Posts Tagged ‘spontaneous coronary dissection’


  • Plaque fissure is  the most common intra-plaque event that   precipitates  an acute coronary syndrome.
  • It is the  site of   attachment  for coronary thrombus
  • It can  either be spontaneous or PCI induced.
  • Plaque fissure can  either be  partial or complete and  may  reenter the lumen.
  • Eccentric plaques are likely  to fissure often  , as the  wall stress on the plaque shoulder region is  high  (Laplace law)
  • Angiographically  it is often difficult to differentiate  fissure from true coronary dissection.Both manifest as intraluminal filling defect.Coronary dissection  often extend beyond the length of plaque.
  • Many of the reported cases of spontaneous coronary dissection are thought to be  nothing  , but plaque fissures and their extensions.

Is plaque fissure a painful event ?

Plaques do not have neural innervation.So the plaque fissure is generally not painful.But when it extends into the media of vessel wall it can be severely painful.

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