Atheroma or Thrombus in Sudden Cardiac Death?

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missy75
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hi all,
im new here. this may be a silly question, but I am going through exam quetions (MCQs) and wondered if you could help me with this one.

A 56 yr old man with a history of angina dies suddenly. An autopsy reveals critical stenosis in the left anterior descending artery. The lesion has a lipid core with a fibrous calf. What is the most likely pathological feature?

A - thrombus
B - atheroma
C - embolus
D - carcinoma in situ
D - infective embolus

I think the answer is A (thrombus), because the thrombus seems to be the cause of this man's death (acute coronary syndrome). I'm thrown off by the words "pathological feature" - it makes me consider anser B (atheroma) because an atheroma would initiallyhave to be present, then rupture to form the thrombus.

Please comment on why you think I am wrong/right.

Thank you!
 
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missy75 said:
I'm thrown off by the words "pathological feature" - it makes me consider anser B (atheroma) because an atheroma would initiallyhave to be present, then rupture to form the thrombus.

Please comment on why you think I am wrong/right.

Thank you!

Why do you think it's a thrombus? What would you expect in a 'tissue' prep of a thrombus? What about an atheroma? In fact, a fatal event would likely be due to a combination of both, with a thrombus closing a lumen already partially blocked by an atheroma. What does the histopathology describe? I think that's what the question is asking.
 
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thanks, I've changed my answer to atheroma now. The lipid core and fibrous calf hints at this, and there is no mention of a blood clot/evidence of rupture of the plaque.