Coronary artery thrombosis, gross
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The red-brown thrombus is seen occluding the coronary artery. Thrombosis occurs with injury to the endothelium, for example, when an atherosclerotic plaque ruptures. This can occur at any time, even before the plaque has significantly occluded the coronary. Thrombosis, of course, will cause 100% occlusion, and can occur within a matter of seconds. Thrombosis is definitely linked to the onset of angina, as is often demonstrated in the cardiac catheterization lab.