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Inflammation and the Onset of Myocardial Infarction

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St. Vincent Hospital and University of Massachusetts Medical School; Worcester, Massachusetts

Ann Intern Med. 1985;102(5):699-702. doi:10.7326/0003-4819-102-5-699
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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


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