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Cardiology Patient Page: inflammation and myocardial infarction.

A myocardial infarction (MI), or heart attack, is caused by a sudden blockage in the arteries that supply the heart muscle, known as the coronary arteries. Most of these blockages occur as a result of atherosclerosis, a process by which cholesterol and white blood cells accumulate in the wall of the artery (Figure).



Figure. 
Formation of an atherosclerotic plaque in the coronary arteries. This is a cross-sectional view (horizontal slice) of a coronary artery with an atherosclerotic plaque. The fibrous cap is made up of a strong material called collagen that is protecting the blood stream from the lipid core. In addition to cholesterol and fats, the lipid core contains white blood cells, which are the inflammatory cells in the body. If the fibrous cap breaks, these inflammatory cells are exposed to the blood stream. A chain reaction then occurs that results in accumulation of platelets, clotting factors, and other cells, leading to rapid obstruction of the coronary artery and subsequent MI.



Atherosclerosis leads to the build up of plaque, which is composed of a fibrous cap and a lipid (fatty) core, and grows slowly over years. The fibrous cap is comprised mostly of a thick, strong material called collagen that functions as a barrier between the blood stream and the lipid core. The lipid core is a collection of fats, cholesterol, white blood cells, and proteins that activates clot formation.

The fibrous cap prevents the lipid core from becoming exposed to the blood. Direct contact between the lipid core and the blood stream triggers a chain reaction that can become fatal: accumulation of platelets, clotting factors, and other cells leads to rapid obstruction of …