Acute Coronary Syndrome
75% arterial narrowing is the point at which coronary occlusion becomes very serious with increased risk for acute coronary syndromes.
Treatment at a glance
- Aspirin plus a P2Y12 inhibitor (clopidogrel or ticagrelor)
- Reperfusion: primary PCI or thrombolysis for STEMI
- High-intensity statin (atorvastatin 40–80 mg)
What our notes say
- 75% arterial narrowing is the point at which coronary occlusion becomes very serious with increased risk for acute coronary syndromes. (CARDIOVASCULAR PATHOLOGY — Past Paper Questions & Answers)
- Topics: acute coronary syndromes, heart failure, arrhythmias, valve disease, hypertension, pericardial disease, infective endocarditis and rheumatic fever. (Cardiology Question Bank: 15 Clinical MCQs)
- European Society of Cardiology guidelines on acute coronary syndromes, heart failure, atrial fibrillation and valvular heart disease. (Cardiology Question Bank: 15 Clinical MCQs)
- Prone to rupture → thrombosis → acute coronary syndrome (CARDIOVASCULAR PATHOLOGY)
- Useful for risk stratification in acute coronary syndromes (Chemical Pathology Sem 1)
- Acute coronary syndrome: A spectrum including unstable angina, acute MI, and sudden cardiac death. (Heart Disease — Must Knows)
Study material on Acute Coronary Syndrome
Practice questions on Acute Coronary Syndrome
Which plaque change is MOST directly responsible for converting stable angina to an acute coronary syndrome?
- Progressive accumulation of lipid in the plaque core
- Plaque rupture or erosion with superimposed thrombosis
- Calcification reducing plaque elasticity
- Smooth muscle cell proliferation narrowing the lumen
- Neovascularization within the plaque
Answer: B. - ACS results from **acute plaque disruption** (rupture/erosion) exposing thrombogenic core material → **superimposed thrombus** → sudden flow-limiting or occlusive event ---
A reduction in the level of which of the following serum laboratory findings is associated with reduction in risk of acute coronary syndrome?
- Cholesterol
- Glucose
- Potassium
- Calcium
- Triglycerides ✅ Answer: A
Answer: A. High serum cholesterol, particularly LDL, is a major risk factor for acute coronary syndrome, so its reduction lowers the risk.
Which of the following pathological changes in a coronary artery plaque is MOST directly responsible for converting stable angina to an acute coronary syndrome?
- Progressive accumulation of lipid in the plaque core
- Plaque rupture or erosion with superimposed thrombosis
- Calcification reducing plaque elasticity
- Smooth muscle cell proliferation narrowing the lumen
- Neovascularization within the plaque
Answer: B. Plaque rupture or erosion with subsequent superimposed thrombosis is the critical event that converts stable angina into an acute coronary syndrome.