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What causes a Heart Attack?
Rupture of a stable plaque in a coronary artery is the initial pathological
event leading to a heart attack. When the rupture occurs, a clot suddenly forms
in the lumen (channel) of the artery at the site of the rupture. Bleeding into
the plaque often accompanies the rupture. The clot then blocks (occludes) the
artery and thereby decreases the blood flow to the heart. This sequence of
events in the coronary arteries is the basic problem in over 75% of people who
suffer a heart attack. In some patients, more often women, there is just an
erosion or ulceration of the plaque surface, rather than a full rupture that
leads to clot formation in the coronary artery. Figure 3 shows an atherosclerotic plaque rupture and a
clot in a coronary artery.
Figure 3: Rupture of Atherosclerotic Plaque in Coronary Artery
Cross-sectional Microscopic View