Unstable Angina and Non-Q Wave Myocardial Infarction: Pathogenetic Mechanisms and Morphology of the Unstable Plaque

Abstract

The acute coronary syndromes, which include unstable angina, non Q wave (NQMI), and Q wave myocardial infarction, constitute the most frequent clinical manifestations of the major disease process observed in clinical cardiology. Un stable angina and NQMI are clinically distinct syndromes of acute ischemia implying the presence of further jeopardized myocardium. Indeed, regardless of whether a small degree of myocardial necrosis has occurred (as measured by the release of creatine kinase and MB isoenzyme in the blood), both diagnoses have in common the likely potential for recur rent angina and infarct extension. Hence, these entities uniquely suggest the possibility of further hazard, rather than the necessity of accepting and managing the consequences of loss of function. The appropriate diagnostic and therapeutic approaches are governed by these characteristics^1-5.