Question 1

What is the Meaning of Fibrous Cap?

Accepted Answer

The fibrous cap is a dense connective tissue layer overlying an atherosclerotic plaque's lipid-rich core within arterial walls. Composed of smooth muscle cells, collagen, and elastin, it forms a crucial barrier separating the plaque's interior from the bloodstream. Its integrity is vital for vascular stability and preventing adverse cardiovascular events.

Question 2

What is the Context of Fibrous Cap?

Accepted Answer

Within the cardiovascular system, the fibrous cap is a critical component of atherosclerotic lesions, primarily in medium and large arteries. It defines atheroma morphology, positioned directly between the lipid core and the arterial lumen. This anatomical arrangement is fundamental to understanding vascular disease progression and its clinical manifestations.

Question 3

What is the Significance of Fibrous Cap?

Accepted Answer

The clinical importance of the fibrous cap correlates directly with plaque stability and thrombotic risk. A thick, robust cap indicates a stable plaque, less prone to rupture. Conversely, a thin, inflamed cap signifies a vulnerable plaque with high rupture propensity. This distinction guides therapeutic interventions to prevent myocardial infarction or stroke.

Question 4

What is the Mechanism of Fibrous Cap?

Accepted Answer

The fibrous cap protects by physically containing the pro-thrombotic lipid core, preventing its exposure to circulating blood. Its formation involves vascular smooth muscle cell migration and proliferation into the intima, followed by extracellular matrix protein synthesis. Disruption compromises cap integrity, leading to plaque rupture and subsequent thrombus formation.

Question 5

What is the Application of Fibrous Cap?

Accepted Answer

In clinical practice, fibrous cap characteristics are assessed using advanced intravascular imaging, specifically intravascular ultrasound and optical coherence tomography. These techniques visualize plaque morphology, measure cap thickness, and identify vulnerability features. This information informs risk stratification and guides management strategies for individuals with high-risk plaques.

Question 6

What is the Metric of Fibrous Cap?

Accepted Answer

Fibrous cap integrity and thickness are primarily assessed via direct visualization using intravascular imaging. Optical coherence tomography (OCT) offers sub-micrometer resolution for precise cap thickness and micro-rupture detection. Intravascular ultrasound (IVUS) provides broader plaque characterization. No direct blood biomarkers measure cap thickness; however, systemic inflammatory markers may correlate with cap vulnerability.

Question 7

What is the Risk of Fibrous Cap?

Accepted Answer

A primary clinical risk associated with the fibrous cap is its structural integrity. A thin or ruptured cap exposes the highly thrombogenic lipid core to the bloodstream, initiating platelet aggregation and thrombus formation. This can lead to acute arterial occlusion, resulting in acute coronary syndromes like myocardial infarction, or ischemic stroke. A vulnerable fibrous cap signifies elevated risk for severe cardiovascular events.

Fibrous Cap

Meaning

Context

Significance

Mechanism

Application

Metric

Risk

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