Documentation by intravascular ultrasound of thrombus overlying a small atheromatous plaque in a coronary artery in unstable angina pectoris and in acute myocardial infarction

Rupture of atheromatous plaques leading to acute coronary syndromes usually occur in lipid-reach and well-developed coronary lesions. We describe 2 unusual patients with acute coronary syndromes in whom there was angiographic and intravascular ultrasound evidence of an intraluminal thrombus overlying a small, nonocclusive plaque in an enlarged coronary artery.