Cardiology>>>>>Ischaemic heart disease
Question 14#

Atherosclerotic plaque rupture is the most common event leading to clinically relevant ischaemia.

Which one of the following statements regarding this process is not true?

A. Thin-capped fibroatheromas are most prone to cap disruption and thrombus formation
B. Fracture of the fibrous cap allows platelets, clotting factors, and inflammatory cells to come into contact with the thrombogenic necrotic lipid core, leading to thrombus
C. Disrupted plaques can be accurately identified by optical coherence tomography
D. Plaque rupture will always result in some degree of clinical ischaemia (ACS)
E. Patients presenting with an ACS who have a ruptured plaque identified during angiography can be managed without stenting

Correct Answer is D

Comment:

Clinically silent plaque rupture with spontaneous healing is well recognized. If a patient presents with an ACS, and a ruptured culprit plaque is identified without luminal stenosis (i.e. ongoing ischaemia), it is reasonable to continue medical therapy without stenting as long as the event has stabilized.