chapter  6
10 Pages

Pathology of Coronary Artery Atherosclerosis: Aspects Relevant to Cardiac Imaging

ByDylan V Miller

Recent years have seen exponential improvements in rapidity

and resolution of tomographic cardiac imaging, such that it

seems the once science-fiction notion of externally ‘scanning’

near-microscopic details of living patients is becoming a real-

ity. While histopathology remains the standard for defini-

tively characterizing coronary plaques (as the oft-repeated

pathology joke punchline goes) the answer comes a week too

late. Consequently, there has been a cooperative striving

among several disciplines for an accurate noninvasive means

of assessing coronary disease and predicting which patients

will develop acute coronary syndrome, and when. An excit-

ing opportunity has arisen to connect the knowledge and

experience from decades of histopathologic studies of autopsy

and explanted hearts with the emerging ability to radi-

ographically resolve fine details of plaque morphology. This

chapter will attempt to realize that opportunity.