Multivascular atheromatous coronary microembolism

We report an unusual case of coronary-multivascular, small coronary artery embolism by atheromatous elements originating in a plaque in the main right coronary artery of a 52-year-old man who died of acute thrombotic occlusion of the severely stenotic left anterior descending vessel. The embolized arteries showed the characteristic multiphasic inflammatory changes of different ages previously described in arteries occluded by this material. The myocardium supplied by the involved channels showed ischemic damage of varying ages. Both these observations indicate that the multiple emboli had been discharged at different times, rather than as a single shower. Finally, we make a plea for the use of the correct term 'erosion' rather than 'ulcer' for the lesion that is the source of the invasive obstructions.