Pathology - Ischemic Heart Disease Flashcards
Which one is more stable?
The one on the right!
Describe both the gross and histologic changes that occur post-MI from immediately after the MI to 3+ weeks post-MI.
0-12 hours: no changes
12-24 hours:
Gross - blue-gray discoloration caused by stagnated blood
Histologic - contraction bands from denatured myosin crumpling up
1-3 days:
Gross - still blue-gray from trapped blood
Histologic: neutrophil infiltration, nuclei look like shadows/ghosts
4-10 days:
Gross - tan-yellow color w/ hyperemic border
Histologic - macrophages come in and eat up proteins - harder to see actin and myosin leftovers
10 days - 3 weeks:
Gross - yellow-tan or grey color
Histologic - granulation tissue laid down
3+ weeks:
Gross - grey-white scar
Histologic - dense scar tissue
Describe the pathophysiology of coagulative necrosis after/during MI.
Ischemia –> low pH –> denaturation of nuclear membrane and cellular proteins
How old is this infarct?
1-3 days old (neutrophil infiltrate)
How old is this infarct?
4-10 days (yellow-tan w/ hyperemic border)
How old is this infarct?
10 days to 3 weeks
That’s all granulation tissue
How old this be?
3+ weeks - that’s all dense CT/scar tissue!
How old this be?
1-3 days old (neutrophils!)
How old?
4-10 days (yellow-tan w/ hyperemic border)
At what time period post-MI is this most likely to occur?
4-10 days post-MI is when stuff is weakest.
Ventricular wall rupture –> cardiac tamponade
What does this lead to clinically?
Septal rupture –> left to right shunt
What happened and what would it cause?
Papillary muscle rupture –> regurgitation
Name a drug that aims to prevent the formation of this…
Heparin is an anti-coagulant
This is a mural thrombus that formed due to stasis in the ventricle from decreased contractility post-MI
What happened?
Ventricular aneurysm
