Hemodynamic factors and atheromatic plaque rupture in the coronary arteries: from vulnerable plaque to vulnerable coronary segment

Coron Artery Dis. 2007 May;18(3):229-37. doi: 10.1097/MCA.0b013e328012a93d.


Coronary plaque disruption with superimposed thrombosis is the underlying pathology in the acute coronary syndromes and sudden death. Coronary plaques are constantly stressed by a variety of mechanical and hemodynamic forces that may precipitate or 'trigger' disruption of vulnerable or, at extreme conditions, even stable plaques. This paper reviews the exciting new evidence on the hemodynamic factors that may play a role in this process and provides the rationale for the introduction of the concept of the vulnerable coronary segment in the study of acute coronary syndromes.

Publication types

  • Review

MeSH terms

  • Animals
  • Coronary Artery Disease / physiopathology*
  • Coronary Thrombosis / physiopathology*
  • Humans
  • Risk Factors
  • Rupture, Spontaneous / physiopathology*