Pathogenesis of Acute Coronary Syndrome part 1

       Acute Coronary Syndrome is one of the clinical manifestations of coronary heart disease is mainly caused by the addition of the further atherothrombotic ischemic stroke, and peripheral arterial disease (PAD). Further atherothrombotic is a chronic disease with a very complex process and multifactorial and interrelated.

        Atherothrombotic consists of atherosclerosis and thrombosis. Atherosclerosis is the process of the formation of plaque (atherosclerotic plaques) due to the accumulation of some materials such as lipid-filled macrophages (foam cells), massive extracellular lipid and fibrous plaque containing smooth muscle cells and collagen.

        Recent developments explained that atherosclerosis is an inflammatory process / infection, which was initially characterized by the presence of early abnormalities in the endothelial layer, the formation of foam cells and fatty streks, cups and formation of fibrous lesions further, and the rupture of unstable atherosclerotic plaque.

          There are so many studies that prove that inflammation plays an important role in the process of atherosclerosis. On coronary heart disease of inflammation begins early plaque formation to plaque instability which eventually resulted in the occurrence of plaque rupture and thrombosis in Acute Coronary Syndrome.

        Atherosclerosis process (initiation, progression and complication in atherosclerotic plaques), gradually goes from a young age even say also since the age of the children had formed a line patches of fat (fatty streaks) in the surface layers of the blood vessels, and gradually in old age can develop into patches of sclerosis (plaques or crusts on the blood vessels) so that the narrowing and / or blockage of blood vessels. If the plaque had ruptured, torn or bleeding subendotel, start thrombogenic process, which clog part or all of a coronary artery. At this moment appeared various clinical presentations such as angina or myocardial infarction. The atherosclerotic process can be stabilized, but it may also not be stable or progressive. Consequences that can lead to death is the process of atherosclerosis which is unstable / progressive who is also known as Acute Coronary Syndrome.

Pathogenesis Atheroslerosis in Acute Coronary Syndrome  

        While thrombosis is the formation or presence of clotted blood present in the blood vessel or the heart cavity. There are two kinds of thrombosis, ie arterial thrombosis (white thrombus) that are found in the arteries, which are found in the thrombus more platelets, and venous thrombosis (red thrombus) which is found in veins and contains more red blood cells and platelets less . Components that play a role in the process of thrombosis is a blood vessel wall, blood flow and blood alone includes platelets, coagulation system, fibrinolytic system, and a natural anticoagulant.