Stehbens W E
Lancet. 1985 Sep 21;2(8456):639-42. doi: 10.1016/s0140-6736(85)90006-6.
It is suggested that an occlusive thrombus in a coronary artery develops at the site of an intimal tear but that in the interval between initiation of the thrombus and occlusion of the artery emboli are likely to be shed continually, causing multiple occlusions of myocardial vessels in the area of supply. Multiple and confluent areas of ischaemia can progress to complete occlusion of the coronary artery, or the intimal tear can regress and heal. Such a pathogenesis could account for the very variable clinical and pathological findings in myocardial infarction and for the apparently paradoxical time-relationship between coronary artery thrombosis and myocardial infarction.
有人提出，冠状动脉内的闭塞性血栓形成于内膜撕裂处，但在血栓形成至动脉闭塞的间隔期间，栓子可能会持续脱落，导致供血区域的心肌血管多处闭塞。多个缺血区域相互融合可进展为冠状动脉完全闭塞，或者内膜撕裂可消退并愈合。这种发病机制可以解释心肌梗死中非常多变的临床和病理表现，以及冠状动脉血栓形成与心肌梗死之间明显矛盾的时间关系。
