(P4) Cardiac: Organizing Myocardial Infarct (251)

Question 1

Identify this slide

Answer 1

Organizing myocardial infarct

Question 2

• Identify the Slide*
• 1. identify*
• 2. indentify*
• 3. what type of inflammation*

Answer 2

1. cardiomyocytes
2. granulation tissue
3. neutrophils

Question 3

Name slide:

Answer 3

Organizing Myocardial Infarct​

• rupture/aneurysm*
• pericarditis*
• mural thrombus*
• emboli*

Question 4

Name this condition:

What causes this condition?

Answer 4

Organizing Myocardial Infarct

coronary artery occlusion, ulceration, fissuring

Question 5

Locations of Infarct:

Answer 5

Organizing Myocardial Infarct

lateral or inferior or anterior wall

• of*
• l_eft ventricle_*

Question 6

The most typical morphological complications

of this lesion are:

name 4

Answer 6

rupture/aneurysm

pericarditis

mural thrombus

emboli

Question 7

Review:

Answer 7

Question 8

Name Causes of

infarction

Answer 8

-coronary arterial occlusion-

o Coronary artery occlusion caused by change in the morphology of atheromatous plaque

Question 9

Change in the

morphology of atheromatous plaque

cause what?

Answer 9

• intraplaque hemorrhage*
• ulceration*
• fissuring*

Question 10

Organizing myocardial infarct

can causes what ?

name 3

Answer 10

• Infarction*
• occlusive thrombosis*
• coagulative necrosis*

Question 11

Organizing myocardial infarct

Visible changes occure after _____hrs.

The necrotic are is replaced by what?

Answer 11

Visible gross changes after 18 hrs

Necrotic area replaced by granulation tissue

Connective tissue, fibroblast, inflammatory cells, thin vessels

Scar maturation – more collagen

Question 12

In Organizing myocardial infarct

name complications after infarction:

(6)

Answer 12

arrhythmias

rupture

left ventricular heart failure

thromboemboli

aneurysm

Cardiac tamponade

Question 13

Organizing myocardial infarct

name the location of the infarct:

Answer 13

• Left circumflex* – lateral wall of left ventricle (except apex)
• LAD* – anterior wall of left ventricle, near apex; anterior ventricular septum

Right coronary – inferior/posterior left ventricle; posterior ventricular septum

Question 14

Hemorrhagic infarction

is found?

Answer 14

on the lateral wall of the left ventricle

Question 15

Ischemic myocardial infarction

is found where?

Answer 15

Ischemic myocardial infarction

is found on the

ventricular septum

Question 16

old myocardial infarction

is found?

Answer 16

from the ventricular septum to the part of the anterior wall are observed.

Question 17

Organizing myocardial infarct

Macroscopy of:

• Old infarct:*
• Acute infarct:*
• 2nd week:*

Answer 17

• Old infarct* – fibrosis – white (granulation tissue)
• Acute infarct* – dark yellow mottling
• 2nd week* – collagen fibers deposit, scar formation begins

Question 18

Name specifics:

Answer 18

Question 19

name specifics:

Answer 19

Question 20

Organizing myocardial infarct

Micro:

Answer 20

1. after first few hours: intracellular edema, begining coagulative necrosis

2. after 12hrs: ongoing necrosis, pyknosis of nuclei, hypereosinophilia, neutrophils infiltration

3. 3‐7days: necrotic myocytes digested by invading macrophages

• *4.** 7‐10 days: growth of granulation tissue
• *5.**from 2 week: progressive synthes is of collagen and fibrosis