Pathology of coronary atherosclerosis

doi:10.1016/0033-0620(71)90023-5

Progress in Cardiovascular Diseases

Volume 14, Issue 3, November 1971, Pages 256-274

https://doi.org/10.1016/0033-0620(71)90023-5 Get rights and content

Abstract

Histologic examination of coronary arteries reveals many features of pertinence. In infants, a new layer, the musculo-elastic layer, develops focally associated with thickening of the intima. Later in life, distinction of this normal process from pathologic states may be difficult. In cross sections, two types of lesions are seen: one purely fibrous and the other, a pairing of lipid pools and walling fibrous tissue (the “parite”). Lipid may be seen in phagocytes, as pools and in collagen, the latter, whether part of a fibrous lesion or part of a parite. Lipid collagen may be termed “collipid.” In established atherosclerosis, an episodic character to the development of atherosclerosis is strongly supported. Intimal hemorrhages rarely narrow the lumen but may underlie formation of thrombi. Calcification in atheromas is a sign of age of the lesion, but by itself has no direct bearing on the severity of luminal obstruction by the atheroma. The location and the shape of the arterial lumen in segments with severe sclerosis varies. The lumen may be central or eccentric. In about one-quarter of obstructed segments, the lumen is eccentric and slit-like. This is perhaps the basis for a false-negative arteriographic reading. Study of the distribution of atheromatous lesions indicates that the segment of the right coronary artery between the marginal and posterior descending arteries is the most commonly involved of all segments in the conorary tree. Second to this site is the proximal half of the anterior descending coronary artery.

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^☆: Supported by USPHS Research Grant 5 RO1 HE05694 and Research Training Grant 5 TO 1 HE05570 from the National Heart Institute, and by the Otto Bremer Foundation.

¹: Senior Research Associate, Charles T. Miller Hospital, St. Paul, Minn.

²: Director of Laboratories, Charles T. Miller Hospital, St. Paul, Minn., and Professor of Pathology, University of Minnesota Graduate School, Minneapolis, Minn.

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Pathology of coronary atherosclerosis☆

Abstract

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JAMA

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Arch. Path. (Chicago)

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J. Path. Bact.

Coronary arteries in fetuses, infants, and juveniles

Circulation

Coronary arteries in fetuses, infants, juveniles, and young adults

Lab. Invest.

The structural changes in the coronary arteries of infants

Bull. Cardiol. Pediat. Europ.

The coronary arteries in early life in three different ethnic groups

Circulation

Changes in the circulation at birth

The musculo-elastic layer in the coronary arteries. A histological and hemodynamic concept

Vasc. Dis.