ABSTRACT
Functional or mechanical impairment of endothelial integrity may lead stealthily to atherosclerotic plaque formation and acute episodes of vasospasm or localized intravascular thrombosis. In the coronary circulation the clinical consequences might be silent or symptomatic episodes of myocardial ischaemia, sometimes progressing over the years to an ischaemic cardiomyopathy or, in the presence of a critical flow-limiting thrombus, to more profound ischaemic events, such as unstable angina or myocardial necrosis if the occlusion is not relieved. The degree and consequences of myocardial necrosis (infarction) will depend on the vessel affected, the proximal site, extent and duration of the occlusion, the extent of other vessel disease and the quality of collateral coronary flow.
