Acute myocardial infarction is primarily caused by atheroscle- rotic plaque rupture within coronary arteries accompanied by intraluminal thrombus formation, sudden vessel occlusion, and impaired oxygen supply to the myocardium. However, study of plaque rupture has been previously limited to histological analysis of autopsy specimens and animal experiments. Using a high-resolution imaging technique, called intracoronary optical frequency domain imaging (OFDI), we have directly observed the microstructural detail of human coronary plaque rupture in vivo at multiple time points ( 1 ). This case of a dynamic observation in a patient provides evidence to support hypotheses about coronary plaque rupture and is illustrative of our current model of the pathogenesis of acute coronary syndromes ( 2,3 ). Please see Figures 1 , 2 , and 3 for case images,
JACC: Cardiovascular Imaging
Erasmus MC: University Medical Center Rotterdam

Gonzalo, N., Tearney, G., van Soest, G., Serruys, P., Garcia-Garcia, H., Bouma, B., & Regar, E. (2011). Witnessed coronary plaque rupture during cardiac catheterization. JACC: Cardiovascular Imaging, 4(4), 437–438. doi:10.1016/j.jcmg.2010.11.021