Pathology · Cardiac Pathology (IHD, Myocardial Infarction, Valvular, Endocarditis)

A 55-year-old man with chronic stable angina undergoes coronary angiography showing a 70% stenosis of the left anterior descending artery. At autopsy, the corresponding plaque is found to have a thick fibrous cap overlying a small lipid core. In comparison, plaques responsible for acute coronary syndromes are characterized by which of the following features?

  • A Thick fibrous cap and small lipid core
  • B Extensive calcification with no lipid core
  • C Thin fibrous cap and large lipid core
  • D Absence of inflammatory cells
Correct answer: C. Thin fibrous cap and large lipid core

Explanation

Vulnerable plaques responsible for acute coronary syndromes have thin fibrous caps, large lipid-rich necrotic cores, and abundant inflammatory cells (macrophages, T cells). Stable angina plaques have thick fibrous caps and small lipid cores. The thin cap is prone to rupture or erosion, triggering thrombosis.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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