vulnerable plaque
Coronary atherosclerotic plaque prone to rupture. Characterized by thin fibrous cap, large lipid core, and active inflammation.
Full Definition
Vulnerable plaque refers to coronary atherosclerotic lesions at high risk for rupture, leading to acute coronary syndromes. These plaques typically feature a thin fibrous cap (<65 microns), large necrotic lipid core (>40% of plaque volume), active inflammation with macrophage infiltration, and positive remodeling. Unlike stable plaques that cause flow-limiting stenosis, vulnerable plaques may cause minimal luminal narrowing but pose significant thrombotic risk upon rupture. Advanced imaging techniques including intravascular ultrasound, optical coherence tomography, and cardiac CT are being developed to identify these high-risk lesions before clinical events occur.
Usage
Usage note: Distinguish from 'culprit plaque' which refers to the lesion responsible for current acute event.
In Context
- "OCT imaging revealed features consistent with vulnerable plaque in the proximal LAD." — Intravascular imaging report
- "The patient's acute MI resulted from vulnerable plaque rupture despite minimal prior stenosis." — Clinical case discussion