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when a myocardial infarction strikes the blood supply to the cardiac muscles is suddenly restricted starved for oxygen these muscles begin to die and within minutes are unable to keep the heart beating the cause of this life-threatening attack is the obstruction of a coronary artery by a blood clot resulting in most cases from atherosclerosis which in the coronary artery is called coronary artery disease or cad in patients with cad atherosclerosis can begin to develop decades before symptoms arise since atheroscl plaques grow slowly [Music] when a plaque ruptures and a blood clot forms the threat of a vascular event becomes very real [Music] clots consist of activated platelets stabilized by fibrin strands while activated platelets aggregate to seal the rupture site fibrin formation is triggered by the coagulation cascade an important part of this chain reaction involves factor 10a and prothrombin when factor 10a encounters prothrombin it cleaves prothrombin into thrombin one molecule