Pathology - Ischemic Heart Disease Flashcards

1
Q

Which one is more stable?

A

The one on the right!

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2
Q

Describe both the gross and histologic changes that occur post-MI from immediately after the MI to 3+ weeks post-MI.

A

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

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3
Q

Describe the pathophysiology of coagulative necrosis after/during MI.

A

Ischemia –> low pH –> denaturation of nuclear membrane and cellular proteins

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4
Q

How old is this infarct?

A

1-3 days old (neutrophil infiltrate)

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5
Q

How old is this infarct?

A

4-10 days (yellow-tan w/ hyperemic border)

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6
Q

How old is this infarct?

A

10 days to 3 weeks

That’s all granulation tissue

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7
Q

How old this be?

A

3+ weeks - that’s all dense CT/scar tissue!

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8
Q

How old this be?

A

1-3 days old (neutrophils!)

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9
Q

How old?

A

4-10 days (yellow-tan w/ hyperemic border)

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10
Q

At what time period post-MI is this most likely to occur?

A

4-10 days post-MI is when stuff is weakest.

Ventricular wall rupture –> cardiac tamponade

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11
Q

What does this lead to clinically?

A

Septal rupture –> left to right shunt

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12
Q

What happened and what would it cause?

A

Papillary muscle rupture –> regurgitation

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13
Q

Name a drug that aims to prevent the formation of this…

A

Heparin is an anti-coagulant

This is a mural thrombus that formed due to stasis in the ventricle from decreased contractility post-MI

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14
Q

What happened?

A

Ventricular aneurysm

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