The heart muscle requires a constant supply of oxygen-rich blood to nourish it. The coronary arteries provide the heart with this critical blood supply. If a blood clot totally blocks the artery, the heart muscle becomes "starved" for oxygen. Within a short time, death of heart muscle cells occurs, causing permanent damage. This is a heart attack.
Most heart attacks (myocardium infarction) occur as result of soft plaque that ruptures through the inner layer of the coronary vessel into vessel channel (lumen) and this presentation represents about 90% of fatal heart attacks. The soft plaque builds up within the layers of the vessel and is not always detected with the usual heart tests such as echocardiogram, stress test, cath, etc.
To evaluate the risk of heart attack with some reliance from a soft plaque rupture would be a CT scan slice 64 or greater. The CT provides an output that measures the degree of soft plaque within the layers of the 4 main coronary arteries and provides a calcium score that enumerates the risk.
The autopsy examined the inner layers of the coronary vessels and that is the basis of their findings. Of interest it has been shown by autopsy that about 26% of war casualties show the beginnings of coronary artery disease.
Thank you for sharing and my condolences for your loss, and I wish you well going forward. Take care,
I am so sorry for your loss. I had a triple bypass exactly 2 years ago. I literally walked into the emergency room with no heart attack nor stroke. Shortness of breath and almost passing out were the promary symptoms. Within 48 hours, they discovered after my admission that I had 98% blockage in three arteries. I bled out after my surgery (had to be resuscitated and was taken back into surgery to repair a ruptured artery.) I remained in a coma for 9 days and in the ICU for 21 days.
There may be some stories and information at my blog, ***** that may help you understand.
"How could someone develop 100% blockage in their heart over 8 months?"
I'm so sorry to hear about your husband. It was once thought that blockages were a gradual process taking many years, but this is not the case. Apart from the obvious ruptures stated in other replies, atherosclerosis can form quite quickly. It's simply a chemical process and this doesn't have a speed limit. I had an angiogram last august which looked clear in my left circumflex artery. By xmas I was having chest pains but they refused to believe it could be heart related. By March this year I had developed 2 blockages in that artery greater than 97%. So, they can form quite quickly. I only know that between November last year and February this year I had a lot of stress in my life and I think this was the cause.
Source: "... complications of advanced atherosclerosis are chronic, slowly progressive and cumulative. Most commonly, soft plaque suddenly ruptures (see vulnerable plaque)
.....Atherosclerosis is a chronic disease that remains asymptomatic for decades. Atherosclerotic lesions, or atherosclerotic plaques are separated into two broad categories: Stable and unstable (also called vulnerable). The pathobiology of atherosclerotic lesions is very complicated but generally, stable atherosclerotic plaques, which tend to be asymptomatic...
....complications of advanced atherosclerosis are chronic, slowly progressive and cumulative. Most commonly, soft plaque suddenly ruptures (see vulnerable plaque), causing the formation of a thrombus that will rapidly slow or stop blood flow, leading to death of the tissues fed by the artery in approximately 5 minutes."
QUOTE prior post...atherosclerosis can form quite quickly. It's simply a chemical process and this doesn't have a speed limit.....
>>>>It is true atherosclerosis is a chemical process but I read no evidence that this a anything but a slow accumulation of various compounded cells... the physiological manifestations may not have a time limit!
">>>>It is true atherosclerosis is a chemical process but I read no evidence that this a anything but a slow accumulation of various compounded cells... the physiological manifestations may not have a time limit!"
I was told that although quite rare, patients do have what is termed accelerated atherosclerosis. I have googled this terminology and you may find this case interesting,