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From our previous example, if John now begins to experience chest pain at rest, this is unstable angina, signaling that something has changed. The atherosclerotic plaques have progressed or there has been some plaque rupture and subsequent thrombus formation. Now, one morning John wakes up at 6am diaphoretic, nauseous, with chest tightness and shortness of breath. John is having an acute myocardial infarction. There has been a rupture or fissure of one of the atherosclerotic plaques and platelets are activated, thrombin generated and a cascade of factors, result in a complete blockage of one of John’s vessels. Heart muscle cells supplied by that vessel are dying. “Time is muscle.” |
