Most
coronary artery disease (CAD) is due to subintimal deposition of atheromas
in the large and medium-sized arteries serving the heart. Risk
factors and the pathogenesis of atherosclerotic lesions and CAD are
discussed in Merck, Chs. 15 and 201. Less often, CAD is due to
coronary spasm, which is usually idiopathic (with or without associated
atheroma) or may be due to drugs such as cocaine. Rare causes include an
embolus to the coronary artery, Kawasaki syndrome (see Merck, Ch.
265), and vasculitis (eg, in SLE).
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