MI complications 12/04 Flashcards
0-4h gross change?
None
0-4h microscopic changes?
none
4-24 h gross change?
dark discoloration
4-24 h microscopic change?
COAGULATION NECROSIS.
Edema, hemorrage, WAWY fibers,
hypereosinophilic myocytes, shrunken nuclei.
Start to migrate neutrophils
None changes?
0-4h
dark discoloration?
4-24 h
COAGULATION NECROSIS.
Edema, hemorrage, WAWY fibers,
hypereosinophilic myocytes, shrunken nuclei.
Start to migrate neutrophils
4-24 h
0-4h/4-24 complications?
Cardiogenic shock (in massive MI>50proc sienos), Arrhytmia, CHF
Cardiogenic shock (in massive MI>50proc sienos), Arrhytmia, CHF
0-4h/4-24 complications
1-3 days gross?
yellow pallor/hyperemia
yellow pallor/hyperemia
1-3 days gross
1-3 days microscopy?
Extensive coagulation necrosis.
NEUTROPHIILS AROUND THE MI ZONE (infiltrate at the border zone). Occurs due to proinflammatory cytokines. Eventually migrate to center of MI.
Neurophils release lysosomal enzymes, ROS, cytokines.
Extensive coagulation necrosis.
NEUTROPHIILS AROUND THE MI ZONE (infiltrate at the border zone). Occurs due to proinflammatory cytokines. Eventually migrate to center of MI.
Neurophils release lysosomal enzymes, ROS, cytokines.
1-3 days microscopy
1-3 days complications
Fibrinous pericarditis (chest pain and friction rub)
Fibrinous pericarditis?
1-3 days complications
3-10 days gross?
Hyperemic border, central yellow/brown softening
Hyperemic border, central yellow/brown softening
3-10 days gross
3-10 days microscopy?
MARCOPHAGES INFILTRATE:
- phagocyte dead myocytes and neutrophils
on 7th day START GRANULATION TISSUE WITH NEOVASCULARIZATION by IL10 and TGF-beta
MARCOPHAGES INFILTRATE:
- phagocyte dead myocytes and neutrophils
on 7th day START GRANULATION TISSUE WITH NEOVASCULARIZATION by IL10 and TGF-beta
3-10 days microscopy
3-10 days complications
Rupture of free ventricular wall -> tamponade
Rupture of interventricular septal wall -> shunt
Rupture of papillar muscle -> mitral insufficiency
LV pseudoaneurysm -> risk of rupture
Rupture of free ventricular wall -> tamponade
Rupture of interventricular septal wall -> shunt
Rupture of papillar muscle -> mitral insufficiency
LV pseudoaneurysm -> risk of rupture
3-10 days complications
Rupture of free ventricular wall -> tamponade
3-10 days
Rupture of interventricular septal wall -> shunt
3-10 days
Rupture of papillar muscle -> mitral insufficiency
3-10 days
LV pseudoaneurysm -> risk of rupture
3-10 days
What predisposes interventricular rupture? what process?
Macrophage-mediated structural degradation
10-14 days microscopic?
VESSELS:Neovascularization of granulation tissue (most prominent on 10-14 days),
FIBROBLASTS proliferation,
COLLAGEN (type III).
Neovascularization of granulation tissue (most prominent on 10-14 days),, fibroblast proliferation, collagen (type III).
10-14 days microscopic
10-14 days gross?
red border emerges as granulation tissue enters from the edge of infarct.
red border emerges as granulation tissue enters from the edge of infarct.
10-14 days gross
2 weeks to 2 months microscopy?
(AKA FIBROSIS) Collagen remodeling and fibroblast differentiation into myofibroblasts drive the formation of scar tissue.
Collagen remodeling and fibroblast differentiation into myofibroblasts drive the formation of scar tissue.
2 weeks to 2 months microscopy
2 months post MI and more
(AKA FIBROSIS) remodeling continues to a slower rate as scar matures and contracts. (contracted scar is mature)
collagen type III and I –> then only I in final stage
(AKA FIBROSIS) remodeling continues to a slower rate as scar matures and contracts.(contracted scar is mature)
2 months post MI and more
Gross when fibrosis starts (from 2 weeks to months)
white scar
In final - type I collagen
2 weeks to 2 months complications
Dresslen syndrome -> results in fibrinous pericarditis
True ventricular aneurysm -> risk of mural thrombus
HF
Arrhythmias
Dresslen syndrome -> results in fibrinous pericarditis
True ventricular aneurysm -> risk of mural thrombus
HF
Arrhythmias
2 weeks to 2 months complications
