Pathology of myocardial infarction

Published:December 20, 2012DOI:https://doi.org/10.1016/j.mpdhp.2012.11.001

      Abstract

      Myocardial infarction (MI) is an increasing problem, worldwide. An appreciation of its causes and morphology helps provide a basis for development of new interventions, as well as its management, and in the future prevention. Studies have shown that the myocardium does not suffer sudden and complete permanent damage, but rather that it takes time for the damage to start and to progress. It is this interval that is used to salvage myocardium, post ischaemic myocardial events, thus improving patient outcomes. This paper discusses the morphological findings at different time points and illustrates them.

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      References

        • Thygesen K.
        • Alpert J.S.
        • White H.D.
        • Joint ESC/ACCF/AHA/WHF Task Force for the Redefinition of Myocardial Infarction
        Universal definition of myocardial infarction.
        Eur Heart J. 2007 Oct; 28: 2525-2538
        • Kung H.-C.
        • Hoyert D.L.
        • Xu J.
        • Murphy S.L.
        Deaths: final data for 2005.
        Natl Vital Stat Rep. 2008 Apr; 56: 1-120
        • Roger V.L.
        • Go A.S.
        • Lloyd-Jones D.M.
        • et al.
        Heart disease and stroke statistics—2012 update: a report from the American Heart Association.
        Circulation. 2012 Jan 3; 125: e2-e220
        • Topol E.J.
        • Smith J.
        • Plow E.F.
        • Wang Q.K.
        Genetic susceptibility to myocardial infarction and coronary artery disease.
        Hum Mol Genet. 2006 Oct 15; 2 (15 Spec No): R117-R123
        • Anand S.S.
        • Islam S.
        • Rosengren A.
        • et al.
        Risk factors for myocardial infarction in women and men: insights from the INTERHEART study.
        Eur Heart J. 2008 Apr; 29: 932-940
        • Antman E.M.
        • Braunwald E.
        ST-elevation myocardial infarction: pathology, pathophysiology, and clinical features.
        in: Libby P. Bonow R.O. Mann D.L. Braunwald's heart disease: a textbook of cardiovascular medicine. Saunders Elsevier, Philadelphia, PA2008: 1207-1232
        • Pasotti M.
        • Prati F.
        • Arbustini E.
        The pathology of myocardial infarction in the pre and post-interventional era.
        Heart. 2006 Nov; 92: 1552-1556
        • Olsen E.G.J.
        Myocardial infarction.
        in: The pathology of the heart. Macmillan Press, Basingstoke and London1980: 99-132
        • Fuster V.
        • Hurst J.W.
        • O'Rourke R.A.
        • et al.
        Pathology of myocardial ischemia, infarction, reperfusion, and sudden death.
        in: Cooke D.B. Strauss M. Loeb M. Hurst's the heart. McGraw-Hill, New York2004: 1223-1240
        • Galankina I.E.
        Morphological characteristics of hemorrhagic myocardial infarction.
        Arkh Patol. 1985; 47: 36-44
        • Caulfield J.
        • Klionsky B.
        Myocardial ischemia and early infarction: an electron microscopic study.
        Am J Pathol. 1959 May–Jun; 35: 489-523
        • Olsen E.G.
        Structural and ultrastructural basis of myocardial disease.
        Proc R Soc Med. 1976 Mar; 69: 195-197
        • Schwartz P.
        • Piper H.M.
        • Spahr R.
        • Spieckermann P.G.
        Ultrastructure of cultured adult myocardial cells during anoxia and reoxygenation.
        Am J Pathol. 1984 Jun; 115: 349-361
        • Waller B.F.
        Pathobiology of myocardial necrosis.
        J Thromb Thrombolysis. 1997; 4: 177-184
        • Karmakar R.N.
        Histological examinations.
        in: Forensic medicine and toxicology. Bimal Kumar Dhur of Academic Publishers, Kolkata, India2010: 265-286
        • Al-Rufaie H.K.
        • Florio R.A.
        • Olsen E.G.J.
        Comparison of the haematoxylin basic fuchsin picric acid method and the fluorescence of haematoxylin and eosin stained sections for the identification of early myocardial infarction.
        J Clin Pathol. 1983 Jun; 36: 646-649
        • Zhai P.
        • Eurell T.E.
        • Cotthaus R.
        • Jeffery E.H.
        • Bahr J.M.
        • Gross D.R.
        Effect of estrogen on global myocardial ischemia-reperfusion injury in female rats.
        Am J Physiol Heart Circ Physiol. 2000 Dec; 279: H2766-H2775
        • Ouyang J.
        • Guzman M.
        • Desoto-Lapaix F.
        • Pincus M.R.
        • Wieczorek
        Utility of desmin and a Masson's trichrome method to detect early acute myocardial infarction in autopsy tissues.
        Int J Clin Exp Pathol. 2010 Sep 20; 3: 98-105
        • Jackowski C.
        • Christe A.
        • Sonnenschein M.
        • Aghayev E.
        • Thali M.J.
        Postmortem unenhanced magnetic resonance imaging of myocardial infarction in correlation to histological infarction age characterization.
        Eur Heart J. 2006 Oct; 27: 2459-2467
        • Jackowski C.
        • Warntjes M.J.B.
        • Berge J.
        • Bar W.
        • Persson A.
        Magnetic resonance imaging goes postmortem: noninvasive detection and assessment of myocardial infarction by postmortem MRI.
        Eur Radiol. 2011 Jan; 21: 70-78
        • Kirschner R.
        • Toth L.
        • Varga-Szemes A.
        • et al.
        Differentiation of acute and four-week old myocardial infarct with Gd (ABE-DTTA)-enhanced CMR.
        J Cardiovasc Magn Reson. 2010 Apr 7; 12: 22-31
        • National Heart Foundation of Australia Coronary Thrombolysis Group
        Coronary thrombolysis and myocardial salvage by tissue plasminogen activator given up to 4 hours after onset of myocardial infarction.
        Lancet. 1988 Jan 30; 1: 203-208
        • Schaper J.
        • Schaper W.
        Time course of myocardial necrosis.
        Cardiovasc Drugs Ther. 1988 May; 2: 17-25
        • Hayashi T.
        • Miyataka M.
        • Kimura A.
        • et al.
        Recent decline in hospital mortality among patients with acute myocardial infarction.
        Circ J. 2005 Apr; 69: 420-426
        • Schömig A.
        • Ndrepepa G.
        • Mehilli J.
        • et al.
        Therapy-dependent influence of time-to-treatment interval on myocardial salvage in patients with acute myocardial infarction treated with coronary artery stenting or thrombolysis.
        Circulation. 2003 Sep 2; 108: 1084-1088