Balaji Balagani: Exploring Stable vs Unstable vs Complete Coronary Block
Balaji Balagani, Cardiologist in Guntur, GKNM Hospital, shared a post on X:
“Stable vs Unstable vs Complete Coronary Block
What’s the difference?
1. Stable Blockage
A stable plaque usually has a thick fibrous covering and causes a fixed narrowing of the coronary artery.
- Blood flow is reduced mainly during exertion.
- Chest pain is usually predictable and occurs with activity.
- Symptoms often improve with rest.
- This is typically associated with Chronic Coronary Syndrome / Stable Angina.
2. Unstable Blockage
An unstable or vulnerable plaque can rupture or erode suddenly, even if the blockage was not very severe.
- A blood clot (thrombus) can form suddenly.
- Blood flow may decrease abruptly.
- Chest pain can occur at rest, become more frequent, or worsen suddenly.
- This can lead to Acute Coronary Syndrome (ACS) — unstable angina or NSTEMI.
3. Complete Coronary Occlusion
When a coronary artery becomes completely blocked, usually due to an acute thrombus over a ruptured plaque, blood flow can be severely interrupted.
- Can cause a major myocardial infarction (heart attack).
- Acute complete occlusion is commonly associated with STEMI, although ECG presentation can vary.
- Urgent reperfusion treatment may be lifesaving.
Important:
A 90% blockage is not always more dangerous than a 50% blockage.
A seemingly mild plaque can suddenly rupture and cause a large blood clot, resulting in a heart attack.
The danger is not determined only by the percentage of blockage — plaque stability and sudden thrombosis matter greatly.
Know your heart.
Recognize the warning signs.
Seek medical attention early.”
Proceed to the video attached to the post.
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