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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 .
Generally an atheroma becomes vulnerable if it grows more rapidly and has a thin cover separating it from the bloodstream inside the arterial lumen. Tearing of the cover is called plaque rupture. However, a repeated atheroma rupture and healing is one of the mechanisms, perhaps the dominant one, that creates artery stenosis.
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]
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.
Progression of atherosclerosis. A fatty streak is the first grossly visible (visible to the naked eye) lesion in the development of atherosclerosis.It appears as an irregular yellow-white discoloration on the luminal surface of an artery.
Atherosclerosis [a] is a pattern of the disease arteriosclerosis, [8] characterized by development of abnormalities called lesions in walls of arteries.This is a chronic inflammatory disease involving many different cell types and driven by elevated levels of cholesterol in the blood. [9]
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]
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 ...