DAVID H. SPODICK, M.D., D.Sc.
How and why is an acute myocardial infarction precipitated in a patient who may not have had significant deterioration of structural and functional coronary abnormalities just before the infarction, and perhaps not for a long time before (1)? Numerous immediate mechanisms come to mind: the final addition to a relentless thrombotic silting over of an atheroma; sudden thrombosis owing to systemic, local arterial, or hemic changes; hemorrhage into, or rupture of, atherosclerotic plaque; and vasospasm with or without thrombosis. Regardless of the immediate "last straw," the question remains, What led to the infarction?
A recent investigation of pericarditis of many
SPODICK DH. Inflammation and the Onset of Myocardial Infarction. Ann Intern Med. 1985;102:699–702. doi: 10.7326/0003-4819-102-5-699
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Published: Ann Intern Med. 1985;102(5):699-702.
Acute Coronary Syndromes, Cardiology, Emergency Medicine.
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