Encyclopedia of Heart Diseases

2011 Edition
| Editors: M. Gabriel Khan


Reference work entry
DOI: https://doi.org/10.1007/978-1-60761-219-3_12


In approximately 90% of cases, the cause of a fatal or a nonfatal myocardial infarction (MI) or stroke is a blood clot in a coronary artery (coronary thrombosis) or cerebral artery (cerebral thrombosis). The clot often occurs on the surface of a plaque of  atheroma that is partially obstructing the lumen of the coronary artery. Patients may have many large atheromatous plaques and yet do not develop a clot over a 5–40-year period. There is no test that can tell us when and where a clot will occur.

Reduction in fatal and nonfatal heart attacks and other thrombotic events requires prevention and therapeutic strategies that include
  • Prevention of atheroma formation in arteries; prevention of erosion or rupture of atheromatous plaques in the coronary arteries and cerebral circulation. Plaque rupture liberates highly thrombogenic substances that rapidly cause clotting and blockage of arteries.

  • Clot-dissolving drugs (thrombolytic agents).

  • Agents that prevent clot formation ( anticoagulants...

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Suggested Reading

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Case Studies

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