The recognition that inflammation plays an important part in the aetiology of the atherotrombotic event has grown over recent years. The slide shows an atherosclerotic plague with in the bottom half an enlargement of the shoulder region of the plague. Large numbers of inflammatory macrophages may play a role in plague vulnerability to rupture and the precipitation of the acute event. The finding of an organisms such as Chlamydia in the atherosclerotic plagues and promising findings of the interventions studies using antichlamidial antibiotics in my mind let to a confusion that tends to equate inflammation in a plague with infection and relate both of these to long-term development of atherosclerosis.