Since we are talking about plaque disease, it would be interesting to read this free full-text article headed by Schaar J et al, that appeared in the European Heart Journal, in 2004, discussing the various terminologies related to plaques and their potential significance.
The terms discussed include culprit lesion, eroded plaque, high-risk vulnerable and thrombosis-prone plaque, inflamed thin-cap fibroatheroma (TCFA), plaque with a calcified nodule, ruptured plaque, thrombosed plaque and vulnerable patient. There are some excellent pathology images that illustrate the various terms.
This is a 67-years old lady who presented with an acute anterior wall and septal infarct. She was unwilling for a catheter angiogram and a cardiac CT was performed. This showed a soft plaque with a calcified nodule with approx. 40-50% stenosis (Figs. 1-3). No other pathology was seen and the rest of the LAD was normal. A catheter angiogram was then performed, which showed the same lesion (Fig. 4). Presumbly, this was the culprit lesion, which had either ruptured or thrombosed.
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