A 59-year-old man with hyperlipidemia and hypertension presents with acute onset crushing substernal chest pain at rest. Vital signs show BP 168/94 mmHg, HR 102 bpm, RR 20, SpO2 98% on room air. Troponin I is elevated at 2.4 ng/mL. Coronary angiography reveals rupture of a previously nonobstructive plaque with superimposed thrombosis occluding the left anterior descending artery. He denies prior anginal episodes. Which plaque feature most strongly predisposed to rupture?
- A)Large lipid core with thin fibrous capGABARITO
- B)Dense medial calcification without inflammation
- C)Small lipid core with thick fibrous cap
- D)Complete endothelial healing with collagen deposition
- E)Marked smooth muscle hyperplasia alone
Explicação
Large lipid core with thin fibrous cap is correct. Vulnerable plaques are rich in lipid and inflammatory cells and have thin fibrous caps that are prone to rupture, exposing thrombogenic material and triggering acute coronary syndrome. These plaques may be onl... Ver explicação completa e trilha adaptativa →