Plaque fissuring--the cause of acute myocardial infarction, sudden ischaemic death, and crescendo angina.

The clinical management of acute myocardial infarc- tion and crescendo angina as well as the prevention of sudden ischaemic death require accurate knowledge of the underlying arterial pathology. It is on just this aspect that until recently there has been disagreement particularly among pathologists. In brief, this con- troversy was concerned with whether coronary artery thrombi were or were not directly responsible for all three clinical pictures of acute ischaemia.