [4] or debris, containing lipids, calcium and a variable amount of fibrous connective tissue.
Foam cells form the fatty streaks of the plaques of atheroma in the tunica intima of arteries. Foam cells are not dangerous as such, but can become a problem when they accumulate at particular foci thus creating a necrotic centre of atherosclerosis.
A vulnerable plaque is a kind of atheromatous plaque – a collection of white blood cells (primarily macrophages) and lipids (including cholesterol) in the wall of an artery – that is particularly unstable and prone to produce sudden major problems such as a heart attack or stroke.
In coronary heart disease, the coronary arteries narrow due to the buildup of atheroma or fatty deposits on the vessel walls. The atheroma causes the blood flow of the arteries to be restricted. [6] By restricting the blood flow, the tissue is still receiving some oxygen, but not enough to sustain the tissue over time. [5]
Coronary artery disease (CAD), also called coronary heart disease (CHD), or ischemic heart disease (IHD), [13] is a type of heart disease involving the reduction of blood flow to the cardiac muscle due to a build-up of atheromatous plaque in the arteries of the heart. [5] [6] [14] It is the most common of the cardiovascular diseases. [15]
The result is the formation of a thrombus (blood clot) overlying the atheroma, which obstructs blood flow acutely. With the obstruction of blood flow, downstream tissues are starved of oxygen and nutrients. If this is the myocardium (heart muscle) angina (cardiac chest pain) or myocardial infarction (heart attack) develops. [citation needed]
The fibrous cap of an atheroma is composed of bundles of muscle cells, macrophages, foam cells, lymphocytes, collagen and elastin. [1] The fibrous cap is prone to rupture and ulceration which can lead to thrombosis. In advanced lesions, further complications may arise including calcification of the fibrous cap. [2]
In those who have ACS, atheroma rupture is most commonly found 60% when compared to atheroma erosion (30%), thus causes the formation of thrombus which block the coronary arteries. Plaque rupture is responsible for 60% in ST elevated myocardial infarction (STEMI) while plaque erosion is responsible for 30% of the STEMI and vice versa for Non ST ...