Coronary Thrombosis Read Now, Why!

Coronary Thrombosis
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Coronary Thrombosis And Definition

Coronary Thrombosis is defined as formation of a blood clot inside the blood vessels of the heart. This blood clot, may then restrict blood flow within the heart, leading to heart tissue damage or a myocardial infarction, also know as the heart attack. [1]

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Coronary Thrombosis is most commonly caused as a downstream effects of atherosclerosis, a build of cholesterol and fats in the artery walls. The smaller vessel diameter allows less blood flow and facilitates progression to a myocardial infarction. Leading risk factors for coronary Thrombosis are high LDL cholesterol, smoking, sedentary lifestyle and hypertension. [2]

Pathogenesis

Coronary Thrombosis and myocardial infarction are sometimes used as symptoms, although this is technically inaccurate as the Thrombosis refers to the blocking of blood vessels with thrombus, while myocardial infarction refers to the heart tissue death due to consequent loss of blood flow to the heart.

Due to collateral circulation, a coronary thrombosis does not necessarily cause tissue death and may be asymptomatic.

The formation of coronary Thrombosis generally follows the same mechanism as other blood clot in the body, the coagulation cascade.

Also applicable is the Virchow’s triad of blood stasis, endothelial injury, and hypercoagulable state. Atherosclerosis contributes to coronary Thrombosis formation by facilitating blood stasis as well as causing local endothelial injury.

Due to the large number of cases of myocardial infarction leading to death and diseases in the world.

there has been extensive studies towards the generation of clot, specifically in the coronary arteries. Some areas of focus are:

1. Coronary Thrombosis

This can be a complication associated with drug-eluting stents [3]. These sents that are place to open up narrowed arteries are infused with medicine to prevent repeat stenosis.

However, they are actually lead to an increased coronary Thrombus formation due to increased tissue factor expression and delayed healing within the vessels.

Further more, the downstream endothelium has been shown to be impaired, leading to an environment that favours formation of clot.

Evidence remaince remains inconclusive about whether these risks outweigh the benefits of a coronary arterial sent. [3]4].

2. Inflammation

may play a causal role in coronary artery disease and subsequent myocardial infarction due to coronary Thrombosis.

Increased levels of information may lead to higher risk of clotting as well as increased risk/device subsequent thrombosis. There is an ongoing search for inflammatory biomarkers that can help determine at-risk individual. [5]

3. Coronary Microembolization

This is being explored as a focal point for coronary thrombus formation and subsequent sudden death due to acute myocardial infarctions.[6]

High Mobility Group Box-1 ( HMGB-1)

proteins as important mediators in thrombus formation. [7]

4. Coronary sinus

Thrombosis as a severe complication after procedure. [8]. The coronary sinus is the venous counterpart to the coronary arteries, where the de- oxygenated blood returns from heart tissue.

A large thrombus slows overall blood circulation to heart tissue as well as may mechanically compress a coronary artery.[8]

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