Abstract
A quantitative analysis of inflammatory lesions in the coronary arterial adventitia in addition to intimal lesions (luminal narrowing, thrombus) is described in a group of 14 autopsy cases with clinical history of angina at rest (6 succumbed from acute myocardial infarction, 6 suddenly from anginal attacks, 2 from non-cardiac reasons). Cross-sections were examined histologically, especially with meticulous attention to the adventitia in a total 308 sections of 14 study patients (2 from each of 11 segments from each heart), compared with 396 sections of 18 control subjects.
Of the 154 segments in the study patients 47 (31%) were 76 to 100 percent narrowed by atherosclerotic plaques (control 1%), and 23 (15%) had occlusive thrombi. Of the 308 sections in the study patients 97 (31%) showed infiltration of small round cells in the adventitia (control 9%). Involvement of vascular nerve fibers was noticed approximately one half of the sections of inflammatory lesions.
These findings in the adventitia may correlate to the vasospastic component of angina at rest.
