Coronary Artery Thrombus

Excerpt

Coronary artery thrombus occurs due to rupture or preexisting coronary artery plaque erosion, resulting in the artery's complete occlusion. It manifests clinically as an acute coronary syndrome, including ST-elevation MI, Non-ST elevation myocardial infarction, and unstable angina. The coronary thrombus can occur in both symptomatic and asymptomatic patients with significant or less than 50% stenosis. Coronary thrombus is 1 of the frequent causes of sudden cardiac death. The literature review shows that coronary thrombus causes one-third of the sudden cardiac death, completely occluding the culprit artery on autopsy. The amount and duration of coronary thrombus play an essential role in determining the prognosis of acute coronary syndrome patients. The coronary thrombus has a crucial impact on the performance and outcome of percutaneous coronary intervention (PCI). It is a strong predictor of PCI-induced major adverse coronary events, distal embolization, and stent thrombosis. This topic reviews the etiology, epidemiology, pathophysiology, histopathology, history and physical examination, treatment, differential diagnosis, staging, and prognosis of coronary thrombus.