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Acute myocardial infarction generally forms in the presence of severe coronary artery stenosis or occlusion which, in about 40% of cases, is not necessarily preceded by severe stenosis but can also have developed acutely in the presence of plaque rupture with only slight prior narrowing of the lumen. Since function is maintained for only a short time, contraction disturbances have almost always already started even if only a very short period has elapsed between the onset of symptoms and the angiography. The only exception is in patients who already have a well-developed collateral blood supply to the region supplied by the stenosed or occluded coronary artery.
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